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Prospective Associations Between Driven Exercise and Other Eating Disorder Behaviors in Adolescence: A Longitudinal Cohort Study

Research output: Contribution to journalArticlepeer-review

Katherine E. Schaumberg, Lauren Robinson, Ayelet Hochman, Nadia Micali

Original languageEnglish
Pages (from-to)781-787
Number of pages7
JournalJournal of Adolescent Health
Issue number5
Early online date24 Jan 2022
Accepted/In press2022
E-pub ahead of print24 Jan 2022
PublishedMay 2022

Bibliographical note

Funding Information: This research was specifically funded by NIH K01MH123914 (PI: Schaumberg). Dr. Lauren Robinson receives salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM) and KCL. Funding Information: The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z ) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors, and Nadia Micali, Katherine Schaumberg, Lauren Robinson, and Ayelet Hochman will serve as guarantors for the contents of this paper. Publisher Copyright: © 2021 Society for Adolescent Health and Medicine

King's Authors


Purpose: Dysfunctional exercise is a common, debilitating symptom across eating disorders (ED). We examined the cross-sectional and longitudinal associations between experiences of exercise and ED behaviors and cognitions in an adolescent, population-based sample. Methods: Adolescents (n = 4,054) self-reported whether they exercised to control shape and weight (exercise for weight loss [EWL]), and, if so, whether they exercised even when injured, and whether exercise interfered with life functioning (driven exercise) at age 14 years, allowing delineation of three exercise-based groups: no-EWL, EWL, and driven exercise. Participants also reported ED cognitions at age 14 years along with other ED behaviors (fasting, purging, binge eating) at ages 14 and 16 years. Sex-stratified regression approaches were employed to examine relationships between these exercise categories at age 14 and ED behaviors and cognitions at ages 14 and 16. Results: Cross-sectionally, those in the driven exercise group, compared to the no-EWL group, consistently reported higher levels of ED cognitions and behaviors, with those in the EWL group also reporting higher levels of some ED cognitions and behaviors relative to the no-EWL group. Those in the EWL and driven exercise groups at age 14 also demonstrated a higher prospective likelihood of fasting (boys and girls) and purging (girls only) at age 16, relative to those in the no-EWL group at age 14. Discussion: Results inform our understanding of EWL and driven exercise and the developmental timing of ED behaviors in adolescence and point toward the potential utility of targeted prevention for young people who report EWL.

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