Social physique anxiety and disordered eating: what's the connection?

Social Physique Anxiety Scale: Psychometric Evaluation and Development of a Chinese Adaptation

The Social Physique Anxiety Scale (SPAS) is a popular measure of individual anxiety related to body image. This study assessed the psychometric properties of the 12-, 9-, 8- and 7-item versions of the SPAS. Two cross-sectional studies recruited 466 Chinese university students. Study 1 (n = 273) evaluated the construct validity and internal consistency of the SPAS. Study 2 (n = 193) further assessed the construct validity, factorial validity, internal consistency, convergent validity and divergent validity of the SPAS. The results indicated that none of the existing SPAS versions possess good psychometric properties suitable for the Chinese student population. In short, a new 7-item version of the SPAS that is more suitable for measuring social physique anxiety among Chinese university students. The implications of our results and future research directions are discussed.

The Association Between Autistic Traits and Disordered Eating is Moderated by Sex/Gender and Independent of Anxiety and Depression

Previous studies have reported positive correlations between autistic traits and disordered eating, though it is unclear whether the association is moderated by sex/gender or whether it is independent of anxiety or depression. We present the findings of an online survey of 691 participants who completed the Autism Spectrum Quotient (AQ), Hospital Anxiety and Depression Scale (HADS), and Eating Attitudes Test-26 (EAT-26). Following a pre-registered analysis plan, we observed positive correlations between AQ and EAT-26 in males and females, with the association being significantly stronger in females. AQ also remained a significant predictor of EAT-26 when anxiety and depression were controlled for statistically. These findings may be relevant when considering therapeutic interventions in disordered eating populations that exhibit autistic traits.

Emotional intelligence and eating disorders: a systematic review

BACKGROUND

Prior research indicates that deficits in emotional abilities are key predictors of the onset and maintenance of eating disorders (ED). As a relatively new emotion-related construct, emotional intelligence (EI) comprises a set of basic emotional abilities. Preliminary research suggests that deficits in EI are linked with disordered eating and other impulsive behaviours. Also, previous research reveals that emotional and socio-cognitive abilities, as well as ED symptomatology, varies across lifespan development. However, while the findings suggest promising results for the development of potential effective treatments for emotional deficits and disordered eating, it is difficult to summarise the relationship between EI and ED due to the diversity of theoretical approaches and variety of EI and ED measures.

OBJECTIVE

Our study, therefore, aimed to systematically review the current evidence on EI and ED in both the general and clinical populations and across different developmental stages.

METHODS

The databases examined were Medline, PsycInfo and Scopus, and 15 eligible articles were identified. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used.

RESULTS

All the studies reviewed indicated negative associations between EI and the dimensions of ED. Additionally, several mechanisms involved, namely adaptability, stress tolerance and emotional regulation were highlighted.

CONCLUSION

The systematic review suggests promising but challenging preliminary evidence of the associations between EI and the dimensions of ED across diverse stages of development. In addition, future research, practical implications and limitations are discussed.

LEVEL OF EVIDENCE I

Systematic review.

Morbid exercise behaviour and eating disorders: A meta-analysis

BACKGROUND AND AIMS

This study examined the relationship between self-reported symptoms of morbid exercise behaviour (MEB) and eating disorders (ED) using meta-analytic techniques.

METHODS

We systematically searched MEDLINE, PsycINFO, Web of Science, SciELO and Scopus. Random effects models were used to compute pooled effect sizes estimates (r). The robustness of the summarized estimates was examined through sensitivity analyses by removing studies one at a time.

RESULTS

Sixty-six studies comprising 135 effect-sizes (N = 21,816) were included. The results revealed: (a) small-sized relationship in the case of bulimic symptoms (r = 0.19), (b) small- (r = 0.28) to medium-sized relationships (r = 0.41) in the case of body/eating concerns, and (c) medium-sized relationships in the case of overall ED symptoms (r = 0.35) and dietary restraint (r = 0.42). Larger effect sizes were observed in the case of overall ED symptoms in clinical, younger, and thinner populations, as well as when employing a continuously-scored instrument for assessing ED or the Compulsive Exercise Test for assessing MEB. Larger effect sizes were also found in female samples when the ED outcome was dietary restraint.

