Examining the ability of facets of shape and weight concerns to differentiate between maladaptive and adaptive exercise engagement

Maladaptive exercise is endorsed by more than fifty percent of treatment-seeking individuals with eating disorders, including bulimia nervosa (BN) and binge eating disorder (BED; Monell et al., 2018). Engagement in maladaptive exercise is associated with poorer treatment outcomes compared to individuals who do not engage in maladaptive exercise (Bardone-Cone et al., 2016; Carter et al., 2004; Kostrzewa et al., 2013). Maladaptive exercise is intended to influence one’s body shape and weight and can be either compulsive or compensatory (Fairburn et al., 2014; Meyer et al., 2011). However, exercise in eating disorders is not solely maladaptive. Some individuals with binge-spectrum eating disorders (i.e., individuals with BN, BED, and subthreshold variants of these diagnoses) engage in adaptive exercise whereas others engage in both maladaptive and adaptive exercise (Lampe et al., 2021). Engagement in adaptive exercise is associated with improved treatment outcomes (Calogero & Pedrotty, 2004; Lampe, Forman, et al., 2022; Mathisen, 2018; Mathisen et al., 2021, 2023; Pendleton et al., 2002). Incorporating adaptive exercise into current treatments (i.e., Enhanced Cognitive Behavior Therapy (CBT-E)) for eating disorders may confer better treatment outcomes by improving shape and weight concerns (Lampe, Forman, et al., 2022). Existing literature demonstrates that several facets of shape and weight concerns may be associated with both maladaptive and adaptive exercise. However, research to date has examined associations between isolated facets of shape and weight concern and maladaptive and/or adaptive exercise. To our knowledge, no research has examined the contributions of these facets to maladaptive and adaptive exercise engagement concurrently. More research is needed to better understand which facets of shape and weight concerns are associated with maladaptive and adaptive exercise. Existing literature is also limited by its examination of exercise as either maladaptive or adaptive. Individuals with binge-spectrum eating disorders may engage in both types of exercise (Lampe et al., 2021). More research is needed to better understand which facets of shape and weight concerns are associated with engagement in both maladaptive and adaptive exercise. Furthermore, understanding which facets of shape and weight concerns are associated with maladaptive and adaptive exercise engagement may lead to more targeted treatments and better patient outcomes by decreasing maladaptive exercise without decreasing adaptive exercise.