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ViewAttendees 8

Symposia

Eating Disorders

Session: Innovative Approaches to Eating Disorder Treatment in Adults

4 - (SYM 35) Targeting Shape and Weight-related Cognitions to Promote an Adaptive Relationship with Exercise: Evidence from a Longitudinal Study Using Ecological Momentary Assessment

Friday, November 17, 2023
2:30 PM – 4:00 PM PST
Location: Chelan (401), Level 4
Pathological exercise is a dangerous behavior that is often present across eating disorder diagnoses. Limited interventions currently exist to target pathological exercise directly within the context of eating disorder treatment. Although there is a growing body of theoretical and empirical investigations outlining the behavioral and emotionally regulative aspects of pathological exercise, comparatively little is known about the cognitive element of pathological exercise, including cognitions present during exercise itself. Therefore, the primary aim of this study was to investigate what individuals with eating psychopathology think about while they exercise and to test whether thoughts during exercise about shape, weight, or calories predicted later engagement in eating disorder behaviors. Secondary aims included testing 1) unique associations between thoughts during exercise and exercise type, and 2) whether exercise predicted an increase in positive emotion. We monitored thirty-one women for three weeks as they reported on their exercise and eating disorder behaviors and used generalized multi-level modeling to test whether thoughts about shape, weight, or calories during exercise predict later same-day eating disorder behaviors. We found that thinking about weight loss during exercise predicted later engagement in body checking behaviors [OR = 3.62, (95% CI: 1.38 – 9.46)]. Engagement in yoga/martial arts was associated with a decreased likelihood in thinking about weight loss during exercise [OR = 0.23, (95% CI: 0.05 – 0.98)]. Exercise in general was associated with a significant increase in positive affect [b = -0.14, SE = 0.05, t = -2.81, p = .01, (95% CI: -0.24 – -0.04), d = 0.12] and in self-determination on days where exercise occurred [b = 0.21, SE = 0.09, t = 2.47, p = .014, (95% CI: 0.04 – 0.38), d = 0.23]. Overall, results indicate that not only may weight concerns be more important than shape concerns when motivating pathological exercise behavior, but also their influence in eating disorder continuance may exist on a much briefer time scale (i.e., within a day) than previous studies show. Findings strengthen and extend previous literature showing that shape and weight concerns are etiologically significant for the development of pathological exercise and may therefore be an important treatment target. Clinically, future studies may seek to test interventions aimed at changing or restructuring cognitions during exercise to help shape adaptive exercise behavior during and after treatment.