Systematic Review|Articles in Press

Treating Binge Eating Disorder With Physical Exercise: A Systematic Review and Meta-analysis



      This review aimed to collect evidence about the effectiveness of exercise programs for managing binge eating disorder (BED) (recurrent binge eating episodes).


      Meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in PubMed, Scopus, Web of Science, and Cochrane Library. Randomized controlled trials were eligible for inclusion if they reported the effect of an exercise-based program on BED symptoms in adults. Outcomes were changes in binge eating symptom severity, measured through validated assessment instruments, after an exercise-based intervention. Study results were pooled using the Bayesian model averaging for random and fixed effects meta-analysis.


      Of 2,757 studies, 5 trials were included, with 264 participants. The mean age was 44.7 ± 8.1 years for the intervention group and 46.6 ± 8.5 years for the control group. All participants were female. A significant improvement was observed between groups (standardized mean difference, 0.94; 95% credibility interval, −1.46 to −0.31). Patients obtained significant improvements either following supervised exercise programs or home-based exercise prescriptions.

      Implications for Research and Practice

      These findings suggest that physical exercise, within a multidisciplinary clinical and psychotherapeutic approach, may be an effective intervention for managing BED symptoms. Further comparative studies are needed to clarify which exercise modality is associated with greater clinical benefits.

      Key Words

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        • Ágh T
        • Kovács G
        • Pawaskar M
        • Supina D
        • Inotai A
        • Vokó Z.
        Epidemiology, health-related quality of life and economic burden of binge eating disorder: a systematic literature review.
        Eat Weight Disord. 2015; 20: 1-12
      1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.