CONCLUSIONS

The identified gaps in the literature suggest that future research on the topic may benefit from: (a) considering a range of clinical (in terms of diagnosed ED) and non-clinical populations from diverse exercise modalities, (b) addressing a wide range of ED symptomatology, and (c) employing longitudinal designs that clarify the temporal direction of the relationship under consideration.

Disgust and fear: common emotions between eating and phobic disorders

Eating disorders (ED) are prevalent mental illnesses composed mainly of anorexia nervosa, bulimia nervosa and binge eating disorders. Anxiety disorders are another set of mental illnesses, with phobic disorder (PD) being the most prevalent disorder. ED and PD are highly comorbid. The aim of this study is to assess, in 131 individuals attending an outpatient clinic for different health issues, the level of fear related to situations generating avoidance such as in social anxiety and specific phobias according to the fear questionnaire (FQ), the level of disgust according to the disgust scale (DS-R) and the vulnerability towards ED according to the SCOFF scale to demonstrate that high levels of both fear and disgust increase the vulnerability towards ED. The study demonstrated that the level of disgust increased when fear increases (r = 0.377, p < 0.001 for the first part of the FQ; r = 0.225, p = 0.01 for the second part of the FQ). Moreover, individuals with vulnerability towards having an ED presented a higher level of disgust than individuals without this vulnerability (p = 0.009). Furthermore, individuals with vulnerability towards ED have a higher level of anxiety related to PD subtypes (p = 0.008 for agoraphobia; p = 0.001 for injection/blood phobia) as well as to social anxiety (p = 0.01), independently from having a depressive or another anxiety disorder. In the multivariate analysis, a history of psychiatric consultation has been the only significantly different parameter between individuals with or without vulnerability towards ED (p = 0.0439). Accordingly, fear and disgust are negative emotions that seem to be clinically associated which better explains the comorbidity of ED with PD. LEVEL OF EVIDENCE: Level III. Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

Social Physique Anxiety, Mental Health, and Exercise: Analyzing the Role of Basic Psychological Needs and Psychological Inflexibility

This study aimed to determine the usefulness of integrating basic psychological needs theory (BPNT) and relational frames theory (RFT) in order to explain the effects of social physique anxiety (SPA) - in the context of exercise - on exercisers' mental health. A total of 296 recreational cyclists and triathletes (100% males) aged 18 to 60 years old (M age = 35.65, SD = 9.49) completed a multi-section questionnaire assessing the target variables. Two models of structural equations with multiple mediators were tested using 5000 bootstrap samples. While the BPNT-based model explained 20% of variance in satisfaction with life (SWL) and 25% of variance in mental health (MH), the model that also incorporated RFT explained 43% of variance in both of those variables. Results showed that SPA negatively impacted exercisers' mental health via two different mechanisms: a) through a decrease in perceived satisfaction of basic psychological needs (β = -.05, p = .045 for SWL; β = -.07, p = .002 for MH); b) through an increase in psychological inflexibility, generated directly by SPA (β = -.24, p < .001 for SWL; β = -.20, p < .001 for MH) and also mediated by basic psychological need thwarting (β = -.09, p < .001 for SWL; β = -.08, p = .002 for MH). Results supported integrating the two theories, elucidating the processes by which a controlling social factor like SPA can affect the potential benefits of exercise.

Self-esteem moderates the associations between body-related self-conscious emotions and depressive symptoms

The objectives of this study were to describe the cross-sectional associations between body-related self-conscious emotions and depressive symptoms in young adults and examine self-esteem as a moderator of these associations. Data from a population-based sample of 811 young adults were analyzed using hierarchical multivariate linear regression analysis. Body-related shame ( β = .26) and guilt ( β = .25) were positively related to frequency of depressive symptoms. Self-esteem was negatively related to frequency of depressive symptoms ( β = −.46). Self-esteem moderated the association between body-related guilt and frequency of depressive symptoms. These findings suggest promoting self-esteem may help to reduce the negative effects of body-related guilt on depressive symptoms.

Social Physique Anxiety in Adolescence: An Exploration of Influences, Coping Strategies, and Health Behaviors

This study explored adolescent females’ experiences of social physique anxiety (SPA) and related coping strategies. A final sample of 31 adolescent females ages 13 to 18 years discussed dealing with SPA during individual semistructured interviews. Resultant themes pertaining to the transactional experiences of SPA were coded using content analysis. There were 107 unique coping strategies reported, which were coded into 10 subthemes. The main coping categories included behavioral and cognitive avoidance, appearance management, diet, social support, physical activity, reappraisal, cognitive deflection and comparison to others, seeking sexual attention, and substance use. Informed by a stress and coping framework, it is evident that body-related thoughts and emotions are linked to various adolescent health behaviors.

