{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:10:27Z","timestamp":1791497427928,"version":"4.3.4"},"reference-count":112,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Abnormally high levels of physical activity have been documented throughout the literature in patients with eating disorders (ED), especially those diagnosed with anorexia nervosa (AN). Yet no clear definition, conceptualization, or treatment of the problematic use of physical activity (PPA) in ED patients exists. The aim of this review is to propose a new classification of PPA, report the prevalence, triggers, predictors, maintainers and other related factors of PPA in ED patients, in addition to proposing a comprehensive model of the development of PPA in AN. A total of 47 articles, retrieved from Medline and Web of Science, met the inclusion criteria and were included in the analysis. As a result, the new approach of PPA was divided into two groups (group 1 and group 2) according to the dimension (quantitative vs qualitative approach) of physical activity that was evaluated. The prevalence of PPA in ED was reported in 20 out of 47 studies, the comparison of PPA between ED versus controls in 21 articles, and the links between PPA and psychological factors in ED in 26 articles, including depression (16\/26), anxiety (13\/26), obsessive\u2013compulsiveness (9\/26), self-esteem (4\/26), addictiveness (1\/26), regulation and verbal expression of emotions (1\/26) and anhedonia (1\/26). The links between PPA and ED symptomatology, PPA and weight, body mass index (BMI) and body composition in ED, PPA and age, onset, illness duration and lifetime activity status in ED, PPA and ED treatment outcome were reported in 18, 15, 7, 5 articles, respectively. All of the factors have been systematically clustered into group 1 and group 2. Results focused more on AN rather than BN due to the limited studies on the latter. Additionally, a model for the development of PPA in AN patients was proposed, encompassing five periods evolving into three clinical stages. Thus, two very opposite components of PPA in AN were suggested: voluntarily PPA increased in AN was viewed as a conscious strategy to maximize weight loss, while involuntarily PPA increased proportionally with weight-loss, indicating that exercise might be under the control of a subconscious biological drive and involuntary cognition.<\/jats:p>","DOI":"10.3390\/nu12010183","type":"journal-article","created":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T04:06:51Z","timestamp":1578629211000},"page":"183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":112,"title":["Physical Activity in Eating Disorders: A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Rizk","family":"Melissa","sequence":"first","affiliation":[{"name":"INSERM U1178, Maison de Solenn, 97 Boulevard De Port Royal, 75014 Paris, France"},{"name":"Universit\u00e9 Paris-Sud and Universit\u00e9 Paris Descartes, Ecole Doctorale des 3C (Cerveau, Cognition, Comportement), UMR-S0669, 75006 Paris, France"},{"name":"Psychiatry Unit, Institut Mutualiste Montsouris 42, Boulevard Jourdan, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattar","family":"Lama","sequence":"additional","affiliation":[{"name":"Nutrition Program, Department of Natural Sciences, Lebanese American University, Beirut 1102, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kern","family":"Laurence","sequence":"additional","affiliation":[{"name":"Laboratoire EA 29 31, LINP2-APSA, et Laboratoire EA 4430 CLIPSYD Universit\u00e9 Paris Nanterre UFR-STAPS, 200, Avenue de la R\u00e9publique, 92001 Nanterre CEDEX, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthoz","family":"Sylvie","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Institut Mutualiste Montsouris 42, Boulevard Jourdan, 75014 Paris, France"},{"name":"INCIA UMR-5287 CNRS, Universit\u00e9 de Bordeaux, 33076 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duclos","family":"Jeanne","sequence":"additional","affiliation":[{"name":"Sciences Cognitives et Sciences Affectives, Universit\u00e9 de Lille, CNRS, UMR 9193\u2014SCALab, 59045 Lille, France"},{"name":"D\u00e9partement de Psychiatrie, H\u00f4pital Saint Vincent de Paul, GHICL, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4801-3586","authenticated-orcid":false,"given":"Viltart","family":"Odile","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry and Neurosciences of Paris, Unit\u00e9 Mixte de Recherche en Sant\u00e9 (UMRS) 1266 Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), University Paris Descartes, 75014 Paris, France"},{"name":"Department of Biology, University of Lille, 59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godart","family":"Nathalie","sequence":"additional","affiliation":[{"name":"INSERM U1178, Maison de Solenn, 97 Boulevard De Port Royal, 75014 Paris, France"},{"name":"Psychiatry Unit, Institut Mutualiste Montsouris 42, Boulevard Jourdan, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"ref_1","first-page":"22","article-title":"Anorexia Nervosa","volume":"7","author":"Gull","year":"1874","journal-title":"Philos. 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