        • Kornstein SG.
        Epidemiology and recognition of binge-eating disorder in psychiatry and primary care.
        J Clin Psychiatry. 2017; 78: 3-8
        • Hudson JI
        • Hiripi E
        • Pope HG
        • Jr Kessler RC
        The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication.
        Biol Psychiatry. 2007; 61: 348-358
        • Wassenaar E
        • Friedman J
        • Mehler PS.
        Medical complications of binge eating disorder.
        Psychiatr Clin North Am. 2019; 42: 275-286
        • Uhe AM
        • Szmukler GI
        • Collier GR
        • Hansky J
        • O'Dea K
        • Young GP
        Potential regulators of feeding behavior in anorexia nervosa.
        Am J Clin Nutr. 1992; 55: 28-32
        • Holman RT
        • Adams CE
        • Nelson RA
        • et al.
        Patients with anorexia nervosa demonstrate deficiencies of selected essential fatty acids, compensatory changes in nonessential fatty acids and decreased fluidity of plasma lipids.
        J Nutr. 1995; 125: 901-907
        • Bulik CM
        • Brinded EC.
        The effect of food deprivation on the reinforcing value of food and smoking in bulimic and control women.
        Physiol Behav. 1994; 55: 665-672
        • Fandiño J
        • Moreira RO
        • Preissler C
        • et al.
        Impact of binge eating disorder in the psychopathological profile of obese women.
        Compr Psychiatry. 2010; 51: 110-114
        • Mitchell JE
        • Mussell MP.
        Comorbidity and binge eating disorder.
        Addict Behav. 1995; 20: 725-732
        • Wilfley DE
        • Bishop ME
        • Wilson GT
        • Agras WS.
        Classification of eating disorders: toward DSM-V.
        Int J Eat Disord. 2007; 40: S123-S129
        • Levine MD
        • Marcus MD
        • Moulton P.
        Exercise in the treatment of binge eating disorder.
        Int J Eat Disord. 1996; 19: 171-177
        • Cossrow N
        • Pawaskar M
        • Witt EA
        • et al.
        Estimating the prevalence of binge eating disorder in a community sample from the United States: comparing DSM-IV-TR and DSM-5 criteria.
        J Clin Psychiatry. 2016; 77: e968-e974
        • Iacovino JM
        • Gredysa DM
        • Altman M
        • Wilfley DE.
        Psychological treatments for binge eating disorder.
        Curr Psychiatry Rep. 2012; 14: 432-446
        • Vocks S
        • Tuschen-Caffier B
        • Pietrowsky R
        • Rustenbach SJ
        • Kersting A
        • Herpertz S.
        Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder.
        Int J Eat Disord. 2010; 43: 205-217
        • Ashdown-Franks G
        • Firth J
        • Carney R
        • et al.
        Exercise as medicine for mental and substance use disorders: a meta-review of the benefits for neuropsychiatric and cognitive outcomes.
        Sports Med. 2020; 50: 151-170
        • Bray GA
        • Frühbeck G
        • Ryan DH
        • Wilding JP.
        Management of obesity.
        Lancet. 2016; 387: 1947-1956
        • Petridou A
        • Siopi A
        • Mougios V.
        Exercise in the management of obesity.
        Metabolism. 2019; 92: 163-169
      2. ACSM's Guidelines for Exercise Testing and Prescription.
        Lippincott Williams & Wilkins, 2013
        • Yumuk V
        • Tsigos C
        • Fried M
        • et al.
        European guidelines for obesity management in adults.
        Obes Facts. 2015; 8: 402-424
        • Ekkekakis P
        • Vazou S
        • Bixby WR
        • Georgiadis E.
        The mysterious case of the public health guideline that is (almost) entirely ignored: call for a research agenda on the causes of the extreme avoidance of physical activity in obesity.
        Obes Rev. 2016; 17: 313-329
        • Fabricatore AN
        • Wadden TA
        Annu Rev Clin Psychol. 2006; 2: 357-377
        • Crandall J
        • Esienman PA
        • Ransdell L
        • Reel J.
        Physical activity perceptions and binge eating disorder in community dwelling women.
        Food Public Health. 2012; 2: 119-126
        • Crandall KJ
        • Eisenman PA
        • Ransdell L
        • Reel J.
        Exploring binge eating and physical activity among community-dwelling women.
        Int J Psychol Behav Sci. 2011; 1: 1-8
        • Vancampfort D
        • Vanderlinden J
        • De Hert M
        • et al.
        A systematic review on physical therapy interventions for patients with binge eating disorder.
        Disabil Rehabil. 2013; 35: 2191-2196
        • Blanchet C
        • Mathieu MÈ
        • St-Laurent A
        • Fecteau S
        • St-Amour N
        • Drapeau V.
        A systematic review of physical activity interventions in individuals with binge eating disorders.
        Curr Obes Rep. 2018; 7: 76-88
      3. Higgins J, Thomas J, eds. Cochrane Handbook for Systematic Reviews of Interventions. Version 6.2. Accessed January 7, 2023.

        • Liberati A
        • Altman DG
        • Tetzlaff J
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.
        BMJ. 2009; 339: b2700
        • Grilo CM
        • Ivezaj V
        • White MA.
        Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample.
        Behav Res Ther. 2015; 71: 110-114
        • Sterne JAC
        • Savović J
        • Page MJ
        • et al.
        RoB 2: a revised tool for assessing risk of bias in randomised trials.
        BMJ. 2019; 366: l4898
        • Cohen J.
        Statistical Power Analysis for the Behavioral Science.
        2nd ed. Lawrence Erlbaum Associates, 1988
        • Hedges LV
        • Vevea JL.
        Fixed- and random-effects models in meta-analysis.
        Psychol Methods. 1998; 3: 486-504
        • Gronau QF
        • Heck DW
        • Berkhout SW
        • Haaf JM
        • Wagenmakers E-J.
        A primer on Bayesian model-averaged meta-analysis.
        Adv Methods Pract Psychol Sci. 2021; 425152459211031256
      4. Heck DW, Gronau QF, Wagenmakers E-J. metaBMA: Bayesian model averaging for random and fixed effects meta-analysis. Accessed January 10, 2023.

