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Obligatory exercise and coping in treatment-seeking women with poor body image

  • Kelsey N. Serier
  • Jane Ellen Smith
  • Denise N. Lash
  • Loren M. Gianini
  • Jennifer A. Harriger
  • Ruth E. Sarafin
  • Brenda L. Wolfe
Original Article

Abstract

Purpose

Obligatory exercise is characterized by continued exercise despite negative consequences, and intense negative affect when unable to exercise. Research suggests psychosocial differences between individuals that exercise in an obligatory manner and those that do not. It also has been speculated that obligatory exercise may serve coping and affect regulation functions, yet these factors have not been routinely examined in community women with poor body image. The purpose of the current study was to investigate psychosocial differences between obligatory and non-obligatory exercisers, and to examine the use of obligatory exercise as an avoidant coping strategy in a sample of women with poor body image.

Methods

Women (n = 70) seeking treatment for body dissatisfaction were divided into obligatory and non-obligatory exercise groups based on their scores on the Obligatory Exercise Questionnaire. Participants then completed an assessment battery about eating pathology, body image, reasons for exercise, coping strategies, and negative affect.

Results

Independent t test analyses indicated that obligatory exercisers had significantly greater eating disorder symptomatology, avoidant coping, and appearance- and mood-related reasons for exercise than non-obligatory exercisers. Multiple regression analyses revealed that eating disorder symptomatology and avoidant coping were significant predictors of obligatory exercise.

Conclusions

There are distinct psychosocial differences between women with poor body image who exercise in an obligatory fashion and those who do not. The current study suggests that obligatory exercise may serve as an avoidant coping strategy for women with poor body image. Enhancing healthy coping strategies may be an important addition to body image improvement programs.

Level of evidence

V, cross-sectional descriptive study.

Keywords

Obligatory exercise Coping Body image Negative affect 

Notes

Funding

This study was not supported by funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

