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Eating disorders linked to exercise addiction

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A meta-analysis found that people displaying characteristics of an eating disorder are 3.7 times more likely to suffer from addiction to exercise than people displaying no indication of an eating disorder.

The study, led by Mike Trott of Anglia Ruskin University (ARU) is the first to measure rates of exercise addiction in groups of people with and without the characteristics of an eating disorder. The meta-analysis examined data from 2,140 participants across nine different studies, including from the UK, the US, Australia and Italy.

Trott, a PhD researcher in Sport Science at Anglia Ruskin University (ARU), said: “It is known that those with eating disorders are more likely to display addictive personality and obsessive-compulsive behaviours. We are also aware that having an unhealthy relationship with food often means an increased amount of exercising, but this is the first time that a risk factor has been calculated.

“It is not uncommon to want to improve our lifestyles by eating healthier and doing more exercise, particularly at the start of the year. However, it is important to moderate this behaviour and not fall victim to ‘crash diets’ or anything that eliminates certain foods entirely, as these can easily lead to eating disorders.

“Our study shows that displaying signs of an eating disorder significantly increases the chance of an unhealthy relationship with exercise, and this can have negative consequences, including mental health issues and injury.

“Health professionals working with people with eating disorders should consider monitoring exercise levels as a priority, as this group have been shown to suffer from serious medical conditions as a result of excessive exercise, such as fractures, increased rates of cardiovascular disease in younger patients, and increased overall mortality.”

Abstract
Background: Exercise addiction is associated with multiple adverse outcomes and can be classified as co-occurring with an eating disorder, or a primary condition with no indication of eating disorders. We conducted a meta-analysis exploring the prevalence of exercise addiction in adults with and without indicated eating disorders.
Methods: A systematic review of major databases and grey literature was undertaken from inception to 30/04/2019. Studies reporting prevalence of exercise addiction with and without indicated eating disorders in adults were identified. A random effect meta-analysis was undertaken, calculating odds ratios for exercise addiction with versus without indicated eating disorders.

Results: Nine studies with a total sample of 2140 participants (mean age = 25.06; 70.6% female) were included. Within these, 1732 participants did not show indicated eating disorders (mean age = 26.4; 63.0% female) and 408 had indicated eating disorders (mean age = 23.46; 79.2% female). The odds ratio for exercise addiction in populations with versus without indicated eating disorders was 3.71 (95% CI 2.00–6.89; I2 = 81; p  ≤ 0.001). Exercise addiction prevalence in both populations differed according to the measurement instrument used.
Discussion: Exercise addiction occurs more than three and a half times as often as a comorbidity to an eating disorder than in people without an indicated eating disorder. The creation of a measurement tool able to identify exercise addiction risk in both populations would benefit researchers and practitioners by easily classifying samples.

Authors
Mike Trott, Sarah E. Jackson, Joseph Firth, Louis Jacob, Igor Grabovac, Amit Mistry, Brendon Stubbs, Lee Smith

Anglia Ruskin University material

Eating and Weight Disorders: Studies on Anorexia, Bulimia and Obesity 2020 abstract

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