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The role of physical activity in the development and maintenance of eating disorders

Published online by Cambridge University Press:  09 July 2009

C. Davis ,
S. H. Kennedy ,
E. Ravelski  and
M. Dionne
C. Davis*
Affiliation:
Departments of Psychiatry and Psychology, The Toronto Hospital, Toronto, Ontario, Canada
S. H. Kennedy
Affiliation:
Departments of Psychiatry and Psychology, The Toronto Hospital, Toronto, Ontario, Canada
E. Ravelski
Affiliation:
Departments of Psychiatry and Psychology, The Toronto Hospital, Toronto, Ontario, Canada
M. Dionne
Affiliation:
Departments of Psychiatry and Psychology, The Toronto Hospital, Toronto, Ontario, Canada
*
*Address for correspondence: Dr Caroline Davis, 343 Bethune College, York University, 4700 Keele Street, North York, Ontario, M3J 1P3, Canada
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Synopsis

This study was intended to establish the pathogenic significance of sport and exercise in the development of eating disorders. Hospitalized eating disordered patients and an age-matched control group were assessed. Historical and current physical activity data were collected. An in-depth interview was also conducted to ascertain the age of onset of the diagnostic symptoms for eating disorders, and to determine whether: (i) exercising predated dieting; (ii) patients had been involved in competitive athletics; (iii) exercise was excessive; and (iv) weight loss was inversely related to level of exercise. The results indicated that patients were more physically active than controls from adolescence onwards, and prior to the onset of the primary diagnostic criteria for anorexia nervosa. A content analysis of the interview data indicated that 78% of patients engaged in excessive exercise, 60% were competitive athletes prior to the onset of their disorder, 60% reported that sport or exercise pre-dated dieting, and 75% claimed that physical activity levels steadily increased during the period when food intake and weight loss decreased the most. Together our results suggest that overactivity should not be routinely viewed as a secondary symptom in anorexia nervosa, equivalent to other behaviours. For a number of anorexic women, sport/exercise is an integral part of the pathogenesis and progression of self-starvation.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 4 , November 1994 , pp. 957 - 967
Copyright
Copyright © Cambridge University Press 1994

