Unhealthy Exercise Research Articles

Gender differences in compulsive exercise facets and their associations with eating disorder symptoms

Compulsive exercise (CE) is a core symptom of eating disorders (EDs) that is common in undergraduate men and women. Importantly, CE is a multidimensional construct, and certain facets of CE (i.e., exercise to control weight or to avoid negative affect associated with missed exercise) are more strongly associated with ED symptoms in undergraduate women than others. However, less is known about how CE facets relate to ED symptoms in men. This study examined: 1) gender differences in levels of CE facets, assessed using the Compulsive Exercise Test (CET); 2) whether specific CE facets independently relate to ED symptoms; and 3) whether gender moderates these relationships. Five hundred and ninety-one university students (58.5 % men) completed the CET and Eating Pathology Symptoms Inventory. Women reported significantly greater weight control exercise, exercise for mood improvement, lack of exercise enjoyment, body dissatisfaction, and purging than men, while men reported more muscle building than women. CE motivated by avoidance of negative emotions and performed in a rule-driven manner and weight control CE were associated with the greatest number of ED symptoms. Further, rigid exercise routines were associated with greater muscle building. Women with greater weight control CE experienced more body dissatisfaction, and women with more CE motivated by avoidance of negative emotions experienced more restriction, compared to men. Overall, specific CE facets relate to ED symptoms in men and women. Findings highlight the importance of interventions designed to target unhealthy exercise motivations and of cultivating healthy attitudes towards exercise across genders.

The Fitter I Am, the Larger I Feel-The Vicious Circle of Physical Exercise in Anorexia Nervosa.

Introduction: Body image distortion is a core symptom of anorexia nervosa (AN), embodying dissatisfaction and overvaluation of body appearance and weight. Body image distortion is an important factor in the maintenance of weight loss behaviours such as compulsive physical exercise. Conversely, physical exercise seems to have an aggravating effect on body image in patients with AN, but the evidence is still poor. The aim of this study was to examine the relationship between body image distortion and physical exercise in AN in order to understand whether physical exercise may play a specific role in body image distortion beyond psychopathological severity. Methods: Forty patients with AN and 21 healthy controls were tested for body image distortion and different proxies of physical exercise. Univariate correlations tested the relationship between body image distortion and physical exercise in AN and control groups. Then, to experimentally assess the effect of exercise on body image distortion, participants were invited to rate their body image before and after a standardised effort test. Results: In the AN group, a correlation was found between physical activity and body image distortion (p < 0.01), which was still significant after controlling for psychopathological severity. No correlation was found in healthy controls. After a standardised effort, patients with AN had higher increases in body image distortion than healthy controls (almost 4 kg/m2 vs. 0.8 kg/m2) (p < 0.01). Discussion: Physical exercise may contribute to the distortion of body image in anorexia nervosa and explain the paradoxical augmentation of unhealthy exercise despite ongoing weight loss.

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Incorporating interventions for unhealthy exercise into eating disorders treatment

Abstract. Introduction: There is little consensus on the treatment of unhealthy exercise in eating disorders. Many treatment programmes do not offer any interventions at all. This study explored the attitudes of those with lived experience towards incorporating treatments for unhealthy exercise in eating disorders. Methods: An online survey was created using onlinesurveys.ac.uk and distributed through social media. Analyses included calculation of descriptive statistics and inductive thematic analysis of free text responses. Results: One hundred and forty-six respondents completed the survey, over 50% identified as having lived experience of an eating disorder. Thematic analysis of free text responses from those with lived experience identified themes around the benefits of incorporating exercise into the treatment of eating disorders including the benefits of exercise on mental and physical health and the opportunity to develop a healthier relationship with exercise. The themes around the risks of incorporating exercise included slowing or limiting recovery and physical risks of exercising at low weight. The themes around the risks of not addressing exercise included leaving part of the disorder untreated and how this could affect recovery. Conclusion: Those with lived experience of eating disorders feel unhealthy exercise is an important part of the disorder to treat. There is recognition of the risks of doing so, but also benefits in helping people to learn a new healthy relationship with exercise.

Changes in unhealthy exercise in outpatient eating disorder treatment: examining emotion avoidance mechanisms.

