secondary exercise addiction Flashcards
does exercise addiction occur in the absnece of eating issues
Whilst primary exercise addiction has emegred as a thing, most studies measuring this fail to account for eating disorders-
mixed findings on whether exercise addiction occurs in the absence of eating issues-
Many studies assessing primary exercise addiction do not screen for eating
problems.
* EA deemed to be present among non-eating disordered sample (Trott et al., 2020).
* Cunningham et al., (2016) 22% of likely cases of identified problematic exercise
were not linked with any ED symptoms.
* BUT exercise addiction is three times more common in those with EDs (Trott et al.,
2021)
* Elevated levels of disordered eating symptoms in EA sample compared to controls
(Grandi et al., 2011)
cunningham study suggests 2 types of exercise addiction- Cunningham et al., (2016)
* ~ 1500 adults completed a range of measures of problematic exercise and disordered eating.
* Correlations between all measures of problematic exercise (regardless of framework).
* Participants with EDs scored highest on all measures of problematic exercise
* Those with PE and an ED scored higher on measures that adopted a compulsive framework.
* EDE-Q and problematic exercise link was strongest in women.
however this study is cross sectional and we do not know if these people later developed ED
Minnesota study
Minnesota semi-starvation
experiment (Keys et al., 1950)
* 36 young men – a year-long experiment into the physiological and psychological
effects of semi-starvation.
Ethical concerns?
12-week control 24-weeks semistarvation
12-week rehabilitation
* Significant physiological and psychological effects
* Food obsessions and overeating
* Increased restlessness in some men
desire to move/ fidgiting
urge to exercise in EDs
Anorexia nervosa is characterised by drive for thinness, weight loss, food restriction
and fear of weight gain.
* Unexpected relationship between undernutrition and underweight with desire and
ability for movement in those with anorexia nervosa (e.g., Gull, 1874; Lasegue,
1873).
* Davis et al., (1997) – increases in exercise prior to, and in the acute phases of an ED.
* Association between food restriction and recorded physical activity and degree of
restlessness in AN. High levels of ‘fidgeting’ (Belak et al., 2017).
Casper et al., (2020).
* N = 83 adolescent patients with AN.
* Measures - Reactions to weight loss questionnaire; measures of eating psychopathology;
Compulsive Exercise Test; information on physical activity behaviours.
* Most (>80%) reported increased desire or urge for movement, physical restlessness, or
mental restlessness after significant weight loss
* Increased urge for movement co-existed with feelings of lethargy and fatigue.
* Dysfunction of energy-regulating pathways in AN?
problematic exercise and ED
Up to 80% of ED patients present with compulsive exercise (Shroff et al., 2006).
* Eating disorders are common among athletes (Sundgot-Borgen & Torstveit, 2004).
* Exercise attitudes/behaviours change in the early stages of an eating disorder.
* Notion of “excessive exercise”
*Exercise for calorie burning & weight loss
*Frequency/duration of activity unrelated to eating psychopathology
Transdiagnostic definition of Compulsive Exercise in EDs
clinicical questions
Transdiagnostic definition of Compulsive Exercise in EDs (A+B)
A(1) Excessive exercise that the patient feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
A(2) The exercise aims to prevent some dreaded consequence or reducing distress, often based on distorted beliefs about exercise.
B The exercise is time-consuming (> 1 hour a day), significantly interferes
with the person’s daily routine, occupational functioning or social relationships or is continued despite medical injury, illness, or lack of enjoyment.
(OPTIONAL)
C The patient recognises that the compulsive exercising is excessive or
unreasonable.
theory of compulsive exercise in ED
summarizing the Cognitive-Behavioral Model of Compulsive Exercise (Meyer et al., 2011) in the context of eating disorders. It highlights the key cognitive and behavioral components that drive compulsive exercise in individuals with disordered eating. Here’s a breakdown of each point:
Cognitive-Behavioral Components; Multi-Faceted (Meyer et al., 2011)
This emphasizes that compulsive exercise is driven by both cognitive (thought-based) and behavioral (action-based) factors and is influenced by multiple aspects, including emotional regulation, rigid beliefs, and reinforcement mechanisms.
Rigidity Towards Exercise (e.g., routes, calories)
Individuals with compulsive exercise tendencies follow strict rules about their workouts, such as:
Always exercising at the same time or taking the exact same route.
Ensuring a specific number of calories are burned per session.
Feeling distress if they cannot stick to their planned routine.
Feeling Guilty When Unable to Exercise
Missing a workout leads to intense guilt, anxiety, or self-criticism.
This guilt reinforces the need to compensate by exercising more later or restricting food intake.
Exercising Despite Illness or Injury
The drive to exercise overrides physical well-being, leading individuals to push through pain, fatigue, or sickness rather than resting.
