Author(s): BRATLAND-SANDA, S., OLSEN, H.T., Institution: UNIVERSITY OF SOUTH-EASTERN NORWAY, Country: NORWAY, Abstract-ID: 622

INTRODUCTION:
Introduction: Safe Exercise at Every Stage (SEES) guidelines (Dobinson et al., 2022) are developed for proper prescription and adaptation of exercise during treatment of eating disorders. The guidelines were developed in Canada and USA, and based on North American culture for sport, exercise, and physical activity. The aim of this study was therefore to identify necessary adaptations of the guidelines to a Norwegian cultural and semantic context.
METHODS:
Methods: Focus group interviews (n=4 interviews, total of 11 informants) were conducted. The informants included experienced researchers, clinicians, and user representatives within the field of eating disorders and exercise. All interviews lasted 60-90 minutes and generated a total of x pages of transcripts. The data were analysed by thematic analysis.
RESULTS:
Results: Four overarching themes were identified: 1) Exercise and eating disorders in the context of a sporty, hiking, social-democratic nation. The Norwegian cultural heritage was formative for views and attitudes about physical activity and exercise in the context of eating disorders. The traditions of “friluftsliv” and its connection to asceticism, the broad participation in youth sport, and the connection to nature as core cultural heritage that was highlighted. Further, the egalitarian welfare society with highly regulated labor marked and work hours, and wealthy personal economy, were also considered key factors for accessibility to leisure-time sport and outdoor activities. 2) Lack of addressing PA and exercise in treatment. There was expressed lack of competence about exercise in the context of eating disorders, and thus an experienced fear about harming more than doing good. User perspective included insecurity, ambivalence and reluctance to treat-seeking due to lack of trust in how the therapist would approach exercise. 3) The healing exercise. Incorporating adapted and supervised exercise as part of the eating disorders treatment was considered important to adapt to normality, balancing exercise with rest, create cognitive restructuring about exercise, create space and time-out from difficult therapeutic processes in the treatment setting, and facilitate empowerment, mastery, and body awareness. 4) Tailor-making of the SEES guidelines. The current guidelines were considered too narrow and focused on the users with underweight, and there were expressed needs for tailor-making to a Norwegian treatment context with larger diversities in gender, age, body types, diagnoses, and users’ previous experiences with physical activity and exercise.
CONCLUSION:
Discussion: The findings highlight the importance of not only linguistic translation of such guidelines, but also translations to different cultural and therapeutic contexts.

Reference: Dobinson, A., Cooper, M., & Quesnel, D. (2022). The Safe Exercise at Every Stage (SEES) guideline-A clinical tool for treating and managing dysfunctional exercise in eating disorders, 2019.