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Article ; Online: Patterns of maladaptive exercise behavior from ages 14-24 in a longitudinal cohort.

Schaumberg, Katherine / Bulik, Cynthia M / Micali, Nadia

Journal of child psychology and psychiatry, and allied disciplines

2023 Volume 64, Issue 11, Page(s) 1555–1568

Abstract: Background: Exercise for weight loss and maladaptive exercise (exercise that results in negative consequences or interference with daily life) are common behaviors among youth and are associated with increased risk of disordered eating symptoms. The ... ...

Abstract	Background: Exercise for weight loss and maladaptive exercise (exercise that results in negative consequences or interference with daily life) are common behaviors among youth and are associated with increased risk of disordered eating symptoms. The current study clarifies processes that influence exercise-related risk in adolescence and young adulthood, including the frequency with which young people transition between engaging in exercise for weight loss and experiencing negative consequences of this behavior. Method: Participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) reported on eating disorder cognitions at age 14, and exercise behavior at ages 14, 16, 18, and 24 years old. Analyses examined rates of transition between the categories of 'No Exercise for Weight Loss', 'Exercise for Weight Loss', and 'Maladaptive Exercise' over time, identified overall trends in endorsement of exercise for weight loss and maladaptive exercise, and clarified predictors of these behaviors. Results: Endorsement of exercise for weight loss and maladaptive exercise increased over time in both males and females. Those in the 'Exercise for Weight Loss' category were more likely than those in the 'No Exercise for Weight Loss Category' to transition to 'Maladaptive Exercise' over time. Body mass index (Age 13) and fear of weight gain (Age 14) were consistent predictors of maladaptive exercise across sex. Conclusions: Results support re-framing motivations for exercise in youth away from weight loss at a population level and targeting reductions in fear of weight gain for high-risk individuals.
MeSH term(s)	Male ; Female ; Adolescent ; Child ; Humans ; Young Adult ; Adult ; Longitudinal Studies ; Feeding Behavior ; Body Mass Index ; Weight Gain ; Weight Loss ; Feeding and Eating Disorders
Language	English
Publishing date	2023-05-31
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	218136-8
ISSN	1469-7610 ; 0021-9630 ; 0373-8086
ISSN (online)	1469-7610
ISSN	0021-9630 ; 0373-8086
DOI	10.1111/jcpp.13844
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Article ; Online: A pilot randomized trial of the body advocacy movement: a novel, dissonance-based intervention designed to target fear of weight gain and anti-fat bias in young adults.

Pictor, Lauren E / Laboe, A A / Dillon, K / Frank, M / Gavuji, M / Krawczyk, A / Schaumberg, Katherine

Eating disorders

2024 , Page(s) 1–20

Abstract: The Body Advocacy Movement (BAM) is a novel, cognitive-dissonance-based intervention designed to target fatphobia and anti-fat bias as mechanisms to drive reductions in eating disorder (ED) risk. Previous dissonance-based programs (i.e. the Body Project; ...

Abstract	The Body Advocacy Movement (BAM) is a novel, cognitive-dissonance-based intervention designed to target fatphobia and anti-fat bias as mechanisms to drive reductions in eating disorder (ED) risk. Previous dissonance-based programs (i.e. the Body Project; BP) have successfully targeted thin-ideal internalization as an intervention mechanism. As burgeoning research indicates that fatphobia and anti-fat bias may play a central role in the maintenance of ED pathology, a focused intervention designed to target these constructs could bolster prevention efforts. The aims of this pilot study include confirming acceptability and feasibility of BAM and developing preliminary estimates of its effects on intervention targets, along with benchmarking these effects against the BP intervention. BAM was found to be accepted by participants and feasible to facilitate in a peer-led model. Preliminary results from 50 participants (BAM:
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1209799-8
ISSN	1532-530X ; 1064-0266 ; 1067-1633
ISSN (online)	1532-530X
ISSN	1064-0266 ; 1067-1633
DOI	10.1080/10640266.2024.2332823
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Article ; Online: Working out measurement overlap in the assessment of maladaptive exercise.

Lampe, Elizabeth W / Schaumberg, Katherine / Kolar, David / Coniglio, Kathryn / Cooper, Marita / Chapa, Danielle A N / Gorrell, Sasha

The International journal of eating disorders

2024 Volume 57, Issue 3, Page(s) 558–567

Abstract: Objective: Although exercise is generally considered healthy, many individuals engage in maladaptive exercise (e.g., compulsive in nature). Several definitions of maladaptive exercise exist, leading to multiple, varied assessment tools; assuming ... ...