A Self-determination Theory Approach to the Study of Body Image Concerns, Self-presentation and Self-perceptions in a Sample of Aerobic Instructors

This study examined motivational predictors of body image concerns, self-presentation and self-perceptions using Self-determination Theory as a guiding framework. Aerobic instructors ( N = 149) completed questionnaires measuring general need satisfaction, exercise motivational regulations, body image concerns, social physique anxiety and self-perceptions. Introjected regulation predicted all outcome variables in the expected direction. Intrinsic motivation positively predicted physical self-worth. Further, autonomy need satisfaction negatively predicted body image concerns. Finally, differences existed in need satisfaction, introjected regulation, self-perceptions and social physique anxiety between those at risk of developing eating disorders and those not at risk. The results underline the importance of overall and exercise-specific feelings of self-determination in dealing with body image concerns and low self-perceptions of aerobics instructors.

The influence of exercise identity and social physique anxiety on exercise dependence

BACKGROUND

Previous research has identified exercise identity and social physique anxiety as two independent factors that are associated with exercise dependence.

AIMS

The purpose of our study was to investigate the unique and interactive effect of these two known correlates of exercise dependence in a sample of 1,766 female runners.

METHODS

Regression analyses tested the main effects of exercise identity and social physique anxiety on exercise dependence. An interaction term was calculated to examine the potential moderating effect of social physique anxiety on the exercise identity and exercise dependence relationship.

RESULTS

Results indicate a main effect for exercise identity and social physique anxiety on exercise dependence; and the interaction of these factors explained exercise dependence scores beyond the independent effects. Thus, social physique anxiety acted as a moderator in the exercise identity and exercise dependence relationship.

DISCUSSION

Our results indicate that individuals who strongly identify themselves as an exerciser and also endorse a high degree of social physique anxiety may be at risk for developing exercise dependence.

CONCLUSIONS

Our study supports previous research which has examined factors that may contribute to the development of exercise dependence and also suggests a previously unknown moderating relationship for social physique anxiety on exercise dependence.

A weighty issue: explaining the association between body mass index and appearance-based social anxiety

Research has indicated that individuals who are overweight or obese are more likely to experience mental health difficulties. One line of research has indicated that body mass index (BMI) is positively associated with appearance-based social anxiety, rather than social anxiety more generally. However, there is a lack of research that has attempted to explain this association. Thus, the current study recruited an undergraduate sample (N=90) and aimed (a) to replicate previous research by examining the associations between BMI, social anxiety, and appearance-based social anxiety and (b) to extend previous research by examining two potential mediators in the relationship between BMI and appearance-based social anxiety suggested in the literature (i.e., body image dissatisfaction and emotional eating). Analyses indicated that BMI was not associated with social anxiety but positively associated with appearance-based social anxiety. The association between BMI and appearance-based social anxiety was only mediated by body image dissatisfaction, and the model of these relationships emerged as the best fitting model relative to a plausible alternative model. The findings replicate and extend previous research on weight status and psychological factors and highlight the need for future longitudinal research on BMI, appearance-based social anxiety, and body image dissatisfaction so that interventions for obesity and weight loss maintenance programs can be ultimately enhanced.

The influence of social anxiety on the body checking behaviors of female college students

Social anxiety and eating pathology frequently co-occur. However, there is limited research examining the relationship between anxiety and body checking, aside from one study in which social physique anxiety partially mediated the relationship between body checking cognitions and body checking behavior (Haase, Mountford, & Waller, 2007). In an independent sample of 567 college women, we tested the fit of Haase and colleagues' foundational model but did not find evidence of mediation. Thus we tested the fit of an expanded path model that included eating pathology and clinical impairment. In the best-fitting path model (CFI=.991; RMSEA=.083) eating pathology and social physique anxiety positively predicted body checking, and body checking positively predicted clinical impairment. Therefore, women who endorse social physique anxiety may be more likely to engage in body checking behaviors and experience impaired psychosocial functioning.

