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. 2025 Feb;31(1):e14319.
doi: 10.1111/jep.14319.

Evaluating the Impact of a Safe Exercise Training on Clinician Knowledge and Self-Efficacy in Managing Dysfunctional Exercise in an Eating Disorder Treatment Setting

Danika A Quesnel  1   2   3 , Marita Cooper  4 , Brian Cook, Rachel M Calogero  2
Affiliations

Evaluating the Impact of a Safe Exercise Training on Clinician Knowledge and Self-Efficacy in Managing Dysfunctional Exercise in an Eating Disorder Treatment Setting

Danika A Quesnel et al. J Eval Clin Pract. 2025 Feb.

Abstract

Introduction: Dysfunctional exercise (DEX) is common among individuals with an eating disorder (ED) and poses significant challenges to treatment and recovery. While safe and nutritionally supported physical activity can enhance treatment outcomes without hindering weight restoration, clinicians often hesitate to address DEX with their patients. This mixed-method study aimed to evaluate the impact of a Safe Exercise at Every Stage (SEES) informed training on clinician knowledge and self-efficacy in managing DEX during ED treatment.

Methods: Clinicians from a national ED centre completed measures of knowledge and self-efficacy about managing DEX before (n = 96) and after (n = 44) a synchronous virtual training. A subset of participants (n = 7) participated in semi-structured interviews to gather their perceptions of exercise in the context of EDs and feedback on the training.

Results: Paired sample t-tests revealed a significant increase in both self-efficacy and knowledge following the SEES training. Thematic analysis identified three key themes: (1) the Current State, (2) the Training Impact and (3) bridging the Gap Through Staff and Community Support. Results are contextualized within the broader ED field, highlighting how training and policy changes can enhance clinician confidence in managing DEX.

Conclusion: DEX continues to be preceived as a core ED symptom. To improve its managment clinician training and shifts in overarching field ideologies are needed. Providing programme-wide training is fundamental to equipping clinicians with the skills needed to address DEX and ultimately improve patient outcomes.

Keywords: clinician knowledge; clinician self‐efficacy; clinician training; dysfunctional exercise; eating disorders; physical activity; semi‐structured interviews.

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References

    1. T. Berends, N. Boonstra, and A. Van Elburg, “Relapse in Anorexia Nervosa: A Systematic Review and Meta‐Analysis,” Current Opinion in Psychiatry 31, no. 6 (2018): 445–455, https://doi.org/10.1097/YCO.0000000000000453.
    1. M. Alberti, C. Galvani, M. EL Ghoch, et al., “Assessment of Physical Activity in Anorexia Nervosa and Treatment Outcome,” Medicine & Science in Sports & Exercise 45, no. 9 (2013): 1643–1648, https://doi.org/10.1249/MSS.0b013e31828e8f07.
    1. R. M. Calogero and K. N. Pedrotty‐Stump, “Incorporating Exercise Into Eating Disorder Treatment and Recovery: Cultivating a Mindful Approach,” in Treatment of Eating Disorders (Academic Press, 2010), 425–441.
    1. J. C. Carter, E. Blackmore, K. Sutandar‐Pinnock, and D. B. Woodside, “Relapse in Anorexia Nervosa: A Survival Analysis,” Psychological Medicine 34, no. 4 (2004): 671–679, https://doi.org/10.1017/S0033291703001168.
    1. S. E. Solenberger, “Exercise and Eating Disorders: A 3‐Year Inpatient Hospital Record Analysis,” Eating Behaviors 2, no. 2 (2001): 151–168, https://doi.org/10.1016/S1471-0153(01)00026-5.