Assessment and treatment of compulsive exercise in anorexia nervosa - A combined investigation of Compulsive Exercise Activity Therapy (LEAP) and Compulsive Exercise Test subscales

Astrid Harris; Haider Mannan; Phillipa Hay; Phillip Aouad; Jon Arcelus; Evelyn Attia; Ross Crosby; Sloane Madden; Caroline Meyer; Stephen Touyz

doi:10.1016/j.eatbeh.2023.101825

Assessment and treatment of compulsive exercise in anorexia nervosa - A combined investigation of Compulsive Exercise Activity Therapy (LEAP) and Compulsive Exercise Test subscales

Eat Behav. 2024 Jan:52:101825. doi: 10.1016/j.eatbeh.2023.101825. Epub 2023 Nov 13.

Authors

Astrid Harris¹, Haider Mannan², Phillipa Hay³, Phillip Aouad⁴, Jon Arcelus⁵, Evelyn Attia⁶, Ross Crosby⁷, Sloane Madden⁸, Caroline Meyer⁹, Stephen Touyz¹⁰

Affiliations

¹ The University of Sydney, Australia. Electronic address: astrid.harris@sydney.edu.au.
² Translational Health Research Institute, School of Medicine, Western Sydney University. Electronic address: H.Mannan@westernsydney.edu.au.
³ Translational Health Research Institute, School of Medicine, Western Sydney University; Mental Health Services, SWSLHD, Campbellown, Australia. Electronic address: P.Hay@westernsydney.edu.au.
⁴ The University of Sydney, Australia; InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District. Electronic address: phillip.aouad@sydney.edu.au.
⁵ Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom. Electronic address: Jon.Arcelus@nottingham.ac.uk.
⁶ New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, USA; Weill Cornell Medical College, New York, USA. Electronic address: Evelyn.Attia@nyspi.columbia.edu.
⁷ Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA. Electronic address: Ross.Crosby@SandfordHealth.org.
⁸ Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. Electronic address: sloane.madden@health.nsw.gov.au.
⁹ International Digital Laboratory, The University of Warwick, Coventry CV4 7AL, UK. Electronic address: C.Meyer@warwick.ac.uk.
¹⁰ The University of Sydney, Australia; InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District. Electronic address: stephen.touyz@sydney.edu.au.

PMID: 38006774
DOI: 10.1016/j.eatbeh.2023.101825

Abstract

Introduction: Compulsive exercise is a transdiagnostic feature of eating disorders which adversely affects aspects of recovery, such as length of hospitalisation, risk of a chronic outcome, and risk of relapse. CompuLsive Exercise Activity TheraPy (LEAP) aims to reduce compulsive exercise through a cognitive behavioural approach. This study aims to investigate the effect of LEAP on compulsive exercise behaviour using subscales of the Compulsive Exercise Test (CET), a measure of exercise in individuals with eating disorders. Predictive validity of the CET's subscales and its ability to predict eating psychopathology are investigated.

Method: This study used data from a randomized controlled trial of LEAP (1). Linear mixed modelling was used to investigate the effect of LEAP on compulsive exercise behaviour, and the predictive ability of CET subscales on various outcomes. The CET was compared to other exercise measures to assess its superiority in predicting eating psychopathology.

Results: LEAP was superior in reducing the scores of the CET's Avoidance and Rule Driven Behaviour and Exercise Rigidity subscales. All subscales made a contribution to the respective models. The CET was superior to other measures in predicting eating pathology.

Conclusion: The results lend credibility to LEAP's ability to reduce core parts of compulsive exercise. The CET has been found to target important aspects of compulsive exercise behaviour, and has was superior to other exercise measures in predicting eating psychopathology.

Keywords: Assessment; Compulsive exercise; Compulsive exercise test; Eating disorders; Psychometrics; compuLsive Exercise Activity Therapy.

Publication types

Randomized Controlled Trial

MeSH terms

Anorexia Nervosa* / diagnosis
Anorexia Nervosa* / therapy
Cephalothin
Compulsive Behavior / diagnosis
Compulsive Behavior / psychology
Compulsive Behavior / therapy
Compulsive Exercise
Exercise / psychology
Feeding and Eating Disorders*
Humans

Substances

Cephalothin