Abstract	Objective: Although exercise is generally considered healthy, many individuals engage in maladaptive exercise (e.g., compulsive in nature). Several definitions of maladaptive exercise exist, leading to multiple, varied assessment tools; assuming homogeneity across these assessments contributes to low consensus in etiological models. Method: We used a Jaccard Index to quantify content overlap among 15 commonly-used self-report instruments measuring maladaptive exercise, with 31 features identified across 224 items. Results: The most common features were exercise to control weight/shape and to avoid negative affect (both included in 9/15 instruments), or compensate for calories consumed (8/15 instruments). Overlap among instruments was low (.206) and no features were common across all instruments. Conclusions: Findings generally support theoretical models of exercise in eating pathology. However, instruments most commonly used to assess maladaptive exercise measure heterogenous content. Careful consideration should be taken when comparing findings derived from differing instruments, when synthesizing literature on maladaptive exercise, and when selecting instruments to measure specific maladaptive exercise features. Public significance: Many, varied, tools exist for the assessment of maladaptive exercise (e.g., compulsive or compensatory) in the context of eating disorders. Assuming homogeneity across tools contributes to low consensus in the field. We used a Jaccard Index to quantify content overlap among 15 self-report instruments measuring maladaptive exercise. The most commonly used instruments measure heterogenous content. Careful consideration should be taken when synthesizing literature and selecting instruments to use in research.
MeSH term(s)	Humans ; Feeding and Eating Disorders/diagnosis
Language	English
Publishing date	2024-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.24127
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Article ; Online: Open Science in eating disorders: Using current evidence to inspire a plan for increasing the transparency of our research.

Gorrell, Sasha / Cohen, Shira / Schaumberg, Katherine / Anderson, Lisa Marie / Reilly, Erin E

The International journal of eating disorders

2023 Volume 56, Issue 5, Page(s) 925–932

Abstract: Objective: There is increasing consensus that open science practices improve the transparency and quality of clinical science. However, several barriers impede the implementation of these practices at the individual, institutional, and field levels; ... ...

Abstract	Objective: There is increasing consensus that open science practices improve the transparency and quality of clinical science. However, several barriers impede the implementation of these practices at the individual, institutional, and field levels; understanding and addressing these barriers is critical to promoting targeted efforts in increasing effective uptake of open science. Methods: Within this research forum, we drew from publicly available online information sources to identify initial characterizations of researchers engaged in several types of open science practices in the field of eating disorders. We use these observations to discuss potential barriers and recommendations for next steps in the promotion of these practices. Results: Data from online open science repositories suggest that individuals using these publishing approaches with pre-prints and articles with eating-disorder-relevant content are predominantly non-male gender identifying, early to mid-career stage, and are more likely to be European-, United States-, or Canada-based. Discussion: We outline recommendations for tangible ways that the eating disorder field can support broad, increased uptake of open science practices, including supporting initiatives to increase knowledge and correct misconceptions; and prioritizing the development and accessibility of open science resources. Public significance statement: The use of open science practices has the potential to increase the transparency and quality of clinical science. This Forum uses publicly sourced online data to characterize researchers engaged in open science practices in the field of eating disorders. These observations provide an important framework from which to discuss potential barriers to open science and recommendations for next steps in the promotion of these practices.
MeSH term(s)	Humans ; Publishing ; Feeding and Eating Disorders ; Canada
Language	English
Publishing date	2023-01-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.23893
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Article ; Online: Change in adaptive and maladaptive exercise and objective physical activity throughout CBT for individuals with eating disorders.

Wons, Olivia / Lampe, Elizabeth / Patarinski, Anna Gabrielle / Schaumberg, Katherine / Juarascio, Adrienne

Eating and weight disorders : EWD

2023 Volume 28, Issue 1, Page(s) 40

Abstract: Maladaptive exercise (i.e., exercise that compensates for binge eating or is used to avoid negative consequences of not exercising-like weight gain) is a common eating disorder (ED) behavior, yet, some individuals with EDs only engage in adaptive ... ...

