Taking a LEAP forward: Compulsive exercise training in Sweden
Compulsive exercise is an important symptom of the eating disorders. It affects up to 80% of patients and is associated with longer length of hospitalisation, poor recovery, increased physiological complications and relapse rates. Work conducted by Professor Caroline Meyer and her team has increased our understanding of the causes and maintenance factors associated with problematic exercise and has led to the development of screening and assessment tools. In addition, this work has resulted in the development of LEAP, which is a cognitive-behavioural based approach specifically aimed at reducing compulsive exercise cognitions and behaviours.
The first treatment of its kind, LEAP has been the subject of 3 initial treatment trials and shows real promise. It is used widely in eating disorders services across the globe. This week, Caroline and her colleague, Tara Cousins, from Leicestershire Partnership NHS Trust delivered a virtual training day to clinicians and researchers from eating disorders services in Sweden and the Karolinska Institute in Stockholm.
“LEAP works by helping people to challenge their beliefs about exercise and change the way in which they use exercise to control their emotional states as well as their shape and weight”. Often for these patients, exercise becomes the primary mood regulation strategy”.
Exercise has a known positive effect on emotion, however, for some people the consequences of not reaching their, often unrealistic, exercise goals can lead to unbearable levels of guilt.
Dr Emma Forsén Mantilla, at the Karolinska Institute said "Listening to Tara and Caroline, all their experience of working with compulsive exercise and specifically LEAP, was an absolute pleasure and incredibly valuable for us. We are so excited to start our trial evaluating LEAP in Sweden in a few months time!"
"As we do not yet have experience of using LEAP with patients, this day gave us so much: valuable information and more importantly confidence in how to work with the LEAP material in our Swedish trial."
Future collaborations between Warwick and colleagues at the Karolinska Institute to test further the efficacy of LEAP among in-patient anorexia nervosa patients, as well as development of an on-line self-help version for use with community groups are planned.