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References

American Psychiatric Association (1987). Diagnostic and Statistical Manual for Mental Disorders, 3rd edn, Revised. APA: Washington, DC.Google Scholar
Barr, L. C., Goodman, W. K., Price, L. H., McDougle, C. J. & Charney, D. S. (1992). The serotonin hypothesis of obsessive compulsive disorder: Implications of pharmacologic challenge studies. Journal of Clinical Psychiatry 53, 17–28.Google ScholarPubMed
Bouchard, C., Shephard, R. J. & Stephens, T. (1993). Physical Activity, Fitness and Health Consensus Statement. Human Kinetics Publishers: Champaign, IL.Google Scholar
Brownell, K. D. & Rodin, J. (1992). Prevalence of eating disorders in athletes. In Eating, Body Weight and Performance in Athletes (ed. Brownell, K. D., Rodin, J. and Wilmore, J.), pp. 128–145. Lea & Febiger: Philadelphia.Google Scholar
Bruch, H. (1965). Anorexia nervosa – Its differential diagnosis. Journal of Mental and Nervous Disorders 141, 555–566.CrossRefGoogle Scholar
Buck, M. & Marrazzi, M. A. (1987). Atypical responses to morphine in mice: a possible relationship to anorexia nervosa? Life Sciences 41, 765–773.CrossRefGoogle ScholarPubMed
Burckes-Miller, M. & Black, D. (1991). College athletes and eating disorders: a theoretical context. In Eating Disorders Among Athletes: Theories, Issues, and Research (ed. Black, D.), pp. 11–26. American Alliance for Health, Physical Education, Recreation & Dance: Reston, VA.Google Scholar
Casperson, C. (1989). Physical activity epidemiology: Concepts, methods, and application to exercise science. Exercise and Sport Sciences Reviews: Volume 17 (ed. Pandolf, K. B.), pp. 423–473. Williams & Wilkins: Baltimore.Google Scholar
Crisp, A. H. (1967). The possible significance of some behavioral correlates of weight and carbohydrate intake. Journal of Psychosomatic Research 11, 117–131.CrossRefGoogle ScholarPubMed
Dally, P. J. (1969). Anorexia Nervosa. Grune & Stratton: New York.Google Scholar
Davis, C. (1992). Body image, dieting behaviours, and personality factors: a study of high-performance female athletes. International Journal of Sport Psychology 23, 179–192.Google Scholar
Durnin, J. V. G. A. (1990). Assessment of physical activity during leisure and work. In Exercise, Fitness, and Health (ed. Bouchard, C., Shephard, R. J., Stephens, T., Sutton, J. R. and McPherson, B. D.), pp. 63–70. Human Kinetics Publishers: Champaign, IL.Google Scholar
Epling, W. F. & Pierce, W. D. (1984). Activity-based anorexia in rats as a function of opportunity to run on an activity wheel. Nutrition and Behavior 2, 37–49.Google Scholar
Epling, W. F. & Pierce, W. D. (1988). Activity-based anorexia: A biobehavioral perspective. International Journal of Eating Disorders 7, 475–485.3.0.CO;2-M>CrossRefGoogle Scholar
Epling, W. F. & Pierce, W. D. (1992). Solving the Anorexia Puzzle. Hogrefe & Huber Publishers: Toronto.Google Scholar
Epling, W. F., Pierce, W. D. & Stefan, L. (1983). A theory of activity-based anorexia. International Journal of Eating Disorders 3, 27–43.3.0.CO;2-T>CrossRefGoogle Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 57–63.CrossRefGoogle ScholarPubMed
Garfinkel, P. E. & Goldbloom, D. M. (1988). Anorexia nervosa and bulimia nervosa (chapter 1.). Anorexia Nervosa and Bulimia Nervosa: Current Update. Toronto: Eating Disorders Group. Department of Psychiatry, Toronto General Hospital.Google Scholar
Garner, D. M., Rockert, W., Olmsted, M. P., Johnson, C. & Coscina, D. V. (1985). Psychoeducational principles in the treatment of bulimia and anorexia nervosa. In Handbook of Psychotherapy for Anorexia Nervosa and Bulimia (ed. Garner, D. M. and Garfinkel, P.), pp. 513–572. The Guilford Press: New York.Google Scholar
Gull, W. W. (1874). Anorexia nervosa. Transactions of the Clinical Society (London) 7, 22–28. (Cited by Warah, A. (1993). In Overactivity and boundary setting in anorexia nervosa: an existential perspective. Journal of Adolescence 16, 93–100.)Google Scholar
Holden, N. L. (1990). Is anorexia nervosa an obsessive-compulsive disorder? British Journal of Psychiatry 157, 1–5.CrossRefGoogle ScholarPubMed
Inches, P. (1895). Anorexia nervosa. Maritime Medical News 7, 73–75.Google Scholar
Katz, J. L. (1986). Long-distance running, anorexia nervosa, and bulimia: a report of two cases. Comprehensive Psychiatry 27, 74–78.CrossRefGoogle ScholarPubMed
Kaye, W. H., Gwirtsman, H. E., George, D. T., Ebert, M. H., Jimerson, D. C., Tomai, T. P., Chrousos, G. P. & Gold, P. W. (1987). Elevated cerebrospinal fluid levels of immunoreactive corticotropin-releasing hormone in anorexia nervosa: relation to state of nutrition, adrenal function, and intensity of depression. Journal of Clinical Endocrinology and Metabolism 64, 203–208.CrossRefGoogle ScholarPubMed
Kaye, W. H., Weltzin, T. & Hsu, L. K. G. (1993). Relationship between anorexia nervosa and obsessive compulsive behaviors. Psychiatric Annals 23, 365–373.CrossRefGoogle Scholar
Kriska, A. M., Sandier, R. B., Cauley, J. A., LaPorte, R. E., Hom, D. L. & Pambianco, G. (1988). The assessment of historical physical activity and its relation to adult bone parameter. American Journal of Epidemiology 127, 1053–1063.CrossRefGoogle Scholar
Kron, L., Katz, J. L., Gorzynski, G. & Weiner, W. (1978). Hyperactivity in anorexia nervosa: A fundamental clinical feature. Comprehensive Psychiatry 19, 433–439.CrossRefGoogle ScholarPubMed
Loftus, E. F. & Marburger, W. (1983). Since the eruption of Mt. St. Helens, has anyone beaten you up? Improving the accuracy of retrospective reports with landmark events. Memory and Cognition 11, 114–120.CrossRefGoogle ScholarPubMed
Lowe, M. R. (1993). Anorexics aren't neurotic. Contemporary Psychology 38, 42–43.CrossRefGoogle Scholar
Marrazzi, M. A., Mullings-Brown, J., Stack, L., Powers, R. J., Lawhorn, J., Graham, U., Eccles, T. & Gunter, S. (1990). Atypical endogenous opioid systems in mice in relation to an auto-addiction opioid model of anorexia nervosa. Life Sciences 47, 1427–1435.CrossRefGoogle Scholar
Marazziti, D., Hollander, E., Lensi, P., Ravagli, S. & Cassano, G. B. (1992). Peripheral markers of serotonin and dopamine function in obsessive-compulsive disorder. Psychiatry Research 42, 41–51.CrossRefGoogle ScholarPubMed
Paykel, E. (1983). Methodological aspects of life events research. Journal of Psychosomatic Research 27, 341–352.CrossRefGoogle ScholarPubMed
Rivest, S. & Richard, D. (1990). Involvement of corticotrophin-releasing factor in the anorexia induced by exercise. Brain Research Bulletin 25, 169–172.CrossRefGoogle ScholarPubMed
Rodin, J. & Larsen, L. (1992). Social factors and the ideal body shape. In Eating, Body Weight and Performance in Athletes (ed. Brownell, K., Rodin, J. and Wilmore, J. H.), pp. 146–158. Lea & Febiger: Philadelphia.Google Scholar
Russell, J. C., Epling, W. F., Pierce, W. D., Amy, R. M. & Boer, D. P. (1987). Induction of voluntary prolonged running in rats. Journal of Applied Physiology 63, 2549–2553.CrossRefGoogle Scholar
Sacks, M. H. (1987). Eating disorders and long-distance running. Integrative Psychiatry 5, 201–211.Google Scholar
Smith, N. J. (1980). Excessive weight loss and food aversion simulating anorexia nervosa. Pediatrics 66, 139–142.CrossRefGoogle ScholarPubMed
Sobell, L. C., Toneatto, T., Sobell, M. B., Schuller, R. & Maxwell, M. (1990). A procedure for reducing errors in reports of life events. Journal of Psychosomatic Research 34, 163–170.CrossRefGoogle ScholarPubMed
Wiseman, C. V., Gray, J. J., Mosimann, J. E. & Ahrens, A. H. (1992). Cultural expectations of thinness in women: an update. International Journal of Eating Disorders 11, 85–89.3.0.CO;2-T>CrossRefGoogle Scholar
Yates, A. (1991). Compulsive Exercise and the Eating Disorders. Brunner/Mazel: New York.Google Scholar
Yates, A., Shisslak, C. M., Allender, J., Crago, M. & Leehey, K. (1992). Comparing obligatory and nonobligatory runners. Psychosomatics 33, 180–189.CrossRefGoogle ScholarPubMed