Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions.

Melissa Rizk, Christophe Lalanne, Sylvie Berthoz, Laurence Kern, Nathalie Godart,
PLoS ONE. 2015-11-30; 10(11): e0143352
DOI: 10.1371/journal.pone.0143352

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1. PLoS One. 2015 Nov 30;10(11):e0143352. doi: 10.1371/journal.pone.0143352.
eCollection 2015.

Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against
Different Definitions.

Rizk M(1), Lalanne C(2), Berthoz S(3)(4), Kern L(5); EVHAN Group, Godart N(3)(4).

Collaborators: Godart N, Berthoz S, Lalanne C, Duclos J, Mattar L, Roux H,
Thiébaud MR, Vibert S, Hubert T, Courty A, Ringuenet D, Benoit JP, Blanchet C,
Moro MR, Bignami L, Nordon C, Rouillon F, Cook S, Doyen C, Siméoni MC, Gerardin
P, Lebecq S, Podlipski MA, Gayet C, Lasfar M, Delorme M, Pommereau X, Bioulac S,
Bouvard M, Carrere J, Doncieux K, Faucher S, Fayollet C, Prexl A, Billard S, Lang
F, Mourier-Soleillant V, Greiner R, Gay A, Carrot G, Lambert S, Rousselet M,
Placé L, Venisse JL, Bronnec M, Falissard B, Genolini C, Hassler C, Tréluyer JM,
Chacornac O, Delattre M, Moulopo N, Turuban C, Auger C.

Author information:
(1)CESP, INSERM, University Paris-Descartes, USPC, Paris, France.
(2)University Paris Diderot, Paris Sorbonne Cité, EA 7334 (REMES),
Patient-Centered Outcomes Research, Paris, France.
(3)CESP, INSERM, University Paris-Sud, UVSQ, Université Paris-Saclay, Paris,
(4)Psychiatry Unit, Institut Mutualiste Montsouris, Paris, France.
(5)Laboratory EA 2931, CERSM, UFR-STAPS, Nanterre, France.

« Hyperactivity » has a wide prevalence range of 31% to 80% in the anorexia nervosa
literature that could be partly due to the plethora of definitions provided by
researchers in this field. The purpose of this study was two-fold: 1) To assess
the variance across prevalence rates of problematic exercise encountered in
patients with anorexia nervosa, in relation to seven different definitions found
in the literature. 2) To examine how core eating disorder symptoms and the
dimensions of emotional profile are associated with these different definitions
and the impact of these definitions on the assessment of patients’ quality of
life. Exercise was evaluated in terms of duration, intensity, type and compulsion
using a semi-structured questionnaire administered to 180 women suffering from
severe anorexia nervosa. Seven different definitions of problematic exercise were
identified in the literature: three entailing a single dimension of problematic
exercise (duration, compulsion or intensity) and four combining these different
dimensions. Emotional profile scores, obsessive-compulsive symptoms, eating
disorder symptomatology, worries and concerns about body shape, self-esteem and
quality of life were assessed using several established questionnaires. The
prevalence of problematic exercise varied considerably from, 5% to 54%, depending
on the number of criteria used for its definition. The type and level of eating
disorder symptomatology was found to be associated with several definitions of
problematic exercise. Surprisingly, a better self-reported quality of life was
found among problematic exercisers compared to non-problematic exercisers in
three of the definitions. The different definitions of problematic exercise
explain the broad prevalence ranges and the conflicting associations generally
reported in the literature between problematic exercise and eating
disorder-related psychological parameters. There is an urgent need for a valid
consensus on the definition of problematic exercise in anorexia nervosa. This
will support the development of further research on the etiology and treatment of
problematic exercise.

DOI: 10.1371/journal.pone.0143352
PMCID: PMC4664470
PMID: 26618359 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus