How do clinical specialists understand the role of physical activity in eating disorders?

Objective To assess clinical specialists' understanding of the link between physical activity and eating disorder with special focus on anorexia nervosa (AN) and to describe their assessment and management strategies for physical activity. Method A semi-structured questionnaire was administered to 33 clinical specialists from four different country-groups (USA/Canada, Europe, Japan/China, and Australia/New Zealand). Results The majority of respondents (84.8%) perceived physical activity as an important component in the pathogenesis and maintenance of eating disorders. Those respondents who considered physical activity to be less important were all from Japan and/or China. The majority (> 75.0%) incorporated a comprehensive assessment. Psychoeducation, challenging patients' beliefs and self-monitoring were the most frequently used treatment strategies. Conclusion Even though the clinical specialists acknowledged the importance of physical activity, comprehensive assessment tools and published exercise programmes were rarely used, indicating the need to extend treatment guidelines to include physical activity. In addition, when examining clinical presentations of eating disorders, cross-cultural differences in the experience of physical activity may need to be explored as a potential differentiating factor, particularly between Asian and Caucasian patients.