Abstract	Maladaptive exercise (i.e., exercise that compensates for binge eating or is used to avoid negative consequences of not exercising-like weight gain) is a common eating disorder (ED) behavior, yet, some individuals with EDs only engage in adaptive exercise. CBT for EDs targets reducing maladaptive exercise but does not address adaptive exercise. Thus, research is limited on how adaptive and maladaptive exercise are impacted during CBT for EDs. The current study examined how assessor-rated adaptive and maladaptive exercise and objectively measured physical activity changed over a 12-week CBT treatment among adults with transdiagnostic binge eating and restrictive eating that did and did not engage in maladaptive exercise at the start of treatment (n = 13 non-maladaptive exercise group, n = 17 maladaptive exercise group). The overall amount of adaptive and maladaptive exercise was measured via the Eating Disorder Examination Interview and objectively measured physical activity (e.g., step count, minutes of moderate-to-vigorous physical activity [MVPA]) was measured via a wrist-worn fitness tracker. Throughout treatment, the overall amount of adaptive exercise did not significantly change for both groups, but the overall amount of maladaptive exercise significantly decreased in the maladaptive exercise group. Step count did not significantly change for both groups, but minutes of MVPA significantly increased over treatment for the non-maladaptive exercise group. Increases in step count and minutes of MVPA were not associated with ED symptom changes in either group. These results enhance an understanding of exercise changes during transdiagnostic CBT-based ED treatment for individuals with varying baseline exercise profiles.Level of evidence: Level 1, randomized controlled trial.
MeSH term(s)	Adult ; Humans ; Cognitive Behavioral Therapy/methods ; Feeding and Eating Disorders/therapy ; Binge-Eating Disorder/therapy ; Exercise ; Bulimia
Language	English
Publishing date	2023-04-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2038625-4
ISSN	1590-1262 ; 1124-4909
ISSN (online)	1590-1262
ISSN	1124-4909
DOI	10.1007/s40519-023-01566-z
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Article ; Online: Prospective Associations Between Driven Exercise and Other Eating Disorder Behaviors in Adolescence: A Longitudinal Cohort Study.

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

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

2022 Volume 70, Issue 5, Page(s) 781–787

Abstract: 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- ... ...

Abstract	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.
MeSH term(s)	Adolescent ; Binge-Eating Disorder ; Cross-Sectional Studies ; Feeding Behavior ; Feeding and Eating Disorders ; Female ; Humans ; Longitudinal Studies ; Male
Language	English
Publishing date	2022-01-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1063374-1
ISSN	1879-1972 ; 1054-139X
ISSN (online)	1879-1972
ISSN	1054-139X
DOI	10.1016/j.jadohealth.2021.11.022
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Article ; Online: Perceived influence of wearable fitness trackers on eating disorder symptoms in a clinical transdiagnostic binge eating and restrictive eating sample.

Wons, Olivia / Lampe, Elizabeth / Patarinski, Anna Gabrielle / Schaumberg, Katherine / Butryn, Meghan / Juarascio, Adrienne

Eating and weight disorders : EWD

2022 Volume 27, Issue 8, Page(s) 3367–3377

Abstract: Wearable fitness trackers are an increasingly popular tool for measuring physical activity (PA) due their accuracy and momentary data collection abilities. Despite the benefits of using wearable fitness trackers, there is limited research in the eating ... ...

Abstract	Wearable fitness trackers are an increasingly popular tool for measuring physical activity (PA) due their accuracy and momentary data collection abilities. Despite the benefits of using wearable fitness trackers, there is limited research in the eating disorder (ED) field using wearable fitness trackers to measure PA in the context of EDs. Wearable fitness trackers are often underused in ED research because there is limited knowledge about whether wearable fitness trackers negatively or positively impact PA engagement and ED symptoms in individuals with EDs. The current study aimed to assess the perceived impact wearable fitness trackers have on PA engagement and ED symptoms over a 12-week CBT treatment for 30 individuals with binge eating and restrictive eating that presented to treatment engaging or not engaging in maladaptive exercise. Participants in the maladaptive exercise group (n = 17) and non-maladaptive exercise group (n = 13) wore a fitness tracker for 12 weeks and completed questionnaires assessing participants' perceptions of the fitness trackers' influence on ED symptoms and PA engagement throughout treatment. Results demonstrated a small percentage of individuals perceived the fitness tracker influenced ED behaviors or PA engagement, and there were mixed results on whether participants positively or negatively perceived the fitness tracker influenced them to engage in ED behaviors or PA engagement. Although preliminary, these results demonstrate the need to continue using objective measurements of PA via wearable fitness trackers to further our understanding of the positive and negative effects of fitness trackers on clinical ED samples.Level of Evidence: Level 1, randomized controlled trial.
MeSH term(s)	Humans ; Binge-Eating Disorder/diagnosis ; Binge-Eating Disorder/therapy ; Feeding and Eating Disorders ; Feeding Behavior ; Fitness Trackers ; Surveys and Questionnaires
Language	English
Publishing date	2022-08-25
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2038625-4
ISSN	1590-1262 ; 1124-4909
ISSN (online)	1590-1262
ISSN	1124-4909
DOI	10.1007/s40519-022-01466-8
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Article: Compulsive exercise or exercise dependence? Clarifying conceptualizations of exercise in the context of eating disorder pathology.

Scharmer, Christina / Gorrell, Sasha / Schaumberg, Katherine / Anderson, Drew

Journal of clinical sport psychology

2019 Volume 46

Abstract: Objective: Maladaptive exercise relates to eating disorder (ED) pathology and impairment in clinical and non-clinical populations. At present, two different conceptualizations of maladaptive exercise are often studied in relation to ED pathology: ... ...