Unhealthy exercise (UE) is a common symptom of eating disorders (EDs) associated with elevated chronicity and relapse. Previous research suggests that UE serves an emotion regulation function, especially to reduce negative affect. UE may be especially prevalent among individuals with anorexia nervosa (AN), as UE and restrictive eating may be used to avoid unpleasant emotions. It is unclear whether changes in emotion avoidance (EA) can lead to changes in UE over time. The current study examined whether month 1 EA mediated the relation between baseline UE and month 2 UE in a clinical sample of 127 patients (Mage = 22.52 [SD = 11.75], 92.9% female) recruited from an ED outpatient treatment program. The current study also explored whether this mediation was stronger for individuals with AN than other ED diagnoses. Findings revealed that changes in EA significantly mediated the relation between changes in UE from baseline to month 2 of treatment. ED diagnosis did not moderate this relation. Findings suggest that improvements in EA may reduce UE over time. Treatment should target UE through cultivation of increased emotion acceptance.Level of evidence Level III: evidence obtained from well-designed cohort study.

Personal trainers’ health advice in the fitness gym space from a gender perspective

ABSTRACT Purpose: This study aimed to describe and problematize the advice on exercise and diet that personal trainers (PTs) provide to their clients from a gender perspective.Method: The present study had an explorative design, and the interviews were analysed using an interpretative qualitative approach. Seven focus group discussions were conducted with 19 PTs (aged 23–47 years).Results: The findings indicated that the PTs had a gender-neutral health advice approach to both women and men, guiding them towards a relaxed attitude to exercise and diet, prioritizing and rationalizing their exercise and diet and eating a natural diet. PTs also had a gendered health advice approach as regards women who showed unhealthy exercise and eating behaviours; advising them to eat more and exercise less, to focus on performance rather than appearance and to avoid heavy weightlifting. Some PTs acted evasively and did not give advice to men.Conclusions: Both approaches include advice that reflect health as control and health as release. From a gender perspective, PTs health advice both challenged and reproduced the stereotypical male norm in the fitness gym space. However, PTs gendered health advice may create different opportunities for men and women to promote their health and well-being in the fitness gym.

Dimensions of unhealthy exercise and their associations with restrictive eating and binge eating

Unhealthy exercise is a core symptom of eating disorders that predicts greater chronicity and risk of relapse. A detailed conceptualization of unhealthy exercise in the context of eating disorders is only beginning to emerge, and associations between specific dimensions of unhealthy exercise and eating disorder symptoms have received little attention. The aim of the current study was to examine associations between three key dimensions of unhealthy exercise – compulsive exercise (i.e., rule-driven exercise to avoid negative affect), exercise to control weight/shape, and exercise to compensate for recent food intake – with restrictive eating and binge eating. Participants were 239 women drawn from two separate studies of emotions and eating behavior; 126 (52.7%) endorsed restrictive eating and/or objective binge eating episodes in the past three months. Unhealthy exercise dimensions were measured using the Compulsive Exercise Test and investigator-designed items, and eating disorder symptoms were assessed using the Eating Pathology Symptoms Inventory. Restrictive eating was only associated with avoidance and rule-driven exercise, whereas binge eating was significantly correlated with all unhealthy exercise variables. Multiple regression results revealed that only compensatory exercise was uniquely associated with binge eating. Unhealthy exercise consists of partially distinct dimensions with differential relations to core eating disorder symptoms. Future research should examine unhealthy exercise dimensions in patients with eating disorder diagnoses and consider whether treatments for specific unhealthy exercise forms might be beneficial.

Selfie-posting on social networking sites, body surveillance, and exercise for weight control among Chinese young women with low body mass index

Under the perspective of self-perception theory and objectification theory, this study aims to examine the association between selfie-posting on social networking sites (SNSs) and exercise for weight control among Chinese young women, as well as the mediating role of body surveillance. A sample of 467 Chinese female students with a BMI lower than 24 were recruited. Participants voluntarily completed questionnaires assessing their selfie-posting behavior on SNSs, body surveillance, and their weight control motivation for exercise. The results show that selfie-posting on SNSs is positively associated with exercise for weight control, and that body surveillance significantly mediates this association. The results suggest that interventions targeting selfie behaviors on SNSs may be an effective way to prevent unhealthy exercise motivations, such as exercise for weight control, among young women with a low BMI.

The Freiburg sport therapy program for eating disorders: a randomized controlled trial