The Psychological Characteristics and Health Related Behavior of Adolescents: The Possible Roles of Social Physique Anxiety and Gender

The purpose of this study was to examine whether or not the social physique anxiety level and gender have an influence on psychological characteristics and health related behavior of adolescents. Five hundred and ninety eight female (Mage= 14.95,SD= .70 years) and three hundred and eighty four male (Mage= 15.08,SD= .76 years) adolescents voluntarily participated in this study. The Social Physique Anxiety Scale (SPAS), three subscales of the Physical Self-Description Questionnaire, and the Multidimensional Perfectionism Scale as indicators of psychological characteristics were administered to all participants. The Eating Attitude Test and Physical Activity Assessment Questionnaire were used to determine health related behavior. It was found that adolescents with high levels of SPA (HSPA) had more unfavourable eating attitudes, higher scores in socially-prescribed perfectionism, negative global physical self-worth and negative body related perceptions than those with low levels of SPA (LSPA). Physical activity levels of adolescents did not differ in the two SPA groups (high/low level). In addition, male adolescents in the present study were more physically active and had favorable eating attitudes and more positive self-perceptions of body fat and general physical self-worth than their female counterparts.

Critical Factors of Social Physique Anxiety: Exercising and Body Image Satisfaction

This study aimed to examine the critical roles of exercising and body image satisfaction on social physique anxiety (SPA) among female university students. For this aim, 118 female university students, 58 of whom exercised regularly, participated in the study. The Social Physique Anxiety Scale, Eating Attitudes Test, and Liebowitz Social Anxiety Scale were administered to the participants; their dieting habits were also investigated. Results revealed that approximately half of the participants used at least one unhealthy weight control method in the past 6 months. An analysis of covariance indicated that, after controlling for the effects of abnormal eating behavior, participants who were dissatisfied with their body image and did not participate in a regular exercise activity experienced higher social physique anxiety. However, such a tendency was not found for social anxiety. Thus, these characteristics seem to be specific to social physique anxiety. It was concluded that individuals who have negative view of their appearance were more prone to experience SPA, and they might be avoiding exercise for self presentational purposes. Findings were discussed in the light of literature.

Developmental and contextual risks of social physique anxiety among female athletes

In the present study, we examined developmental and contextual factors that may increase the odds of reporting higher social physique anxiety (SPA) among 404 adolescent athletes 11 to 16 years old. Findings showed older, later maturing athletes past peak height velocity and with greater body mass index (BMI) reported higher SPA. Individual aesthetic sport athletes were older at menarche, had lower BMI, and reported higher SPA. The odds of reporting higher SPA were 4.5 times higher (odds ratio = 4.61) for individual aesthetic sport athletes than for nonaesthetic sport athletes. Team aesthetic sport contexts were not implicated in SPA risk. Results are discussed in terms of self-selection away from individual aesthetic sports and the relevance of physical size and puberty in the SPA construct.

Weight perception in female athletes: associations with disordered eating correlates and behavior

Although weight perception is associated with disordered eating correlates and unhealthy eating behavior, it is unclear whether these associations exist in specific female populations at greater risk of disordered eating (i.e., athletes). The aim of this study was to examine associations between weight perception and disordered eating correlates (perfectionism and social physique anxiety (SPA)) and eating behavior in female athletes. Measures of perfectionism (positive and negative), SPA, weight perception and disordered eating were completed by 136 female elite athletes. Athletes with overweight perceptions reported greater negative perfectionism, higher SPA and more disordered eating behavior than female athletes with normal-weight perceptions. Overweight perceptions are, therefore, an additional factor to consider in the relationship between perfectionism, physique anxiety and disordered eating in female athletes.

Exploring a model linking social physique anxiety, drive for muscularity, drive for thinness and self-esteem among adolescent boys and girls

This study examined gender differences on body image measures, and tested a model where self-esteem influences social physique anxiety (SPA), which in turn influences drive for muscularity and drive for thinness in a sample of adolescents (N=329; 58% boys). Multi-group invariance analyses indicated that the measurement and structural models were partially invariant for boys and girls, allowing for gender comparisons. Results indicated that boys reported significantly lower drive for thinness and SPA, and higher drive for muscularity and self-esteem compared to girls. The measurement and structural models were an adequate fit for the total sample. Findings supported the proposed sequence in which self-esteem significantly influenced SPA, and SPA significantly influenced the drives for muscularity and thinness. Interventions aimed at decreasing SPA, by promoting self-esteem, may be helpful in decreasing adolescent boys' and girls' drive for muscularity and thinness.

