ArticleJournal of eating disorders2018
Running on empty - a nationwide large-scale examination of compulsive exercise in eating disorders.
Article in Journal of eating disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Perfectionism and compulsive exercise: a systematic review and preliminary meta-analysis.Eating and weight disorders : EWD · 2025Pooled it
- Psychosocial etiology of maladaptive exercise and its role in eating disorders: A systematic review.The International journal of eating disorders · 2021Pooled it
- Physical Activity in Eating Disorders: A Systematic Review.Nutrients · 2020Pooled it
- Swedish Clinicians' Knowledge, Practices, and Access to Structured Guidance Regarding Maladaptive Exercise in Eating Disorders.Scandinavian journal of psychology · 2026Article
- Feeling Better Before, Not After: An Ecological Momentary Assessment of Affect Around Exercise in Women With Eating Disorders.The International journal of eating disorders · 2026Article
- Compulsive exercise in adults with trichotillomania and skin picking disorder.Journal of behavioral addictions · 2026Article
- Reasons for exercise inventory: A validation of the Dutch version in a community sample and a sample of women with an eating disorder.Journal of health psychology · 2026Article
- Associations between compulsive exercise and mental health constructs in eating disorders.Journal of eating disorders · 2026Article
- Maladaptive Exercise in People With a Lifetime History of Eating Disorders: A Multicountry Observational Study.The International journal of eating disorders · 2026Observational
- Feeling Better Before, Not After: An Ecological Momentary Assessment of Affect Around Exercise in Women with Eating Disorders.medRxiv : the preprint server for health sciences · 2025Article
- Psychobiological Exercise Response: A Pilot Investigation of a Laboratory Exercise Assessment Paradigm Among Young Women With Eating Disorders.The International journal of eating disorders · 2025Article
- Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy).Child and adolescent psychiatry and mental health · 2025Article
- Consensus-Based Recommendations for Yoga as Adjunct Therapy in Eating Disorder Treatment: A Delphi Study.The International journal of eating disorders · 2025Article
- "To exercise sustainably" - Patients' experiences of compulsive exercise in eating disorders and the Compulsive Exercise Activity Therapy (LEAP) as a treatment: a qualitative interview study.Journal of eating disorders · 2024Article
- Maladaptive exercise in eating disorders: lifetime and current impact on mental health and treatment seeking.Journal of eating disorders · 2024Article
- Direct, indirect, and reciprocal associations between perfectionism, compulsive exercise and eating disorder pathology in adolescents with eating disorders.Eating and weight disorders : EWD · 2024Article
- Subtypes of exercise are differentially associated with baseline eating disorder pathology and treatment outcome among individuals with bulimia nervosa.The International journal of eating disorders · 2024Article
- Adaptive and Maladaptive Exercise in Eating Disorders.Current topics in behavioral neurosciences · 2024Review
- Patterns of maladaptive exercise behavior from ages 14-24 in a longitudinal cohort.Journal of child psychology and psychiatry, and allied disciplines · 2023Article
- Affective profiles of exercise episodes are associated with maladaptive and adaptive motivations for exercise.European eating disorders review : the journal of the Eating Disorders Association · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCompulsive 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.
methodsCE 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.
resultsCE 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.
conclusionsAt 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.
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