BackgroundUnhealthy attitudes towards sport and problematic exercise behavior in eating disorders (ED) are common and associated with poorer treatment outcome and higher relapse rates. There is a need to develop and empirically test interventions that could complement standard treatment. The study aimed to assess the efficacy of the Freiburg sport therapy program for eating disorders (FSTP).MethodsOutpatients with ED were randomized either to a 3 month sport therapy program (sport therapy group: STG) or a waiting list control group (CG). Patients were assessed when starting the program and at the end of the intervention. The intervention group (STG) was followed up after 6 month. Main outcome criterion was a reduction in unhealthy exercise (Commitment to Exercise Scale, CES). Secondary outcomes encompassed eating pathology (Eating Disorder Examination, EDE), different dimensions of unhealthy exercise (Compulsive Exercise Test, CET subscales) and exercise quantity (accelerometer).ResultsRecruitment was challenging. Fifteen patients were randomized to the STG and 11 were randomized to the CG condition. There was no statistically significant difference between groups according to the main outcome criterion. However, the STG showed a significantly stronger reduction in avoidance and rule driven behavior (CET subscale) when compared to the CG. Improvements (STG) were maintained at follow up.ConclusionsThere was no statistically significant difference in the reduction of unhealthy attitudes towards sport and problematic exercise behavior between the intervention and the group, as measured with the Commitment to Exercise Scale. Further findings may point to the effectiveness of the program, but have to be interpreted with caution and verified in further studies. A major limitation is the small sample size.Trial registrationStudy register: ISRCTN 14776348 (registered 26 January, 2015.

National Classification of Diet and Exercise Behaviours: How Healthy are Canadian Men?

Introduction: Unhealthy behaviours, including poor diet and lack of physical inactivity, are risk factors for premature mortality in men worldwide. Identifying disparities and inequalities regarding these habits in Canadian men may allow for targeted interventions to promote wellness. Our objective was to evaluate a representative sample of the Canadian men to determine current diet and exercise health behaviours and identify predictors of unhealthy habits. Methods: A total of 5,362 men and women were asked to complete an online survey men’s health. Using a stratification algorithm, 2000 male survey participants which represented the population distribution of Canadian provinces were included in this study. Their diet and exercise behaviours were classified based upon pre-determined thresholds. Results: In this national survey of Canadian men, 48.9% did not meet the recommended 150 minutes of moderate exercise per week and 61.8% were classified as having an unhealthy diet. Multivariable analysis identified age (OR 1.01, p=0.001), inability to work (OR 2.10, p=0.022), income less than $100,000 (OR 1.42-2.20) as significant predictors of unhealthy exercise behavior. Living with parents (OR 1.58, p=0.033), living with a partner and children (OR 1.43, p=0.010), and living with relatives (OR 2.32, p=0.042) were significant predictors of unhealthy eating. Conclusion: This study suggests that many Canadian men do not meet minimal requirements for healthy exercise diet. Given most men are pre-contemplative and contemplative about change, interventions to improve these health behaviours should be directed at health education, awareness, and tools for change. Addressing these behaviours may prevent future morbidity and mortality.

Eating behavior and reasons for exercise among competitive collegiate male athletes

Research concerning eating disorders among adolescent and young adult male athletes is limited compared with female counterparts, but increasing evidence indicates that they may be at unique risk for unhealthy exercise and eating behavior. The current study aimed to characterize unhealthy exercise and eating behavior according to competitive athlete status, as well as per sport type. Collegiate male athletes (N = 611), each affiliated with one of the 10 National College Athletics Association (NCAA) Division I schools in the United States, completed an online survey, reporting on eating and extreme weight control behaviors, and reasons for exercise. Competitive athletes endorsed increased driven exercise and exercising when sick. Baseball players, cyclists, and wrestlers emerged as the sports with the most players reporting elevated Eating Disorder Examination-Questionnaire scores in a clinical range, and basketball players reported the highest rates of binge eating. overall, baseball players, cyclists, rowers, and wrestlers appeared to demonstrate the greatest vulnerability for unhealthy eating and exercise behavior. Findings revealed differences between competitive and non-competitive male athletes. Among competitive athletes, results identified unique risk for unhealthy eating and exercise behavior across a variety of sport categories and support continued examination of these attitudes and behaviors in a nuanced manner. Evidence obtained from well-designed controlled trials without randomization.

Relationship between Health Behaviors and Marital Adjustment and Marital Intimacy in Multicultural Family Female Immigrants.

BackgroundThis study analyzed the relationship between health behaviors and marital adjustment in multicultural couples to evaluate their health status.MethodsMarried couples (70 Korean men and their immigrant wives) completed a structured interview on health behaviors and sociodemographic factors, the Revised Dyadic Adjustment Scale (RDAS), and the Marital Intimacy Scale. Based on the cutoff value of the RDAS, respondents were classified into two groups: high or low dyadic adaptation groups. The collected data were compared with health behavior regarding smoking, alcohol consumption, exercise, and weight.ResultsThe odds ratio (OR) (95% confidence interval [CI]) by logistic regression with adjustment for age, educational level, career, occupation, length of residence in Korea, nationality, religion, age difference between couple, number of children, monthly income, and proficiency in Korean was 1.279 (1.113–1.492) for unhealthy exercise and 1.732 (1.604–1.887) for unhealthy body weight in female immigrants with low marital adjustment. In Korean husbands with low marital adjustment, the OR (95% CI) was 1.625 (1.232–2.142) for smoking and 1.327 (1.174– 1.585) for unhealthy exercise. No significant relationship was found between marital intimacy and health behaviors in female immigrants or Korean husbands.ConclusionMore desirable health behaviors were observed in highly adapted couples. Therefore, family physicians should be concerned with marital adjustment and other associative factors to evaluate and improve multicultural couples’ health status.

