運動與厭食症：適應身體活動及運動處方觀點

Exercise and anorexia: Adapted physical activity and exercise prescription perspectives

因現今社會過度強調「瘦即是美」的觀念，導致越來越多人產生社會體型焦慮 （social physiqueanxiety），進而引發神經性厭食症 （anorexia nervosa）。由於節食與過度運動是厭食症患者的主要症狀之一，過去國內對於厭食症患者治療方式會以不鼓勵患者從事健身運動或甚至停止運動為主要治療手段。然而，已有研究逐漸證實運動對厭食症患者的潛在效益，明顯與過去常見的建議方針不符。有鑒於此，本文將以綜評性文獻回顧取向，探討運動及厭食症患者心、生理之間的關係，並整理當前應用適應身體活動與運動介入策略之重要研究發現，最後再以整理的文獻結論為基礎，針對臺灣的現況提出相關的建議。經本文綜整國內外相關文獻可以得知，減少或避免運動行為似乎對厭食症患者的負面徵狀似乎並非最佳的解套方式。相反地，根據研究發現，其建議可以適應身體活動（adapted physical activity） 為設計基礎，並透過個別化教育課程 （individualized educational program, IEP） 來針對個案的個別差異施以合適的訓練處方。值得注意的是，有研究指出應加入阻力訓練（resistance training） 但避免長期、急性與中高強度的運動處方，並同時確實監控患者運動處方內容與強度，以避免再引發運動後所衍生的厭食徵狀。最後，本文期待透過文獻整理的結果，能做為國內厭食症患者之運動方處優化之參考依據。

Nowadays, the over-emphasized concept in “slim is beautiful” has created a massive impact in causing social physique anxiety, which in turn leads to anorexia. Even though dietary restraint and excessive exercise are major symptoms of anorexia, discouraging exercise participation, as a primary intervention and treatment, and overemphasizing the negative effects of it are questionable. Hence, a systematic review approach was adopted in investigating the relationships between exercise and the psycho-physio status of individuals with anorexia. Based on the literature, reducing or avoiding exercise participation was not the best solution for patients with anorexia. On the contrary, research findings suggested the notions of adapted physical activity and the individualized educational program should be adopted in developing rehabilitation programs for individuals with anorexia. Also, resistant training can be added and long-term, acute, moderate-vigorous training should be avoided while designing training prescriptions. In the meantime, consistently monitoring the reactions of participants with anorexia and the intensity of exercise prescription should be administered. In conclusion, may the recommendations of the current study can be used, as a reference, to improve exercise prescription for individuals with anorexia.