This highlights compulsive and maladaptive behaviors, as a healthy relationship with exercise would prioritize recovery.
Exercising to Avoid Negative Feelings or Moods
Exercise is used as a coping mechanism to regulate emotions, such as:
Stress relief
Anxiety reduction
Temporary mood boosts
However, this creates a dependency on exercise for emotional stability, which can be unhealthy when taken to an extreme.
Exercise to Manage Shape and Weight
The primary motivation for exercise in individuals with eating disorders is often weight control and body image concerns rather than health or enjoyment.
This links compulsive exercise to disordered eating behaviors, as it is often paired with food restriction, bingeing, or purging.
Overall Meaning of the Slide
The slide is explaining how exercise becomes compulsive in eating disorders due to rigid cognitive rules, guilt-driven reinforcement, emotional avoidance, and weight-focused motivations. This aligns with Meyer et al.’s (2011) model, which describes how these factors interact to maintain compulsive exercise despite its negative consequences.
cognitive behavioural model of compulsive exercise p2
Meyer 2011-
The Cognitive-Behavioral Model of Compulsive Exercise (often applied to secondary exercise addiction) explains how excessive exercise is maintained and reinforced through a cycle of cognitive distortions (thoughts), behaviors, and emotional responses. It is particularly relevant in individuals with eating disorders, where exercise is used as a means of controlling weight, reducing anxiety, or compensating for food intake.
Key Components of the Model
This model suggests that compulsive exercise is driven by cognitive biases, maladaptive beliefs, and reinforcement mechanisms. Here’s a breakdown:
Core Beliefs About Self-Worth & Control
Individuals with compulsive exercise tendencies often have rigid beliefs linking their self-worth to body image, weight, or performance.
Example: “If I don’t exercise, I am lazy and undisciplined.”
They may also believe exercise is necessary for emotional regulation, control, or maintaining their identity.
Cognitive Distortions & Obsessive Thoughts
These beliefs fuel distorted thinking patterns, such as:
All-or-nothing thinking (“If I don’t exercise every day, I will become overweight.”)
Catastrophizing (“If I skip one workout, I will lose all my progress.”)
Overgeneralization (“People who don’t exercise are failures.”)
The individual may overestimate the impact of missing a workout, increasing anxiety.
Emotional & Psychological Reinforcement
Exercise is used as a coping mechanism to reduce anxiety, guilt, or negative emotions associated with body image or eating.
It provides temporary relief, reinforcing the belief that exercise is necessary to feel okay.
Compulsive Exercise Behavior
Driven by these obsessive thoughts, the person engages in rigid, excessive exercise routines.
They ignore physical pain, fatigue, or injuries to maintain their regimen.
Exercise becomes a non-negotiable part of daily life, prioritized over social, academic, or work commitments.
Negative Consequences & Maintenance of the Cycle
Over time, physical exhaustion, injuries, or burnout may occur.
However, rather than adjusting behavior, the person interprets these negative outcomes as signs of weakness, reinforcing the need to exercise even more.
If unable to exercise, feelings of guilt, anxiety, and self-criticism increase, leading to compensatory behaviors such as food restriction or purging.
How the Cycle Perpetuates Itself
This model forms a self-reinforcing loop:
Rigid Beliefs About Exercise & Self-Worth → Obsessive Thoughts About Exercising → Emotional Relief Through Exercise → Exercise Becomes Compulsive → Negative Consequences (Injury, Fatigue, Social Isolation) → Increased Anxiety & Need to Exercise More.
Since skipping workouts causes intense distress, the person remains trapped in a compulsive cycle, making it difficult to break free.
Implications for Treatment
Understanding this model helps guide Cognitive-Behavioral Therapy (CBT) for compulsive exercise by:
Challenging cognitive distortions (e.g., identifying irrational beliefs about exercise and body image).
Developing healthier coping strategies for stress and anxiety (rather than relying on exercise).
Introducing flexibility in exercise routines to break the rigid, compulsive patterns.
Addressing underlying eating disorder symptoms that contribute to compulsive exercise.
evidence for this model
- Exercise as a form of emotion regulation – e.g., Bratland-Sanda et al., 2010
- Compulsivity for exercise (e.g., feeling guilty) – e.g., Cook & Hausenblas (2008).
- Perfectionism – e.g., Egan et al. (2017).
- Rigidity – e.g., Boyd et al. (2007).
exercise for affect regulation
Emotion regulation difficulties common in ED
(particularly binge-purge).
* Dysfunctional emotion regulation
prospectively linked to CE (e.g., Goodwin, Haycraft
& Meyer, 2014).
* Exercising for emotion regulation (specifically,
avoidance of low mood) a primary feature
among patients (Bratland-Sanda et al., 2010).
* Negative rather than positive reinforcement
mechanism.