Composite health behaviour classifier as the basis for targeted interventions and global comparisons in men’s health

Lifestyle-related diseases are the leading cause of death among North American men. We evaluated health behaviours and their predictors that contribute to morbidity and mortality among Canadian men as a means to making recommendations for targeted interventions. A cross-sectional analysis of Canadian men drawn from 5362 visitors to our online survey page was conducted. The current study sample of 2000 men (inclusion: male and >18 years; exclusion: incomplete surveys) were stratified to the 2016 Canadian census. The primary outcome was the number of unhealthy men classified using our Canadian Composite Classification of Health Behaviour (CCCHB) score. Secondary outcomes included the number of men with unhealthy exercise, diet, smoking, sleep, and alcohol intake, as well as socioeconomic and demographic factors associated with unhealthy behaviours to be used for targeting future interventions. Only 118/2000 (5.9%) men demonstrated 5/5 healthy behaviours, and 829 (41.5%) had 3/5 unhealthy behaviours; 391 (19.6%) men currently smoked, 773 (38.7%) demonstrated alcohol overuse, 1077 (53.9%) did not get optimal sleep (<7 or >9 hours per night), 977 (48.9%) failed to exercise >150 minutes/week, and 1235 (61.8%) had an unhealthy diet. Multivariate analysis indicated that men with high school education were at increased risk of unhealthy behaviours (odds ratio [OR] 1.58; 95% confidence interval [CI] 1.15-2.18; p=0.005), as were men living with relatives (OR 2.10; 95% CI1.04-4.26; p=0.039), or with their partner and children (OR 1.34; 95% CI 1.02-1.76; p=0.034). An overwhelming 41.5% of Canadian men had 3/5 unhealthy behaviours, affirming the need for targeted lifestyle interventions. Significant health inequities within vulnerable subgroups of Canadian men were identified and may guide the content and delivery of future interventions.

Addiction, Passion, or Confusion? New Theoretical Insights on Exercise Addiction Research From the Case Study of a Female Body Builder.

Exercise addiction is widely studied in sport science and psychology, but at this time it is not recognized as an independently diagnosable mental or psychiatric disorder. Indeed, studies on exercise addiction assess a level of risk for disordered exercise behaviour, characterized by lack of control and negative personal consequences. It is argued that commitment and passion are two overlapping features of high exercise involvement which obscure the fine line between healthy and unhealthy exercise. The present case study examined a successful female body builder who initially claimed that she was addicted to exercise. During an interview she also completed three questionnaires and her appraisal of well-being in eight life domains were assessed at present, as well as retrospectively before her intensive involvement with exercise. She was screened under the Non-Substance Related Disorders category of Substance-Related and Addictive Disorders classification of DSM-5 for gambling, by replacing the word "gambling" with "exercise". Although she was susceptible to exercise addiction, attained high scores on obsessive passion, exhibited more than four symptoms on the DSM list, she exhibited no signs of loss of control and she mainly reported positive experiences associated with her exercise behaviour. She has obtained a nearly maximum score on commitment to exercise and high score on harmonious passion. Almost all aspects of her life have changed in positive direction after getting intensely involved in exercise. This case illustrates that the current scholastic path to the study of exercise addiction may be obscured by ambiguous assumptions and unilateral quantitative focus.

Women's dieting goals (weight loss, weight maintenance, or not dieting) predict exercise motivation, goals, and engagement in undergraduate women: A self-determination theory framework

Attempts at weight control are common in university students. Two of the most commonly cited methods of weight control are dieting and exercise. The purpose of this study was to assess if different dieting identities/motives predicted exercise goals, motivations, and frequency/intensity of exercise in undergraduate women. Participants were 117 women from a large university in the United States. Participants completed a set of empirically supported questionnaires inquiring about dieting identity (weight loss, weight maintenance, or non-dieting), exercise frequency and intensity, exercise goals (e.g. health vs. weight loss), and exercise motivations. Women were also asked to self-identify as dieting to lose weight, dieting to maintain weight, or not dieting. Non-dieters and women dieting for weight loss were more likely to engage in exercise for extrinsic and aesthetic reasons. Women dieting for weight maintenance were more likely to report intrinsic goals and motivation for exercise. Consistent with previous work, weight loss as a goal was associated with unhealthy dieting and exercise participation. Individuals dieting for weight loss are at increased risk for discontinuing exercise. Health benefits, and not weight loss, should be emphasised for exercise interventions for undergraduates.