Physique Anxiety and Disordered Eating Correlates in Female Athletes: Differences in Team and Individual Sports

As female athletes participating in physique-salient sports report similar levels of social physique anxiety (SPA) and disordered eating symptoms compared with those in nonphysique salient sports, alternative factors contributing to disordered eating require consideration, specifically participation in sport type (team vs. individual). This study examined SPA and disordered eating correlates in female athletes (N= 137) in two sport types (team sports and individual sports). Individual sport athletes exhibited higher SPA,F(1, 135) = 22.03,p< .001; dieting, Brown and Forsythe’sF(1, 57.05) = 43.79,p< .001; and bulimic behavior, Brown and Forsythe’sF(1, 59.92) = 13.45,p= .001 than team sport athletes. SPA and sport type together predicted 44% of dieting and 22% of bulimic symptom variance, suggesting that individual-sport athletes with higher SPA experienced greater disordered eating. Involvement in individual sports where physique is more open to social evaluation may contribute to dieting and bulimic symptoms among female athletes.

Development and Examination of the Social Appearance Anxiety Scale

The Social Appearance Anxiety Scale (SAAS) was created to measure anxiety about being negatively evaluated by others because of one's overall appearance, including body shape. This study examined the psychometric properties of the SAAS in three large samples of undergraduate students (respective n s = 512, 853, and 541). The SAAS demonstrated a unifactorial structure with high test-retest reliability and internal consistency. The SAAS was positively associated with measures of social anxiety. The SAAS was also related to greater disparity between perceived, actual, and ideal physical attributes, beliefs that one's appearance is inherently flawed and socially unacceptable and that being unattractive is socially deleterious, feelings of unattractiveness, emphasis on appearance and its maintenance, and a preoccupation with being overweight. It was a unique predictor of social anxiety above and beyond negative body image indicators. Findings suggest that the SAAS is a psychometrically valid measure of social anxiety regarding one's overall appearance.

Exercise behaviours and feelings in eating disorder and non-eating disorder groups

OBJECTIVES

To compare exercise feelings and behaviours between female eating disorder (ED) (n = 287) and non-ED (n = 613) groups. To determine if exercise feelings and behaviours predict the presence of an ED.

METHODS

Nine hundred females completed questions about their exercise behaviours and feelings.

RESULTS

Both groups did similar amounts and days of exercise; the ED group scored higher on all other exercise behaviours and feelings except feeling that exercise was important for mood, and for weight loss. Best predictors of an ED diagnosis (VE 15.2%) were; 'being annoyed if exercise interrupted' (OR: 1.49; 95% CI 1.04-2.15), 'others feeling you exercise a lot' (OR: 1.61; 95% CI 1.06-2.44), 'feeling bad if unable to exercise a certain amount' (OR: 1.53; 95% CI 1.34-1.74), 'feeling that you have/have had problems with exercise' (OR: 2.12; 95% CI 1.33-3.39).

DISCUSSION

Clinicians assessing eating disordered individuals should address specific exercise feelings, rather than exercise amount or frequency.

Understanding the link between body checking cognitions and behaviors: the role of social physique anxiety

OBJECTIVE

Recent evidence supports the utility of a model where body checking cognitions and behaviors influence disordered eating. It can be hypothesized that emotional states might explain the links between checking cognitions and behaviors. Social physique anxiety is associated with disordered eating and is an important form of affect to consider in this model. This study aims to examine the associations between these variables, testing a mediational model of the role of social physique anxiety in the links between body checking cognitions and behaviors.

METHOD

A nonclinical group of 292 women completed well-validated measures of social physique anxiety, body checking cognitions, and body checking behaviors.

RESULTS

The data were compatible with a model where social physique anxiety partially mediates the relationship between body checking cognitions and body checking behavior. The combination of cognitions and affect explained a significant proportion of variance in body checking behavior.

CONCLUSION

Incorporating affect allows for a more comprehensive model of understanding the antecedent factors of body checking behaviors. The impact of body checking cognitions on physique anxiety might serve to drive the repetitive body checking behaviors, potentially contributing to disordered eating. Interventions for body checking might be more effective if they included an affective treatment component.