Abstract	Objective: Maladaptive exercise relates to eating disorder (ED) pathology and impairment in clinical and non-clinical populations. At present, two different conceptualizations of maladaptive exercise are often studied in relation to ED pathology: compulsive exercise and exercise dependence. Compulsive exercise functions to avoid negative affect (e.g., guilt and anxiety) associated with not exercising, whereas exercise dependence is associated with tolerance to exercise benefits and avoidance of exercise withdrawal. At present, clinicians and researchers struggle to determine the most appropriate term for describing problematic exercise in individuals with ED pathology. This study aimed to directly compare these conceptualizations of maladaptive exercise in relation to severity of ED pathology. Design: This study examined cross-sectional data. Method: Undergraduate participants ( Results: Results suggest that compulsive qualities of exercise, including exercise to control shape and weight and to avoid negative affect are more strongly associated with severity of ED pathology than qualities of exercise dependence. Conclusions: Clinicians and researchers working with ED populations can benefit from prioritizing assessments that capture compulsive qualities of exercise. Additionally, these results suggest that interventions that effectively target other compulsive behaviors (e.g., exposure and response prevention) may be promising treatment options for problematic exercise in the context of EDs.
Language	English
Publishing date	2019-09-16
Publishing country	United States
Document type	Journal Article
ISSN	1932-9261
ISSN	1932-9261
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Article ; Online: Registered report: A pilot investigation of acute exercise response among girls and young women with and without eating disorders.

Schaumberg, Katherine / Peters, Danielle / Ahrenholtz, Rachel / Crombie, Kevin M / Zhang, Ruisu / Gorrell, Sasha

The International journal of eating disorders

2021 Volume 54, Issue 11, Page(s) 2057–2065

Abstract: Objective: Driven exercise (DEx) is a serious and common feature of eating disorders (EDs), but current understanding of factors that give rise to and maintain DEx is limited. DEx may be reinforced through its effects on the threat reduction and reward ... ...

Abstract	Objective: Driven exercise (DEx) is a serious and common feature of eating disorders (EDs), but current understanding of factors that give rise to and maintain DEx is limited. DEx may be reinforced through its effects on the threat reduction and reward systems. The current protocol is designed to evaluate acute psychobiological response to exercise among female participants (age 16-22) with and without EDs. Method: Twenty medically-stable participants with restrictive-spectrum EDs and 20 healthy control (HC) participants will complete study screening and three task visits which will include two 30-minute bouts of aerobic exercise. Results: We aim to validate and demonstrate feasibility of two tasks capturing exercise response in this sample. Further, we will estimate the degree to which a bout of exercise impacts state body image, affect, and circulating concentrations of biological markers among participants, and we will examine whether the impact of exercise on psychological outcomes may differ across ED and HC groups. Discussion: Completion of this project will contribute to the conceptualization of DEx and how individuals' acute biological and affective responses to exercise contribute to risk for and maintenance of DEx.
MeSH term(s)	Adolescent ; Adult ; Body Image ; Exercise ; Feeding and Eating Disorders/diagnosis ; Feeding and Eating Disorders/therapy ; Female ; Humans ; Pilot Projects ; Young Adult
Language	English
Publishing date	2021-07-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.23587
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Article ; Online: Dietary restraint and weight loss as risk factors for eating pathology.

Schaumberg, Katherine / Anderson, Drew

Eating behaviors

2016 Volume 23, Page(s) 97–103

Abstract: Measures of dietary restraint do not consistently predict caloric restriction, and these scales appear inadequate for differentiating between healthy and risky restraint in individuals. The current study examined the relationship between self-reported ... ...

Abstract	Measures of dietary restraint do not consistently predict caloric restriction, and these scales appear inadequate for differentiating between healthy and risky restraint in individuals. The current study examined the relationship between self-reported dietary restraint, recent weight loss, body mass index (BMI), and eating pathology in a college sample to determine if dietary restraint coupled with caloric restriction would prove to be a more sensitive marker of eating disorder risk than restraint alone. Participants (N=245) completed a series of measures evaluating dietary restraint, recent weight loss, and eating habits. Results suggested that dietary restraint related most consistently to eating pathology, with more nuanced results for women regarding the relations between dietary restraint, recent weight loss, and BMI. Findings provided further evidence that dietary restraint and weight loss may relate to eating pathology through independent pathways. In addition, recent weight loss may be a relevant risk factor for women at lower current BMI.
MeSH term(s)	Body Mass Index ; Caloric Restriction/psychology ; Diet, Reducing/psychology ; Feeding Behavior/psychology ; Feeding and Eating Disorders/psychology ; Female ; Humans ; Risk Factors ; Self Report ; Students/psychology ; Universities ; Weight Loss ; Young Adult
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2073366-5
ISSN	1873-7358 ; 1471-0153
ISSN (online)	1873-7358
ISSN	1471-0153
DOI	10.1016/j.eatbeh.2016.08.009
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