Gymnastik- och idrottshögskolan, GIH

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Running on empty - a nationwide large-scale examination of compulsive exercise in eating disorders
Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..ORCID iD: 0000-0002-3305-4844
Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..ORCID iD: 0000-0001-9550-3820
Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
2018 (English)In: Journal of Eating Disorders, E-ISSN 2050-2974, Vol. 6, article id 11Article in journal (Refereed) Published
Abstract [en]

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Place, publisher, year, edition, pages
BMC , 2018. Vol. 6, article id 11
Keywords [en]
Eating disorder, Compulsive exercise, Outcome, Females, Males
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:gih:diva-7748DOI: 10.1186/s40337-018-0197-zISI: 000435002200001PubMedID: 29942510OAI: oai:DiVA.org:gih-7748DiVA, id: diva2:1795175
Available from: 2023-09-07 Created: 2023-09-07 Last updated: 2023-09-07

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Forsén Mantilla, Emma

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