Children and adolescents diagnosed with malnutrition, alone or in conjunction with an eating disorder (ED), often need to pause participation in school, extracurricular activities, exercise and sports to prioritize nutritional rehabilitation, weight restoration, achievement of medial stability (resolution of bradycardia, hypotension, orthostasis) and hormonal normalization. Many patients are eager to return to their activities, yet there are few published protocols on gradual return to sport during eating disorder treatment, and not any that are specific to children and adolescents. There is growing evidence that participation in structured activity during treatment can mitigate distress, symptoms and difficulties without compromising weight gain. Goals for recovery also include developing a healthy relationship with exercise and movement rather than complete cessation and abstinence.