Prospective Associations Between Driven Exercise and Other Eating Disorder Behaviors in Adolescence: A Longitudinal Cohort Study

Schaumberg, Katherine; Robinson, Lauren; Hochman, Ayelet; Micali, Nadia

doi:10.1016/j.jadohealth.2021.11.022

Cited by 6 publications

(18 citation statements)

References 48 publications

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“…Overall, reported engaging in exercise for weight loss and maladaptive exercise at relatively high rates across adolescence, and endorsement of both increased over time. The relatively high and increasing rates of exercise for weight loss and maladaptive exercise across adolescence are consistent with previous research 20 and are of potential concern as previous research in this cohort suggests that exercise for weight loss and maladaptive exercise at age 14 are associated with increased risk of other ED symptoms 12 .…”

Section: Rates Of Exercise For Weight Loss and Maladaptive Exercise O...supporting

confidence: 85%

“…Further, we characterized overall risk for engaging in maladaptive exercise across age, and identify potential demographic or early (age 14) ED cognition variables that may enhance risk for maladaptive exercise throughout adolescence. Based on previous literature 12,20,21 , we hypothesized that exercise for weight loss would be a common behavior across adolescence, with maladaptive exercise being less common than exercise for weight loss, but occurring in a sizable minority of individuals. Further, we hypothesized that ED cognitions assessed at age 14 will be associated with higher likelihood of exercise for weight loss and maladaptive exercise across adolescence.…”

Section: Current Studymentioning

confidence: 99%

“…Exercise Groups. Exercise groups over time are defined for descriptive analyses and transition states, replicating groups defined in 12 . Those who report no exercise for weight loss at each time point are placed in a 'No Exercise for Weight Loss' group, those who report exercise for weight loss at least sometimes, but do not meet criteria for maladaptive exercise are placed in an 'Exercise for Weight Loss' group, and those meeting maladaptive exercise criteria are placed in the 'Maladaptive Exercise' group.…”

Section: Thin-ideal Internalizationmentioning

confidence: 99%

“…The current paper lays groundwork to untangle distinctions between adaptive and maladaptive exercise behavior across adolescence and young adulthood. While initial work suggests that maladaptive exercise predicts exacerbation of other ED behaviors 12,13 , future work should clarify associations between exercise for weight loss and ED risk, particularly in late adolescence. Further, the degree to which psychological motivations for exercise and maladaptive exercise symptoms associate with objective exercise behavior (frequency, intensity of exercise)…”

Section: Future Directionsmentioning

confidence: 99%

“…Most concerning, maladaptive exercise may itself spur onset and exacerbation of disordered eating, as the activity-based anorexia rodent model suggests that activity in the context of dietary restriction can preempt entrenched hyperactivity and restriction 9 , retrospective reports of individuals with eating disorders (EDs) suggest that maladaptive exercise can be an earlydeveloping ED feature 10,11 , and our previous prospective study indicated that young people who reported either exercise for weight loss or maladaptive exercise at age 14 were more likely to report concurrent and future (Age 16) ED behaviors 12 . Once entrenched, maladaptive exercise patterns can be a pernicious and debilitating ED symptom and a potential marker of poor prognosis 5,[13][14][15] .…”

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confidence: 99%

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Patterns of Maladaptive Exercise Behavior from ages 14-24 in a Longitudinal Cohort

Schaumberg¹,

Bulik²,

Micali³

2022

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Exercise for weight loss and maladaptive exercise (exercise that results in negative consequences or interference with daily life) are common behaviors amongst youth and are associated with increased risk of disordered eating symptoms. The current study clarifies processes that influence exercise-related risk in adolescence and young adulthood, including the frequency with which young people transition between engaging in exercise for weight loss and experiencing negative consequences of this behavior. Method: Participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) reported on eating disorder (ED) cognitions at age 14, and exercise behavior at ages 14, 16, 18, and 24 years old. Analyses examined rates of transition between the categories of ‘No Exercise for Weight Loss’, ‘Exercise for Weight Loss’ and ‘Maladaptive Exercise’ over time, identified overall trends in endorsement of exercise for weight loss and maladaptive exercise, and clarified initial predictors of these behaviors. Results: Endorsement of exercise for weight loss and maladaptive exercise increased over time in both boys and girls. Those in the ‘Exercise for Weight Loss’ category were more likely than those in the ‘No Exercise for Weight Loss Category’ to transition to ‘Maladaptive Exercise’ over time. Body mass index (BMI; Age 13) and fear of weight gain (Age 14) were consistent predictors of maladaptive exercise across gender. Conclusions: Results support re-framing motivations for exercise in youth away from weight loss at a population level and targeting reductions in fear of weight gain for high-risk individuals.

