Psychosocial etiology of maladaptive exercise and its role in eating disorders: A systematic review.

Sasha Gorrell, Rachael E Flatt, Cynthia M Bulik, Daniel Le Grange

Journal: The International journal of eating disorders 2021;54(8):1358-1376

PMID: 33942917

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Abstract

OBJECTIVE

Although maladaptive exercise (ME) is widely recognized as a clinical feature in transdiagnostic eating disorders, less is known about psychosocial factors that give rise to and perpetuate this behavior. This systematic review aimed to examine the empirical status of this association.

METHOD

We reviewed 46 full text articles examining longitudinal associations between psychosocial variables and ME.

RESULTS

Eighteen studies met full inclusion criteria. Based on our qualitative synthesis, evidence suggests reasonably consistent associations between early concern with weight and shape, and negative affect on later development of ME.

DISCUSSION

Inconsistent and insufficient assessment of ME across a majority of studies underscores caution in interpretation of results, but guides important discussion for future clinical and research efforts.

Address: Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA.

DOI: 10.1002/eat.23524