Body checking in the eating disorders: Associations between cognitions and behaviors

OBJECTIVE

Body checking behaviors appear to be a manifestation of the cognitive distortions that are central to the maintenance of the eating disorders. However, there is little understanding of the cognitions that drive these behaviors. This study validates a novel measure of such cognitions (Body Checking Cognitions Scale [BCCS]) and examines the association between body checking cognitions, body checking behaviors, and general eating pathology.

METHOD

Eighty-four eating-disordered women and 205 non-eating-disordered women each completed measures of body checking behaviors, body checking cognitions and eating pathology. A further 130 nonclinical women completed the measures to provide an independent cross-validation sample for the BCCS.

RESULTS

The BCCS was reliable and valid, and cross-validation with an independent sample confirmed the four-factor structure. Eating-disordered women were significantly more likely to experience body checking cognitions than healthy women. Those cognitions were associated with a significant proportion of variance in eating pathology, over and above the variance explained by checking behaviors.

CONCLUSION

This study provides evidence for a range of beliefs underlying body checking behavior in eating-disordered women, suggesting that interventions addressing those beliefs might be pertinent in some cases.

Social anxiety and coping strategies in the eating disorders

Studies of social phobia in the eating disorders have demonstrated high comorbidity with both anorexia and bulimia nervosa. This study examined levels of social anxiety across different types of eating disorders, and determined the association of such anxiety with specific forms of emotional regulation. One hundred fourteen females who met DSM-IV criteria for an eating disorder and a comparison group of 50 nonclinical women completed three self-report questionnaires, which measured bulimic behaviours, dissociation, and social anxiety. The clinical groups reported higher levels of social anxiety than the nonclinical group. In both the nonclinical individuals and the bulimia nervosa patients, social anxiety was found to be associated with higher levels of bulimic psychopathology. By contrast, social anxiety in the restrictive anorexic group was linked to higher levels of dissociation. The present findings highlight the clinical importance of addressing social anxiety in eating-disordered individuals, and suggestions are made for the treatment of different forms of emotional regulation in such cases. Implications for future research are also discussed.

Social physique anxiety and eating attitudes in female athletic and non-athletic groups

One purpose of the present study was to compare Social Physique Anxiety (SPA) scores among four different female groups (physique-salient (PS) athletes-aerobics competitors and divers, n = 63; weight-restricted athletes-rowers, n = 60; non-physique-salient (NPS) athletes--soccer, n = 75; and non-athlete students, n = 53). A second purpose of the study was to examine relations between SPA and disturbed eating attitudes among these four groups. Participants completed the Social Physique Anxiety Scale (SPAS; Hart, Leary, & Rejeski, 1989) and the Eating Attitude Test (EAT; Garner & Garfinkel, 1979). With respect to purpose one, an analysis of variance (ANOVA) with SPA (i.e., 9-item single factor model of the SPAS) as the dependent measure, failed to reach significance (F (3,184) = 1.61, p> .05). With respect to purpose two, significant relations were found between SPA and EAT scores for all four groups. Inferential comparison of the bivariate correlations (Fisher's Z transformations), however, showed no significant differences between groups. In addition, a moderated regression analysis was computed using EAT scores as the dependent measure. The variables were entered in the following order: SPA, followed by dummy vectors for each sport-type category, and then the interaction term between SPA and the dummy vectors. Results showed that there was no significant interaction effect. Thus, these analyses, taken together. suggest that the type of sport activity does not serve to moderate relations between SPA and disordered eating. Implications of the findings are discussed.

Exercise and eating disorder symptoms among young females

BACKGROUND

In various settings, eating disorder symptoms have been linked to physical activity.

METHODS

A random sample of 726 females, aged 17-23 years, responded on a self-administered questionnaire. "High level exercisers" (HiEx) were defined as subjects exercising > or =6 sessions/week, > or =1 h/session. "Exercisers with obligatory attitudes" (ObEx) were those obtaining a result above the 95th percentile on a composite score of obligatory exercise items. These groups were compared to controls regarding composite scores of eating disorder symptoms and other symptoms.

RESULTS

While HiEx did not, ObEx obtained a significant result at the p<0.001 level regarding the score for body image problems, recurrent weight-reducing attempts, bingeing and post-prandial impulses to vomit. ObEx was also associated with symptoms related to stress and in particular with a high level of general activity coupled with perfectionistic ambitions.

CONCLUSIONS

Eating disorder symptoms in young females seem to be associated with obligatory attitudes to exercise rather than with exercise quantity.