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Background <p>This meta-analysis systematically evaluates the effect of physical activity on specific health outcomes in individuals with anorexia nervosa (AN), including body composition parameters and quality of life, to inform clinical exercise rehabilitation.</p> Methods <p>This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. A comprehensive search of PubMed, EMBASE, Web of Science, the Cochrane Library, and CINAHL was performed from database inception to March 2024. Eligible studies were randomized controlled trials that compared physical activity interventions plus usual care against usual care alone in individuals with anorexia nervosa. Two independent reviewers screened articles, extracted data, and assessed risk of bias. Random-effects models were used for all meta-analyses.</p> Results <p>Eleven RCTs met inclusion criteria, with all 11 contributing data to meta-analysis. Pooled analyses showed no statistically significant differences in body weight (MD = 0.62, 95% CI [-0.74, 1.98], <i>P</i> = 0.37), BMI (MD = 0.59, 95% CI [-0.42, 1.60], <i>P</i> = 0.25), body fat percentage (MD = 0.62, 95% CI [-0.22, 1.46], <i>P</i> = 0.15), or quality of life (SMD = 0.07, 95% CI [-0.53, 0.68], <i>P</i> = 0.82), whereas muscle strength improved significantly (SMD = 0.99, 95% CI [0.45, 1.53], <i>P</i> &lt; 0.001). Physical activity interventions were well tolerated, with no adverse effects on weight restoration. Sensitivity analyses excluding high-risk studies confirmed robustness, and no meaningful publication bias was detected.</p> Conclusion <p>Supervised physical activity, particularly resistance training, shows promise as a safe adjunct to standard care in anorexia nervosa. Pooled results indicate significant gains in muscle strength, whereas no statistically significant between-group differences were detected for body weight, BMI, body fat percentage, or quality of life. Due to the limitations of the available data, future studies should include larger multicenter trials, standardized protocols, and longer follow-up periods, with greater attention to outcomes such as eating disorder psychopathology, compulsive exercise behaviors, and relapse rates to support the development of individualized exercise prescriptions.</p> Clinical trial number <p>Not applicable.</p> Level of evidence <p>Level I: Evidence obtained from systematic reviews and meta-analyses.</p>

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The effect of physical activity on health outcomes in individuals with anorexia nervosa: a systematic review and meta-analysis study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月13日

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  • Zikang Yin,
  • Mingyi Liu,
  • Jingjie Cai,
  • Nianxin Kong,
  • Liao Peng,
  • Haipei Gong,
  • Zhiwei Du,
  • Kaiyi Zhang

摘要

Background

This meta-analysis systematically evaluates the effect of physical activity on specific health outcomes in individuals with anorexia nervosa (AN), including body composition parameters and quality of life, to inform clinical exercise rehabilitation.

Methods

This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. A comprehensive search of PubMed, EMBASE, Web of Science, the Cochrane Library, and CINAHL was performed from database inception to March 2024. Eligible studies were randomized controlled trials that compared physical activity interventions plus usual care against usual care alone in individuals with anorexia nervosa. Two independent reviewers screened articles, extracted data, and assessed risk of bias. Random-effects models were used for all meta-analyses.

Results

Eleven RCTs met inclusion criteria, with all 11 contributing data to meta-analysis. Pooled analyses showed no statistically significant differences in body weight (MD = 0.62, 95% CI [-0.74, 1.98], P = 0.37), BMI (MD = 0.59, 95% CI [-0.42, 1.60], P = 0.25), body fat percentage (MD = 0.62, 95% CI [-0.22, 1.46], P = 0.15), or quality of life (SMD = 0.07, 95% CI [-0.53, 0.68], P = 0.82), whereas muscle strength improved significantly (SMD = 0.99, 95% CI [0.45, 1.53], P < 0.001). Physical activity interventions were well tolerated, with no adverse effects on weight restoration. Sensitivity analyses excluding high-risk studies confirmed robustness, and no meaningful publication bias was detected.

Conclusion

Supervised physical activity, particularly resistance training, shows promise as a safe adjunct to standard care in anorexia nervosa. Pooled results indicate significant gains in muscle strength, whereas no statistically significant between-group differences were detected for body weight, BMI, body fat percentage, or quality of life. Due to the limitations of the available data, future studies should include larger multicenter trials, standardized protocols, and longer follow-up periods, with greater attention to outcomes such as eating disorder psychopathology, compulsive exercise behaviors, and relapse rates to support the development of individualized exercise prescriptions.

Clinical trial number

Not applicable.

Level of evidence

Level I: Evidence obtained from systematic reviews and meta-analyses.