Characterization and correlates of exercise among adolescents with anorexia nervosa and bulimia nervosa

Abstract

Objective To characterize exercise behaviors among adolescents with anorexia nervosa (AN), atypical AN, or bulimia nervosa (BN), and determine associations between exercise and medical risk. Study design Cross-sectional electronic medical records of all patients evaluated by the Eating Disorder Program at Stanford between January 1997 and February 2011 were retrospectively reviewed. Results 1,083 subjects (961 females, 122 males; mean age 15.6) met eligibility criteria. Most patients (89.7%) reported exercise (mean 7.0 hours per week over mean 5.4 days per week) prior to presentation. Running (49.9%), calisthenics (40.7%), walking (23.4%), soccer (20.9%), and swimming (18.2%) were the most common exercises; a majority (60.6%) reported team sport participation. Males were less likely to report team exercise (p=0.005). Bradycardia (heart rate <50) at presentation was associated with team sport participation (adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.02–2.72) and hours of exercise per week (AOR 1.05, 95% CI 1.02–1.09), controlling for diagnosis, sex, age, duration of illness, rate of weight loss, and percent median body mass index (%mBMI). Discussion Adolescents with AN, atypical AN, and BN reported high levels of exercise. Females reported more team sport participation. Greater exercise frequency and team sports participation were associated with bradycardia. Further studies assessing the relationship between exercise and bradycardia may help inform the medical management of adolescents with these eating disorders who are more physically active.

Comparison of Factors Associated with Disordered Eating between Male and Female Malaysian University Students

“…A recent study among university students from the United Arab Emirates (UAE) also found that a higher proportion of females were dissatisfied with their body size, whereby females desired to lose weight and preferred diet to exercise, and males desired to gain weight and preferred exercise to diet [38]. Future DE assessment may need to consider examining compulsive exercise [39] and androgenic anabolic steroid use [40], which may be more prevalent among male young adults. In the present study, higher body size dissatisfaction and poorer body appreciation contributed significantly to DE in female students, but not in male students.…”

Prevalence and Correlates of Disordered Eating Behaviors Among Young Adults with Overweight or Obesity

“…40,41 Questions related to vomiting, fasting or skipping meals, diuretics, and laxative use that served as a proxy for unhealthy weight control behaviors represent thinness-oriented goals, which may be more relevant to females. Future research could examine sex differences [42][43][44] in compulsive exercise 45 or androgenic anabolic steroid use, 46 which may be more prevalent among young adult men than women considered overweight or obese.…”

Predictors of muscularity‐oriented disordered eating behaviors in U.S. young adults: A prospective cohort study

“…In particular, weight‐related sports, or sports in which it is important to stay a certain weight, such as wrestling, rowing, or gymnastics, have been shown to be associated with greater odds of AAS use (Vertalino, Eisenberg, Story, & Neumark‐Sztainer, ). Sports team participation and greater frequency of exercise has been shown to be associated with greater medical instability (as measured by bradycardia) among adolescents with anorexia nervosa or bulimia nervosa (Nagata et al, ).…”