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NICE understates role of exercise and CBT in managing ME/CFS, say medical leaders

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2647 (Published 29 October 2021) Cite this as: BMJ 2021;375:n2647
  1. Zosia Kmietowicz
  1. The BMJ

Medical leaders have questioned the updated guideline from the National Institute for Health and Care Excellence (NICE) on myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS) for downplaying the importance of activity and exercise in managing the condition.

They say that the guideline understates the connection between mental and physical health, does not reflect how exercise therapy is used in practice, and fails to represent the positive discussions that leaders have had with patient groups.

The guideline was finally published on 29 October,1 after NICE delayed its publication because three members of the committee overseeing its production resigned in August and royal colleges raised concerns about the recommendations and processes used in developing it.2

NICE said that graded exercise therapy (GET) should no longer be used to treat ME/CFS but that exercise programmes could still …

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