Divergent trajectories of positive affect following maladaptive and non‐maladaptive exercise among individuals with binge‐spectrum eating disorders

Abstract

Objective: Individuals with eating disorders (EDs) often engage in maladaptive exercise (e.g., feeling driven, or to "compensate" for eating) which maintains eating pathology.Maladaptive exercise has been theorized to help individuals with EDs regulate emotions by enhancing positive affect (PA) and reducing negative affect (NA) associated with binge episodes and poor body image. However, no research has considered the presence of non-maladaptive exercise or evaluated this theory in binge-spectrum EDs.Methods: This study evaluated affective trajectories pre-and post-exercise and examined exercise type (maladaptive or non-maladaptive) as a moderator. We recruited adults with binge-spectrum EDs (N = 107; n = 84 endorsed exercise) to complete a 7-to 14-day ecological momentary assessment protocol assessing NA (anxiety, guilt, and sadness), PA (excitement and cheerfulness), and exercise.Results: There was a significant quadratic trajectory of PA pre-exercise, suggesting that the upward trajectory of PA leveled out as it moved closer to an exercise episode. Exercise type significantly moderated the cubic trajectory of PA post-exercise, such that the upward trajectory of PA accelerated in the hours following nonmaladaptive exercise episodes while the downward trajectory of PA accelerated in the hours following maladaptive exercise episodes. No trajectories of NA demonstrated significant effects.Conclusions: Pre-exercise trajectories of PA may reflect positive expectancies around exercise. Post-exercise trajectories of PA suggest that non-maladaptive exercise promotes increased PA. Future research should evaluate when, and for whom, exercise serves to regulate affect and examine other momentary risk factors of exercise in EDs.Public Significance: Individuals with EDs often engage in maladaptive exercise (e.g., feeling driven, or to "compensate" for eating). Maladaptive exercise has been theorized to help individuals with EDs regulate emotions. This study evaluated affective trajectories pre-and post-exercise and examined whether exercise type (maladaptive or non-maladaptive) changed these trajectories. Pre-exercise trajectories of PA may reflect positive expectancies around exercise. Post-exercise trajectories of PA suggest that non-maladaptive exercise promotes increased PA.

Affective profiles of exercise episodes are associated with maladaptive and adaptive motivations for exercise

“…These findings add to previous literature, which has considered affect and fear of weight gain as independent risk‐factors for maladaptive exercise. For example, one recent EMA investigation found no predictable pattern of NA before or after exercise and only an initial increase in PA, followed by a plateau, closer to both adaptive and maladaptive exercise episodes (Lampe et al., 2023). Another study found that increases in fear of weight gain at one survey did not significantly predict any exercise engagement by the next survey (Lampe et al., 2022).…”

“…Fifty‐eight participants in the current analysis were included in other published studies examining associations between exercise engagement and body dissatisfaction (Srivastava et al., 2022), and fear of weight gain (Lampe et al., 2022) and examining reasons for exercise engagement (Lampe, Trainor, et al., 2021). All participants in the current analysis were also included in a published study examining trajectories of positive and NA around exercise episodes (Lampe et al., 2023).…”

“…Across the literature, fear of weight gain has been identified as a central feature contributing to both bulimia nervosa (BN) and binge eating disorder (BED) pathology (Levinson & Williams, 2020; Wang et al., 2019). Another study suggests that PA decreased following maladaptive exercise episodes while it continued to increase following exercise episodes that were not maladaptive (Lampe et al., 2023). Additionally, a large literature base has established both NA and PA as independent predictors of ED behaviours (Engel et al., 2013; Haynos et al., 2017; Lavender et al., 2016; Wonderlich et al., 2015), including maladaptive exercise (De Young & Anderson, 2010; Raedeke, 2007).…”

Working out measurement overlap in the assessment of maladaptive exercise

“…We evaluated 11 full scales assessing maladaptive exercise in populations with eating pathology as well as commonly sourced exercise items from four scales assessing general eating pathology (see Table 1); sources were selected from those used in ED samples, and included in recent reviews and chapters (Lampe & Gorrell, 2023;Rizk et al, 2020). Instruments were included based on their frequency in the literature, appearance in studies comparing multiple scales, and citation count based on a consensus among the seven authors.…”

Subtypes of exercise are differentially associated with baseline eating disorder pathology and treatment outcome among individuals with bulimia nervosa

“…Fifth, the modified EDE questions assessing frequency of compensatory‐only, compulsive‐only, and both compulsive and compensatory exercise have not been independently validated. Previous studies using ecological momentary assessment (EMA) have demonstrated that 94.44% of individuals who endorse these modified exercise items also reported at least one episode of EMA‐measured compensatory and/or compulsive exercise engagement over the following 7–14 days (Lampe et al, 2023). In this study, the correlation between assessment of exercise via modified EDE items and EMA was r = .49 ( p < .001).…”