Physical exercise may be a useful part of a treatment approach for people with BPD, with research indicating that obesity among people with BPD increases over time, escalating the risk of obesity-related chronic medical conditions [1542, 1543]. BPD has been associated with chronic health problems later in life, such as arteriosclerosis, hypertension, heart disease, CVD, stroke, liver disease and arthritis [1544, 1545]. Although there has been no research examining the effect of physical activity on symptoms of BPD, one study recommended that initial interventions include improved sleep and scheduled exercise. It should be noted however, that this recommendation is based on theory, and lacks supportive evidence [1546]. As such, while it may be prudent for people with BPD to maintain healthy living practices, which may include physical activity, a healthy diet, and adequate sleep (see Chapter B1), to date there is no evidence regarding the effect of these practices on symptoms of BPD.