Observational studyThe International journal of eating disorders2026
Maladaptive Exercise in People With a Lifetime History of Eating Disorders: A Multicountry Observational Study.
Observational study in The International journal of eating disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04378101 (Eating Disorders Genetics Initiative), which is not on this map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Eating Disorders Genetics Initiative (EDGI)
Who cites it
3 citing papers in PubMed.
- Maladaptive exercise: the hidden role of physical activity and sport professionals in the early detection of eating disorders.Journal of eating disorders · 2026Article
- Eating disorders and associated mental symptoms in Swedish elite athletes and a comparison group.Discover mental health · 2026Article
- Maladaptive Exercise in People With a Lifetime History of Eating Disorders: A Multicountry Observational Study.The International journal of eating disorders · 2026Observational
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
objectiveMaladaptive exercise (ME), problematic attitudes or behaviors related to physical activity, is often observed in eating disorders (EDs), but its prevalence, severity, and relationships with ED features remain incompletely characterized. This study aimed to describe lifetime and current ME across ED diagnoses, examine associations with ED symptoms, sociodemographic characteristics, and weight status, and compare ME phenotypes to identify those most strongly linked to ED features.
methodsME was assessed in 31,671 individuals with lifetime EDs (anorexia nervosa [AN], bulimia nervosa, and binge-eating disorder [BED]) recruited to sites in the United States, Australia, New Zealand, and Sweden as part of the Eating Disorders Genetics Initiative (NCT04378101). We examined one lifetime ME phenotype, capturing any occurrence of ME across the lifespan (derived from the ED100K), and five current ME phenotypes (any driven exercise [Eating Disorder Examination-Questionnaire, EDE-Q], frequency of driven exercise [EDE-Q], regular driven exercise [EDE-Q], compulsive exercise test [CET] total, and dichotomous compulsive exercise [CET]).
resultsLifetime ME was highly prevalent across countries and ED diagnoses (pooled prevalence 88%). Current ME was also common (40% any driven exercise, 35% compulsive exercise, and 12% regular driven exercise), highest in AN and lowest, but notable, in BED. CET-based phenotypes showed the strongest association with ED symptoms, while EDE-Q-derived regular driven exercise was most strongly associated with underweight (BMI < 18.5). Younger generations exhibited a higher ME risk, likely reflecting societal shifts in body ideals and fitness culture. DISCUSSION: This large, multicountry study demonstrates that ME is highly prevalent across EDs, often emerges early, and can persist or recur for decades. Prevalence and severity vary considerably by assessment method. The ED100K, CET, and EDE-Q capture complementary aspects of ME, and incorporating all three may improve clinical care. We recommend that clinicians assess both current and lifetime ME in all patients with EDs. Routine, harmonized assessment will be essential to advancing research and improving patient outcomes.
trial registrationClinicalTrials.gov identifier: NCT04378101.
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