“If it’s not Iron it’s Iron f*cking biggest Ironman”: personal trainers’ views on health norms, orthorexia and deviant behaviours

ABSTRACTOrthorexia nervosa (ON) describes a pathological obsession with healthy eating to avoid ill health. In the Swedish context, ON is also understood in terms of unhealthy exercise. Fitness gyms are popular health-promoting places, but exercise-related problems, disordered eating and ON-like behaviour are increasing. Personal trainers (PTs) play an important role in detecting unhealthy behaviours. The aim of the present study was to illuminate PTs’ understandings of healthy and unhealthy exercise and eating behaviours in relation to orthorexia nervosa in a fitness gym context. Five focus groups with 14 PTs were conducted. These were analysed using interpretative qualitative content analysis and Becker’s model “Kinds of Deviance.” In contrast to PTs’ health norms (practicing balanced behaviours and contributing to well-being), ON was expressed mainly in terms of exercise behaviour and as being excessive and in total control. The PTs maintain that extreme behaviours are legitimized by an aggressive exercise trend in society and that they fear to falsely accuse clients of being pathological. Certain sport contexts (bodybuilding, fitness competitions and elite sports) and specific groups (fitness professionals) contribute to complicating PTs’ negotiations due to a competition, performance and/or profession norm, making it difficult to determine whether or not to intervene.

Using Social Network Analysis to Better Understand Compulsive Exercise Behavior Among a Sample of Sorority Members.

Compulsive exercise, a form of unhealthy exercise often associated with prioritizing exercise and feeling guilty when exercise is missed, is a common precursor to and symptom of eating disorders. College-aged women are at high risk of exercising compulsively compared with other groups. Social network analysis (SNA) is a theoretical perspective and methodology allowing researchers to observe the effects of relational dynamics on the behaviors of people. SNA was used to assess the relationship between compulsive exercise and body dissatisfaction, physical activity, and network variables. Descriptive statistics were conducted using SPSS, and quadratic assignment procedure (QAP) analyses were conducted using UCINET. QAP regression analysis revealed a statistically significant model (R2 = .375, P < .0001) predicting compulsive exercise behavior. Physical activity, body dissatisfaction, and network variables were statistically significant predictor variables in the QAP regression model. In our sample, women who are connected to "important" or "powerful" people in their network are likely to have higher compulsive exercise scores. This result provides healthcare practitioners key target points for intervention within similar groups of women. For scholars researching eating disorders and associated behaviors, this study supports looking into group dynamics and network structure in conjunction with body dissatisfaction and exercise frequency.

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

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.

Sociocultural and psychological considerations of pediatric obesity and eating disorder symptomatology in Canadian immigrants

This article reviews pediatric obesity and eating disorders in the context of unique issues facing immigrants. Soci- ocultural factors such as the obesogenic environment and unhealthy food and exercise habits as well as psychological factors such as acculturation and fat oppression have been identified as important in understanding and preventing obesity and other eating disorders. In particular, survey data are presented to show that an immigrant's age of first introduction to Canadian culture and subsequent enculturation over the lifespan are highly predictive of eating disorder symptomatology. The possible causal connection between obesity and eating disorder symptomatology is discussed. Recommendations for research, practice and prevention agendas are outlined in the aim of promoting pediatric health and wellness.

Excessive Exercise: a New Definition of Health

Absolutely unrealistic body images promoted by mass media seems to negatively affect behavior of different age groups, but is particularly evident among adolescents and young people. It results with low self-esteem, negative self-image, impaired contacts with peers, unhealthy diet and excessive exercise. The last two can also be accompanied by uncontrolled use of pharmacological agents, including prescription drugs, to achieve a desired body shape. It's not easy to distinguish between healthy and unhealthy exercise since both may share same attributes. In recent years media willing promote, variously defined, a ‘healthy lifestyle’ as defensive shield against various civilization diseases. There are also no doubts about positive effects of sport on variety of health indicators. The aim of the study is to answer whether it's possible to examine social context of exercise addiction. In order to do this authors prepared original questionnaire that was disseminated among participants together with Exercise Addiction Inventory (EAI). Additionally, a special emphasis was placed on previous medical records, other addictions and possible negative consequences of the behavior. The study took place between May and October 2014.