The treatment of compulsive physical activity in anorexia nervosa lacks a conceptual base

Davies, Rhian R.

doi:10.1080/21662630.2014.892835

Cited by 24 publications

(17 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because PA is often a significant component of anorexia nervosa and other EDs, continuing to engage in PA before making significant progress during recovery could serve to maintain the obsessive-compulsive aspects of the ED. Consequently, many healthcare professionals may by wary of the risk-benefit ratio associated with PA, hesitate to formally address PA during the course of ED treatment, and understandably recommend abstinence from PA during ED treatment [ 44 , 45 ]. Nevertheless, the practice of recommending abstinence from PA during ED treatment has been questioned [ 46 ] and many women remain engaged in PA during ED treatment or resume PA shortly thereafter to self-regulate, manage problematic feelings, and accrue the benefits associated with PA [ 33 , 47 ].…”

Section: Introductionmentioning

confidence: 99%

Physical activity behaviors and attitudes among women with an eating disorder: a qualitative study

2021

View full text Add to dashboard Cite

Background Physical activity (PA) is an integral part of healthcare for the general population and individuals with psychiatric disorders. However, PA is significantly more complex for and related to both healthy (e.g., reduced anxiety and depressive symptoms) and unhealthy outcomes (e.g., intrusive, repetitive thoughts that lead to abnormally high levels of PA) among women with an eating disorder (ED). Consequently, many healthcare professionals recommend abstinence from PA during ED treatment. Despite this, women may remain engaged in PA during ED treatment or resume PA shortly thereafter. Little has been done to understand women’s PA behaviors and attitudes and to explore how they integrate PA into their lives during and after ED treatment. Thus, this study sought to explore PA behaviors and attitudes among women with an ED. Methods Nine women who self-reported receiving an ED diagnosis participated in semi-structured interviews, which were transcribed and analysed thematically. Results Six interrelated themes were constructed to represent participants’ PA experiences: PA as a lifestyle, PA can be beneficial, How I feel when I can’t do PA, Being cautious about PA, Reactions to healthcare professionals’ practice of recommending abstinence from PA during ED treatment, and PA programming thoughts. Conclusions Overcoming dysfunctional PA behaviors (e.g., engaging in abnormally high levels of PA) and attitudes (e.g., associating PA with caloric expenditure) can be a long and complicated journey for women with an ED. Nevertheless, women with an ED want PA to be integrated into their ED treatment protocol for two key reasons, namely to accrue the benefits associated with PA and to learn how to engage in PA in adaptive and healthy ways.

show abstract

Section: Introductionmentioning

confidence: 99%

Physical activity behaviors and attitudes among women with an eating disorder: a qualitative study

2021

View full text Add to dashboard Cite

show abstract

“…In the last few decades, several conceptualizations of DEx as a symptom of EDs have emerged (Davies, 2015), with two prominent models characterizing DEx either as an exercise dependence (Hausenblas & Downs, 2002) or as compulsive exercise (Meyer, Taranis, Goodwin, & Haycraft, 2011). The exercise dependence model assumes that, similar to behavioral addictions, DEx in EDs is associated with initially engaging in exercise to experience a positive affective state, which will then lead to tolerance (i.e., increase in exercise intensity needed to experience these states) and withdrawal symptoms (e.g., anxiety, depression, guilt).…”

Section: Introductionmentioning

confidence: 99%

A call to experimentally study acute affect‐regulation mechanisms specific to driven exercise in eating disorders

Kolar

Gorrell

2020

Intl J Eating Disorders

View full text Add to dashboard Cite

Driven exercise (i.e., feeling compelled to exercise to control one's weight or shape, to obtain other positive consequences of exercising, or to avoid other negative consequences of not exercising) is a common phenomenon in individuals with eating disorders (EDs), typically associated with negative clinical outcomes. Current theoretical models of driven exercise highlight the short‐term affect‐regulating outcome of acute driven exercise, which is implicated to maintain this symptom either by positive or negative reinforcement. However, few studies have actually investigated cognitive, affective, and psychobiological mechanisms related to acute driven exercise. In particular, experimental studies that directly test mechanisms leading to the short‐term affective improvement after acute driven exercise are scarce. In this article, we therefore propose potential cognitive, affective, and psychobiological mechanisms that could explain the affect‐regulating function of driven exercise in individuals with EDs. In addition, we suggest examples of experimental studies that could directly test these mechanisms in individuals with EDs, as recent studies have demonstrated the safety of supervised exercise in EDs research. Our aim of stimulating research on the underlying causes and maintenance factors of driven exercise in EDs has the potential to critically inform treatment development for this high‐risk population.

show abstract

“…Nevertheless, the need for a homogenous term and definition remains in the absence of consensus amongst researchers and clinicians surrounding what constitutes unhealthy exercise. Such consensus is required to create comparability across research and clinical settings (Davies et al, ; Gümmer et al, ; Meyer & Taranis, ), which would then provide a foundation to support advances in the treatment of unhealthy exercise in AN.…”

Section: Introductionmentioning

confidence: 99%

The assessment and treatment of unhealthy exercise in adolescents with anorexia nervosa: A Delphi study to synthesize clinical knowledge

Noetel

Dawson

Hay

et al. 2017

Intl J Eating Disorders

View full text Add to dashboard Cite

This study aimed to explore and synthesize expert clinical knowledge on defining and managing unhealthy exercise in adolescents with AN. The Delphi methodology was used. Clinicians (n = 25) considered experts in the treatment of AN in adolescents were recruited internationally to form the panel. The first round of the questionnaires was comprised of five open-ended questions regarding defining, assessing, and treating unhealthy exercise in adolescents with AN. Statements were derived from this data using content analysis, and included as Likert-based items in two subsequent rounds, in which panellists were required to rate their level of agreement for each item. All 25 respondents completed the three rounds of questionnaires. Consensus was achieved for 59.0% of the items included in the second and third round of questionnaires. Although consensus was not achieved, compulsive exercise was the preferred term for the panel when referring to unhealthy exercise in adolescents with AN. The panel clearly delineated features of unhealthy and healthy exercise, and endorsed a number of items considered important to assess for when evaluating exercise in this clinical population. A variety of treatment approaches and strategies reached consensus. Notably, for those who are medically stable and progressing toward recovery, the panel recommended initial exercise restriction practices and reintroducing healthy exercise behaviors, rather than exercise cessation practices. The current findings can serve as preliminary treatment guidelines. A unified approach to labeling and defining unhealthy exercise in the eating disorder literature and clinical settings is required to achieve further progress.

show abstract

The treatment of compulsive physical activity in anorexia nervosa lacks a conceptual base

Cited by 24 publications

References 40 publications

Physical activity behaviors and attitudes among women with an eating disorder: a qualitative study

Physical activity behaviors and attitudes among women with an eating disorder: a qualitative study

A call to experimentally study acute affect‐regulation mechanisms specific to driven exercise in eating disorders

The assessment and treatment of unhealthy exercise in adolescents with anorexia nervosa: A Delphi study to synthesize clinical knowledge

Contact Info

Product

Resources

About