The Prevalence of Excessive Exercise in Eating Disorders: A Systematic Review and Meta-Analysis

Individuals with eating disorders (EDs) often present with maladaptive behaviours such as excessive exercise (EE). The consequences of EE include physical injuries, increased risk of anxiety and depression, and impaired social functioning. No systematic reviews have been conducted on the prevalence of EE in EDs. This study aimed to assess the prevalence of EE in EDs and by ED type.

An electronic database search of the peer-reviewed literature was conducted from inception to October 2024. Review eligibility was restricted to research studies reporting prevalence data for EE in individuals diagnosed with EDs.

Fifty-six studies met the inclusion criteria (n = 21,518; mean age: 22.34 years). The current prevalence of EE in all EDs was 48%. Current prevalence was highest in AN (48%), followed by BN (45%), OSFED (38%), and BED (11%). The lifetime prevalence of EE in all EDs was 63%. Lifetime prevalence was highest in AN (72%), followed by BN (57%) and OSFED (21%).

Nearly half of individuals with an ED engage in EE. High heterogeneity across the included studies likely influenced the prevalence found in this study. Data suggest clinical screening and longitudinal monitoring of EE in those with EDs. Future research into early intervention and treatment for EE in those with EDs is recommended.

PROSPERO: CRD42023464148; Open Science Framework: https://doi.org/10.17605/OSF.IO/MYVXW.