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Section: Rates Of Exercise For Weight Loss and Maladaptive Exercise O...supporting

confidence: 85%

Section: Current Studymentioning

confidence: 99%

Section: Thin-ideal Internalizationmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Patterns of Maladaptive Exercise Behavior from ages 14-24 in a Longitudinal Cohort

Schaumberg¹,

Bulik²,

Micali³

2022

Preprint

View full text Add to dashboard Cite

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Measuring cognitions during exercise: Associations between thoughts and eating disorder behaviors over a 3‐week ecological momentary assessment study

Coniglio

Kleiman

Selby

2023

Intl J Eating Disorders

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ObjectivePrevious work has outlined cognitive beliefs about exercise in general, but very little is known about momentary cognitions while engaging in pathological exercise. The primary aim of this study was to explore thought content during exercise and to test whether these thoughts predicted later engagement in eating disorder behaviors. We also tested associations between thoughts and specific exercise activity.MethodWe monitored 31 women with clinically significant eating psychopathology for 3 weeks via ecological momentary assessment as they reported on their exercise and eating disorder behaviors, and thoughts about shape, weight, or calories during exercise. Thoughts were self‐reported upon cessation of each exercise session.ResultsThinking about weight loss during exercise predicted later engagement in body‐checking behaviors. Weight‐bearing exercise was associated with a decreased likelihood of thinking about calories but an increased likelihood of thinking about shape during exercise.DiscussionThese findings show that shape and weight thoughts are present during exercise and that their influence on eating disorder behaviors may exist on a much briefer time scale (i.e., within a day) than previous studies show. Clinically, future studies may seek to test interventions aimed at changing or restructuring cognitions during exercise to help shape adaptive exercise behavior during and after treatment.Public SignificanceThis is the first study measuring thoughts during pathological exercise in real‐time among those with eating disorder psychopathology. The results show that thinking about weight loss during exercise might increase the likelihood of engaging in body‐checking behaviors. Findings will inform the development of treatment approaches to help those in recovery from eating disorders re‐engage with exercise.

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The Impact of Family‐Based Treatment for Adolescent Anorexia Nervosa on Compulsive Exercise Attitudes and Behaviors

Datta,

Matheson,

Plessow

et al. 2024

Intl J Eating Disorders

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ObjectiveWhile Family‐based treatment for anorexia nervosa (FBT‐AN) is effective for weight restoration and improvement in eating‐related cognitions, its effect on exercise attitudes and behaviors is little studied. Compulsive exercise is common in AN and often challenging to change.MethodThis secondary analysis examined changes in attitudes toward compulsive exercise (Compulsive Exercise Test‐CET) and behaviors (Eating Disorder Examination‐EDE) using data from a randomized clinical trial testing an adjunctive treatment for adolescents with AN who failed to gain 2.4 kg by Session 4—a predictor of poor outcome. The main hypothesis is that attitudes toward compulsive exercise and decreases in compulsive exercise behavior would improve over the course of treatment.ResultsParticipants reported decreases in compulsive exercise attitudes by Session 4 and compulsive exercise episodes by end of treatment (EOT). There were no differences between early FBT responders (weight gain of 2.4 kg by session 4) and early non‐responders.DiscussionThese results suggest that FBT facilitates adolescents with AN to change attitudes toward compulsive exercise early in treatment (by Session 4) as well as reduction in compulsive exercise behaviors by EOT. Future studies should assess whether changes in attitudes toward compulsive exercise early in treatment is a mechanism of FBT treatment effect.

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Prospective Associations Between Driven Exercise and Other Eating Disorder Behaviors in Adolescence: A Longitudinal Cohort Study

Cited by 6 publications

References 48 publications

Patterns of Maladaptive Exercise Behavior from ages 14-24 in a Longitudinal Cohort

Patterns of Maladaptive Exercise Behavior from ages 14-24 in a Longitudinal Cohort

Measuring cognitions during exercise: Associations between thoughts and eating disorder behaviors over a 3‐week ecological momentary assessment study

The Impact of Family‐Based Treatment for Adolescent Anorexia Nervosa on Compulsive Exercise Attitudes and Behaviors

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