Dimensions of unhealthy exercise and their associations with restrictive eating and binge eating

Unhealthy exercise is a core symptom of eating disorders that predicts greater chronicity and risk of relapse. A detailed conceptualization of unhealthy exercise in the context of eating disorders is only beginning to emerge, and associations between specific dimensions of unhealthy exercise and eating disorder symptoms have received little attention. The aim of the current study was to examine associations between three key dimensions of unhealthy exercise - compulsive exercise (i.e., rule-driven exercise to avoid negative affect), exercise to control weight/shape, and exercise to compensate for recent food intake - with restrictive eating and binge eating. Participants were 239 women drawn from two separate studies of emotions and eating behavior; 126 (52.7%) endorsed restrictive eating and/or objective binge eating episodes in the past three months. Unhealthy exercise dimensions were measured using the Compulsive Exercise Test and investigator-designed items, and eating disorder symptoms were assessed using the Eating Pathology Symptoms Inventory. Restrictive eating was only associated with avoidance and rule-driven exercise, whereas binge eating was significantly correlated with all unhealthy exercise variables. Multiple regression results revealed that only compensatory exercise was uniquely associated with binge eating. Unhealthy exercise consists of partially distinct dimensions with differential relations to core eating disorder symptoms. Future research should examine unhealthy exercise dimensions in patients with eating disorder diagnoses and consider whether treatments for specific unhealthy exercise forms might be beneficial.

Developmental trajectories of compensatory exercise and fasting behavior across the middle school years

Compensatory exercise and fasting behavior, in the absence of binge eating and purging, appear to be important eating disorder behaviors that are associated with dysfunction, but little is known about these behaviors in youth. We studied the trajectories of their development in non-binge eating and non-purging girls during early adolescence. Using a longitudinal design, we assessed 564 girls six times over the three years of middle school (grades 6 through 8) and developed trajectories specifying different developmental patterns in relation to the behaviors. Prior to this period, when the girls were in 5th grade (elementary school), we assessed risk factors to predict girls' subsequent trajectory group membership. Compensatory exercise trajectory groups included a non-engagement group, a group that increased in the behavior, and a group that decreased in the behavior. There were two fasting trajectory groups, one consistently engaging in the behavior and the other consistently not. Elementary school levels of depression, eating expectancies, and thinness expectancies predicted subsequent trajectory group membership. Risk for compensatory exercise and fasting should be evaluated as early as in 5th grade. Targeted interventions should focus on girls in late elementary school or middle school, as this appears to be a critical developmental and maintenance period for compensatory exercise and fasting behavior.

An exploration of the influence of thinness expectancies and eating pathology on compensatory exercise

Compensatory exercise (exercise performed in an effort to control weight/shape or in response to caloric intake) and thinness expectancies (beliefs that thinness will improve the overall quality of life) are strongly linked to the development, maintenance, severity, and outcome of eating disorders. There is little literature, however, examining the relationship between compensatory exercise and thinness expectancies. The goal of the current study was to examine whether thinness expectancies contribute significant variance in the endorsement of excessive exercise over and above binge eating, restraint, and shape and weight concerns. A total of 677 undergraduate women (mean age=18.73) completed self-report measures of thinness expectancies and eating disorder symptoms (TREI and EDE-Q). There was a significant association between thinness expectancies and frequency of compensatory exercise behavior. Restraint and subjective binge episodes accounted for significant variance in compensatory exercise. Frequency of objective binge episodes did not, nor did endorsement of thinness expectancies. These findings suggest a potential profile of individuals engaging in compensatory exercise as individuals who actively restrict their diets, feel as if they have binged when they violate those restrictions, and feel the need to excessively exercise to compensate for the subjective binges.