        • Egger M
        • Davey Smith G
        • Schneider M
        • Minder C
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ. 1997; 315: 629-634
        • Begg CB
        • Berlin JA.
        Publication bias: a problem in interpreting medical data.
        J R Stat Soc A. 1988; 151: 419-463
        • Pendleton VR
        • Goodrick GK
        • Poston WS
        • Reeves RS
        • Foreyt JP.
        Exercise augments the effects of cognitive-behavioral therapy in the treatment of binge eating.
        Int J Eat Disord. 2002; 31: 172-184
        • Fossati M
        • Amati F
        • Painot D
        • Reiner M
        • Haenni C
        • Golay A.
        Cognitive-behavioral therapy with simultaneous nutritional and physical activity education in obese patients with binge eating disorder.
        Eat Weight Disord. 2004; 9: 134-138
        • McIver S
        • O'Halloran P
        • McGartland M.
        Yoga as a treatment for binge eating disorder: a preliminary study.
        Complement Ther Med. 2009; 17: 196-202
        • Mama SK
        • Schembre SM
        • O'Connor DP
        • Kaplan CD
        • Bode S
        • Lee RE
        Effectiveness of lifestyle interventions to reduce binge eating symptoms in African American and Hispanic women.
        Appetite. 2015; 95: 269-274
        • Galasso L
        • Montaruli A
        • Jankowski KS
        • et al.
        Binge eating disorder: what is the role of physical activity associated with dietary and psychological treatment?.
        Nutrients. 2020; : 12
        • Gormally J
        • Black S
        • Daston S
        • Rardin D.
        The assessment of binge eating severity among obese persons.
        Addict Behav. 1982; 7: 47-55
        • Wilson GT
        • Nonas CA
        • Rosenblum GD.
        Assessment of binge eating in obese patients.
        Int J Eat Disord. 1993; 13: 25-33
        • Garner DM
        • Olmstead MP
        • Polivy J.
        Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia.
        Int J Eat Disord. 1983; 2: 15-34
        • Garner DM.
        Eating Disorder Inventory-2 Manual.
        Psychological Assessment Resources, 1991
        • Salmon P.
        Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory.
        Clin Psychol Rev. 2001; 21: 33-61
        • Stathopoulou G
        • Powers MB
        • Berry AC
        • Smits JAJ
        • Otto MW.
        Exercise interventions for mental health: a quantitative and qualitative review.
        Clin Psychol Sci Pract. 2006; 13: 179-193
        • Deboer LB
        • Tart CD
        • Presnell KE
        • Powers MB
        • Baldwin AS
        • Smits JA.
        Physical activity as a moderator of the association between anxiety sensitivity and binge eating.
        Eat Behav. 2012; 13: 194-201
        • Drenowatz C
        • Evensen LH
        • Ernstsen L
        • et al.
        Cross-sectional and longitudinal associations between different exercise types and food cravings in free-living healthy young adults.
        Appetite. 2017; 118: 82-89
        • Hone-Blanchet A
        • Fecteau S.
        Overlap of food addiction and substance use disorders definitions: analysis of animal and human studies.
        Neuropharmacology. 2014; 85: 81-90
        • Ströhle A.
        Physical activity, exercise, depression and anxiety disorders.
        J Neural Transm (Vienna). 2009; 116: 777-784
        • Helmich I
        • Latini A
        • Sigwalt A
        • et al.
        Neurobiological alterations induced by exercise and their impact on depressive disorders [corrected].
        Clin Pract Epidemiol Ment Health. 2010; 6: 115-125
        • King NA
        • Horner K
        • Hills AP
        • et al.
        Exercise, appetite and weight management: understanding the compensatory responses in eating behaviour and how they contribute to variability in exercise-induced weight loss.
        Br J Sports Med. 2012; 46: 315-322
        • Blundell JE
        • Gibbons C
        • Caudwell P
        • Finlayson G
        • Hopkins M.
        Appetite control and energy balance: impact of exercise.
        Obes Rev. 2015; 16: 67-76
        • Lin M
        • Ma C
        • Zhu J
        • et al.
        Effects of exercise interventions on executive function in old adults with mild cognitive impairment: A systematic review and meta-analysis of randomized controlled trials.
        Ageing Res Rev. 2022; 82101776