Running on empty - a nationwide large-scale examination of compulsive exercise in eating disorders

Compulsive exercise (CE) has been the neglected "Cinderella" among eating disorder (ED) symptoms, even though it seems to impact severity, treatment and outcome. This prompted a large-scale and systematic examination of the impact of CE in a representative ED sample. CE was examined in ove...

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Bibliographic Details
Published in:Journal of eating disorders 2018-06, Vol.6 (1), p.11-11, Article 11
Main Authors: Monell, Elin, Levallius, Johanna, Forsén Mantilla, Emma, Birgegård, Andreas
Format: Article
Language:English
Subjects:
Anorexia
Anxiety
Attitudes
Behavior
Body mass index
Compulsive exercise
Eating disorder
Eating disorders
Exercise
Exercise addiction
Females
Males
Medicin och hälsovetenskap
Outcome
Patients
Physical fitness
Psychopathology
Studies
Systematic review
Teenagers
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Summary:Compulsive exercise (CE) has been the neglected "Cinderella" among eating disorder (ED) symptoms, even though it seems to impact severity, treatment and outcome. This prompted a large-scale and systematic examination of the impact of CE in a representative ED sample. CE was examined in over 9000 female and male patients from a clinical ED database (covering out-patient, day and/or residential treatment) with respect to prevalence, ED diagnosis, ED symptoms, clinical features, patient characteristics, and outcome at 1-year follow-up. Relationships between changes in CE behavior and remission were also examined. CE was a transdiagnostic symptom, present in nearly half of all patients (48%). It was associated with greater overall ED pathology, particularly dietary restraint, and negative perfectionism. Initial CE did not impact remission rate, but patients continuing or starting CE during treatment had considerably lower remission rates compared to patients who never engaged in, or ceased with, CE. Results were comparable for females and males. At baseline, there were few differences between patients with and without CE, except a somewhat higher symptom load for patients with CE, and CE did not predict ED outcome. However, how CE developed during treatment to 1-year follow-up considerably impacted remission rates. We strongly recommend CE to be systematically assessed, addressed, and continuously evaluated in all ED patients seeking treatment.
ISSN:2050-2974
2050-2974
DOI:10.1186/s40337-018-0197-z