Driven exercise in the absence of binge eating: Implications for purging disorder

作者：Lydecker Janet A.^*; Shea Megan; Grilo Carlos M.

来源：International Journal of Eating Disorders, 2018, 51(2): 139-145.

DOI：10.1002/eat.22811

• compulsive exercise
• driven exercise
• other specified feeding or eating disorder
• purging disorder

ObjectivePurging disorder (PD) is characterized by recurrent purging without objectively large binge-eating episodes. PD has received relatively little attention, and questions remain about the clinical significance of purging by exercise that is driven or compulsive (i.e., as extreme compensatory or weight-control behavior). The little available research suggests that individuals who use exercise as a compensatory behavior might have less eating-disorder psychopathology than those who purge by vomiting or laxatives, but those studies have had smaller sample sizes, defined PD using low-frequency thresholds, and defined exercise without weight-compensatory or driven elements.
MethodParticipants (N=2,017) completed a web-based survey with established measures of eating-disorder psychopathology, depression, and physical activity. Participants were categorized (regular compensatory driven exercise, PD-E, n=297; regular compensatory vomiting/laxatives, PD-VL, n=59; broadly defined anorexia nervosa, AN, n=20; and no eating-disordered behaviors, NED, n=1,658) and compared.
ResultsPD-E, PD-VL, and AN had higher eating-disorder psychopathology and physical activity than NED but did not significantly differ from each other on most domains. PD-VL and AN had higher depression than PD-E, which was higher than NED.
DiscussionFindings suggest that among participants with regularly compensatory behaviors without binge eating, those who use exercise alone have similar levels of associated eating-disorder psychopathology as those who use vomiting/laxatives, although they have lower depression levels and overall frequency of purging. Findings provide further support for the clinical significance of PD. Clinicians and researchers should recognize the severity of driven exercise as a compensatory behavior, and the need for further epidemiological and treatment research.

• 出版日期2018-2