Obligatory exercise and coping in treatment-seeking women with poor body image

Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time

Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.

The Relationship between Obligatory Exercise and Eating Attitudes, and the Mediating Role of Sociocultural Attitudes towards Appearance during the COVID-19 Pandemic

A strong sociocultural context could affect an individual's aesthetic standards. In order to achieve a socially recognized ideal appearance, obligatory exercisers might increase dieting behavior when exercise actions are disturbed, thereby placing the individual at risk of eating disorders. The current study mainly examined the relationship between obligatory exercise and eating attitudes during the COVID-19 pandemic, and considered the mediating role of externalized sociocultural attitudes towards appearance between the two. A total of 342 participants (175 females, 167 males) from various regions of China were invited to fill out the questionnaires including the Obligatory Exercise Questionnaire, the Sociocultural Attitudes Toward Appearance Questionnaire-3, and the Eating Attitudes Test. In total, 51.5% of the participants presented symptoms of an obligatory exercise behavior. Among them, males, young adults, and the participants with lower BMI had higher OEQ scores, whereas females and young adults had higher EAT-26 scores. Meanwhile, 9.4% of the participants might have had an eating disorder. The OEQ score was positively correlated with the EAT-26 total score as well as SATAQ-3 'Pressures' and 'Information' subscales. In addition, the EAT-26 total score was positively correlated with the SATAQ-3 'Pressures' and 'Information' subscales. Externalized sociocultural attitudes towards appearance served as a mediator between obligatory exercise behavior and eating attitudes, and the mediation effect accounted for 56.82% of the total effect. Obligatory exercise behavior may have an indirect effect on eating attitudes through sociocultural attitudes towards appearance. Given the sociocultural information and pressures, in order to maintain or pursue an ideal appearance, many people tend to keep a pathological diet. Thus, forming a positive and healthy social aesthetic orientation is beneficial in helping obligatory exercisers to develop reasonable eating habits.

A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders

BACKGROUND

Exercise addiction is associated with multiple adverse outcomes and can be classified as co-occurring with an eating disorder, or a primary condition with no indication of eating disorders. We conducted a meta-analysis exploring the prevalence of exercise addiction in adults with and without indicated eating disorders.

METHODS

A systematic review of major databases and grey literature was undertaken from inception to 30/04/2019. Studies reporting prevalence of exercise addiction with and without indicated eating disorders in adults were identified. A random effect meta-analysis was undertaken, calculating odds ratios for exercise addiction with versus without indicated eating disorders.

RESULTS

Nine studies with a total sample of 2140 participants (mean age = 25.06; 70.6% female) were included. Within these, 1732 participants did not show indicated eating disorders (mean age = 26.4; 63.0% female) and 408 had indicated eating disorders (mean age = 23.46; 79.2% female). The odds ratio for exercise addiction in populations with versus without indicated eating disorders was 3.71 (95% CI 2.00-6.89; I² = 81; p  ≤ 0.001). Exercise addiction prevalence in both populations differed according to the measurement instrument used.

DISCUSSION

Exercise addiction occurs more than three and a half times as often as a comorbidity to an eating disorder than in people without an indicated eating disorder. The creation of a measurement tool able to identify exercise addiction risk in both populations would benefit researchers and practitioners by easily classifying samples.

A Systematic Review and Meta-Analysis on the Relationship between Body Dissatisfaction and Morbid Exercise Behaviour

Background: The present study aimed to quantify the relationship between body dissatisfaction and morbid exercise behaviour (MEB). Methods: The electronic databases MEDLINE, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global were searched from inception to September 2020. Pooled effect sizes corrected for sampling errors (r⁺) were computed using a bare-bones meta-analysis. The robustness of the results was examined by influence analyses. The presence of moderators was examined by inspection of the variance in r⁺ attributable to sampling errors and 80% credibility intervals, followed by subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined by visual inspection of funnel plot symmetry, cumulative meta-analysis, and Egger’s test. Results: A total of 41 effect sizes from 33 studies (n = 8747) were retrieved. Results showed a significant and near to moderate effect size (r⁺ = 0.267, 95% CI = 0.226 to 0.307), and this did not differ by gender, BMI, age, percentage of Whites, study quality, or MEB measure. Conversely, effect sizes were found to be stronger in published and more recently conducted studies. Conclusion: The findings indicate that body dissatisfaction is one of the likely causes underlying MEB. This suggests the need for further longitudinal research aimed at confirming the potential causal nature of this relationship.

Prevalence and Correlates of Exercise Addiction in the Presence vs. Absence of Indicated Eating Disorders

Despite the many benefits of regular, sustained exercise, there is evidence that exercise can become addictive, to the point where the exerciser experiences negative physiological and psychological symptoms, including withdrawal symptoms upon cessation, training through injury, and the detriment of social relationships. Furthermore, recent evidence suggests that the etiology of exercise addiction is different depending on the presence or absence of eating disorders. The aim of this study was to explore to what extent eating disorder status, body dysmorphic disorder, reasons for exercise, social media use, and fitness instructor status were associated with exercise addiction, and to determine differences according to eating disorder status. The key findings showed that the etiology of exercise addiction differed according to eating disorder status, with variables including social media use, exercise motivation, and ethnicity being uniquely correlated with exercise addiction only in populations with indicated eating disorders. Furthermore, body dysmorphic disorder was highly prevalent in subjects without indicated eating disorders, and could be a primary condition in which exercise addiction is a symptom. It is recommended that clinicians and practitioners working with patients who present with symptoms of exercise addiction should be screened for eating disorders and body dysmorphic disorder before treatments are considered.

Morbid exercise behaviour and eating disorders: A meta-analysis

BACKGROUND AND AIMS

This study examined the relationship between self-reported symptoms of morbid exercise behaviour (MEB) and eating disorders (ED) using meta-analytic techniques.

METHODS

We systematically searched MEDLINE, PsycINFO, Web of Science, SciELO and Scopus. Random effects models were used to compute pooled effect sizes estimates (r). The robustness of the summarized estimates was examined through sensitivity analyses by removing studies one at a time.

RESULTS

Sixty-six studies comprising 135 effect-sizes (N = 21,816) were included. The results revealed: (a) small-sized relationship in the case of bulimic symptoms (r = 0.19), (b) small- (r = 0.28) to medium-sized relationships (r = 0.41) in the case of body/eating concerns, and (c) medium-sized relationships in the case of overall ED symptoms (r = 0.35) and dietary restraint (r = 0.42). Larger effect sizes were observed in the case of overall ED symptoms in clinical, younger, and thinner populations, as well as when employing a continuously-scored instrument for assessing ED or the Compulsive Exercise Test for assessing MEB. Larger effect sizes were also found in female samples when the ED outcome was dietary restraint.

CONCLUSIONS

The identified gaps in the literature suggest that future research on the topic may benefit from: (a) considering a range of clinical (in terms of diagnosed ED) and non-clinical populations from diverse exercise modalities, (b) addressing a wide range of ED symptomatology, and (c) employing longitudinal designs that clarify the temporal direction of the relationship under consideration.