References

  1. 1.
    Fallon EA, Harris BS, Johnson P (2014) Prevalence of body dissatisfaction among a United States adult sample. Eat Behav 15:151–158.  https://doi.org/10.1016/j.eatbeh.2013.11.007 CrossRefPubMedGoogle Scholar
  2. 2.
    Kruger J, Galuska DA, Serdula MK, Jones DA (2004) Attempting to lose weight: specific practices among US adults. Am J Prev Med 26:402–406.  https://doi.org/10.1016/j.amepre.2004.02.001 CrossRefPubMedGoogle Scholar
  3. 3.
    Penedo FJ, Dahn JR (2005) Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry 18:189–193.  https://doi.org/10.1016/j.yco.2004.09.001 CrossRefPubMedGoogle Scholar
  4. 4.
    Mond JM, Hay PJ, Rodgers B, Owen C (2006) An update on the definition of “excessive exercise” in eating disorders research. Int J Eat Disord 39:147–153.  https://doi.org/10.1002/eat.20214 CrossRefPubMedGoogle Scholar
  5. 5.
    Thome JL, Espelage DL (2007) Obligatory exercise and eating pathology in college females: Replication and development of a structural model. Eat Behav 8:334–339.  https://doi.org/10.1016/j.eatbeh.2006.11.009 CrossRefPubMedGoogle Scholar
  6. 6.
    Davis C (1997) Body image, exercise, and eating behaviors. In: Fox K (ed) The physical self: From motivation to well-being. Human Kinetics, Champaign, pp 143–174Google Scholar
  7. 7.
    Peñas-Lledó E, Vaz Leal FJ, Waller G (2002) Excessive exercise in anorexia nervosa and bulimia nervosa: relation to eating characteristics and general psychopathology. Int J Eat Disord 31:370–375.  https://doi.org/10.1002/eat.10042 CrossRefPubMedGoogle Scholar
  8. 8.
    Meyer C, Taranis L, Goodwin H, Haycraft E (2011) Compulsive exercise and eating disorders. Eur Eat Disord Rev 19:174–189.  https://doi.org/10.1002/erv.1122 CrossRefPubMedGoogle Scholar
  9. 9.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th edn). American Psychiatric Publishing, ArlingtonCrossRefGoogle Scholar
  10. 10.
    Rudolph S (2017) The connection between exercise addiction and orthorexia nervosa in German fitness sports. Eat Weight Disord.  https://doi.org/10.1007/s40519-017-0437-2 PubMedGoogle Scholar
  11. 11.
    Adkins EC, Keel PK (2005) Does “excessive” or “compulsive” best describe exercise as a symptom of bulimia nervosa? Int J Eat Disord 38:24–29.  https://doi.org/10.1002/eat.20140 CrossRefPubMedGoogle Scholar
  12. 12.
    Davis C, Fox J (1993) Excessive exercise and weight preoccupation in women. Addict Behav 18:201–211CrossRefPubMedGoogle Scholar
  13. 13.
    Coen SP, Ogles BM (1993) Psychological characteristics of the obligatory runner: a critical examination of the anorexia analogue hypothesis. J Sport Exerc Psychol 15:338–354.  https://doi.org/10.1123/jsep.15.3.338 CrossRefGoogle Scholar
  14. 14.
    Steffen JJ, Brehm BJ (1999) The dimensions of obligatory exercise. Eat Disord 7:219–226.  https://doi.org/10.1080/10640269908249287 CrossRefGoogle Scholar
  15. 15.
    Boyd C, Abraham S, Luscombe G (2007) Exercise behaviours and feelings in eating disorder and non-eating disorder groups. Eur Eat Disord Rev 15:112–118.  https://doi.org/10.1002/erv.769 CrossRefPubMedGoogle Scholar
  16. 16.
    Mond JM, Calogero RM (2009) Excessive exercise in eating disorder patients and in healthy women. Aust N Z J Psychiatry 43:227–234.  https://doi.org/10.1080/00048670802653323 CrossRefPubMedGoogle Scholar
  17. 17.
    Macfarlane L et al (2016) Identifying the features of an exercise addiction: a Delphi study. J Behav Addict 5:474–484.  https://doi.org/10.1556/2006.5.2016.060 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Mond JM, Hay PJ, Rodgers B, Owen C, Beumont PJ (2004) Relationships between exercise behaviour, eating-disordered behaviour and quality of life in a community sample of women: when is exercise ‘excessive?’ Eur Eat Disord Rev 12:265–272.  https://doi.org/10.1002/erv.579 CrossRefGoogle Scholar
  19. 19.
    Taranis L, Meyer C (2011) Associations between specific components of compulsive exercise and eating-disordered cognitions and behaviors among young women. Int J Eat Disord 44:452–458.  https://doi.org/10.1002/eat.20838 CrossRefPubMedGoogle Scholar
  20. 20.
    Freimuth M, Moniz S, Kim SR (2011) Clarifying exercise addiction: Differential diagnosis, co-occurring disorders, and phases of addiction. Int J Res Public Health 8:4069–4081.  https://doi.org/10.3390/ijerph8104069 CrossRefGoogle Scholar
  21. 21.
    Smith JE, Wolfe BL, Laframboise DE (2001) Body image treatment for a community sample of obligatory and non-obligatory exercisers. Int J Eat Disord 30:375–388.  https://doi.org/10.1002/eat.1099 CrossRefPubMedGoogle Scholar
  22. 22.
    Bratland-Sanda S, Martinsen EW, Rosenvinge JH, Rø Ø, Hoffart A, Sundgot-Borgen J (2011) Exercise dependence score in patients with longstanding eating disorders and controls: the importance of affect regulation and physical activity intensity. Eur Eat Disord Rev 19:249–255.  https://doi.org/10.1002/erv.971 CrossRefPubMedGoogle Scholar
  23. 23.
    Lease HJ et al (2016) My mother told me: the roles of maternal messages, body image, and disordered eating in maladaptive exercise. Eat Weight Disord 21:469–476.  https://doi.org/10.1007/s40519-015-0238-4 CrossRefPubMedGoogle Scholar
  24. 24.
    Thome J, Espelage DL (2004) Relations among exercise, coping, disordered eating, and psychological health among college students. Eat Behav 5:337–351.  https://doi.org/10.1016/j.eatbeh.2004.04.002 CrossRefPubMedGoogle Scholar
  25. 25.
    De Young KP, Anderson DA (2010) Prevalence and correlates of exercise motivated by negative affect. Int J Eat Disord 43:50–58.  https://doi.org/10.1002/eat.20656 CrossRefPubMedGoogle Scholar
  26. 26.
    Compas BE, Jaser SS, Dunbar JP, Watson KH, Bettis AH, Gruhn MA, Williams EK (2014) Coping and emotion regulation from childhood to early adulthood: points of convergence and divergence. Aust J Psychol 66:71–81.  https://doi.org/10.1111/ajpy.12043 CrossRefPubMedGoogle Scholar
  27. 27.
    Zalewski M, Lengua LJ, Wilson AC, Trancik A, Bazinet A (2011) Associations of coping and appraisal styles with emotion regulation during preadolescence. J Exp Child Psychol 110:141–158.  https://doi.org/10.1016/j.jecp.2011.03.001 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Fairburn CG, Cooper Z, Shafran R (2003) Cognitive behavior therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther 41:509–528.  https://doi.org/10.1016/S0005-7967(02)00088-8 CrossRefPubMedGoogle Scholar
  29. 29.
    Lawson R, Waller G, Lockwood R (2007) Cognitive content and process in eating disordered patients with obsessive-compulsive features. Eat Behav 8:305–310.  https://doi.org/10.1016/j.eatbeh.2006.11.006 CrossRefPubMedGoogle Scholar
  30. 30.
    Stice E (2001) A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. J Abnorm Psychol 110:124–135.  https://doi.org/10.1037/0021-843X.110.1.124 CrossRefPubMedGoogle Scholar
  31. 31.
    Metropolitan Life Insurance Company (1983). 1983 height and weight tables. Stat Bull Metrop Life Found 6:3–9Google Scholar
  32. 32.
    Brown T, Cash T, Mikulka P (1990) Attitudinal body-image assessment: Factor analysis of the Body-Self Relations Questionnaire. J Pers Assess 55:889–897.  https://doi.org/10.1080/00223891.1990.9674053 CrossRefGoogle Scholar
  33. 33.
    Cash TF (1994) Users’ manual for the Multidimensional Body-Self Relations Questionnaire. Old Dominion University, NorfolkGoogle Scholar
  34. 34.
    First MB, Spitzer RL, Gizzon M, Williams JBW (2002) Structured clinical interview for DSM-IV-RT axis I disorders. Biometrics Research, New YorkGoogle Scholar
  35. 35.
    Pasman, L, Thompson JK (1998) Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. Int J Eat Disord 7:759–769.  https://doi.org/10.1002/1098-108X(198811)7:6<759::AID-EAT2260070605>3.0.CO;2-G CrossRefGoogle Scholar
  36. 36.
    Cooper PJ, Taylor MJ, Cooper Z, Fairburn CG (1987) The development and validation of the body shape questionnaire. Int J Eat Disord 6:485–494.  https://doi.org/10.1002/1098-108X(198707)6:4<485::AID-EAT2260060405>3.0.CO;2-O CrossRefGoogle Scholar
  37. 37.
    Garner DM, Garfinkel PE (1979) The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychol Med 9:273–279.  https://doi.org/10.1017/S0033291700030762 CrossRefPubMedGoogle Scholar
  38. 38.
    Endler NS, Parker JDA (1999) Coping inventory for stressful situations (CISS) manual, 2nd edn. Multi-Health Systems, TorontoGoogle Scholar
  39. 39.
    Silberstein LR, Striegel-Moore RH, Timko C, Rodin J (1988) Behavioral and psychological implications of body dissatisfaction: do men and women differ? Sex Roles 19:219–232.  https://doi.org/10.1007/BF00290156 CrossRefGoogle Scholar
  40. 40.
    Beck AT, Steer RA, Brown GK (1996) Beck depression inventory-II. Psychological Corporation, TexasGoogle Scholar
  41. 41.
    Spielberger C (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, CaliforniaGoogle Scholar
  42. 42.
    Cash T (2008) The body image workbook: an eight-step program for learning to like your looks. New Harbinger Publications, CaliforniaGoogle Scholar
  43. 43.
    IBM Corp (2016) IBM SPSS Statistics for Windows, Version 24.0. IBM, New YorkGoogle Scholar
  44. 44.
    Verhoef MJ, Love EJ (1994) Women and exercise participation: the mixed blessing of motherhood. Health Care Women Int 15:297–306.  https://doi.org/10.1080/07399339409516122 CrossRefPubMedGoogle Scholar
  45. 45.
    Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med 12:871–878.  https://doi.org/10.1017/S0033291700049163 CrossRefPubMedGoogle Scholar
  46. 46.
    Shroff H, Reba L, Thornton LM, Tozzi F, Klump KL, Berrettini WH et al (2006) Features associated with excessive exercise in women with eating disorders. Int J Eat Disord 39:454–461.  https://doi.org/10.1002/eat.20247 CrossRefPubMedGoogle Scholar
  47. 47.
    Borkovec TD (2002) Life in the future versus life in the present. Clin Psychol Sci Pract 9:78–80.  https://doi.org/10.1093/clipsy.9.1.76 CrossRefGoogle Scholar
  48. 48.
    Roemer L, Orsillo SM (2002) Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive behavioral models. Clin Psychol Sci Pract 9:54–68.  https://doi.org/10.1093/clipsy.9.1.54 CrossRefGoogle Scholar
  49. 49.
    Loumidis K, Wells A (2001) Exercising for the wrong reasons: relationships among eating disorder beliefs, dysfunctional exercise beliefs and coping. Clin Psychol Psychother 8:416–423.  https://doi.org/10.1002/cpp.298 CrossRefGoogle Scholar
  50. 50.
    Sherwood NE, Crowther JH, Wills L, Ben-Porath YS (2000) The perceived function of eating for bulimic, subclinical bulimic, and non-eating disordered women. Behav Ther 31:777–793.  https://doi.org/10.1016/S0005-7894(00)80044-1 CrossRefGoogle Scholar
  51. 51.
    VanBoven AM, Espelage DL (2006) Depressive symptoms, coping strategies, and disordered eating among college women. J Couns Dev 84:341–348.  https://doi.org/10.1002/j.1556-6678.2006.tb00413.x CrossRefGoogle Scholar
  52. 52.
    Belon KE, McLaughlin EA, Smith JE, Bryan AD, Witkiewitz K, Lash DN, Winn JL (2015) Testing the measurement invariance of the Eating Disorder Inventory in non-clinical samples of Hispanic and Caucasian women. Int J Eat Disord 48:262–270.  https://doi.org/10.1002/eat.22286 CrossRefPubMedGoogle Scholar
  53. 53.
    Belon KE, Smith JE, Bryan AD, Lash DN, Winn JL, Gianini LM (2011) Measurement invariance of the Eating Attitudes Test-26 in Caucasian and Hispanic women. Eat Behav 12:317–320.  https://doi.org/10.1016/j.eatbeh.2011.07.007 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of New MexicoAlbuquerqueUSA
  2. 2.Intermountain Health CareOgdenUSA
  3. 3.Columbia University Medical CenterNew YorkUSA
  4. 4.Social Science DivisionPepperdine UniversityMalibuUSA
  5. 5.Eating Disorders Institute of New MexicoRio RanchoUSA

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