Assessment of Maladaptive Exercise History Among Individuals With Eating Disorders: Validation of a Brief,...

Maladaptive exercise is a common symptom of eating disorders (EDs). While several measures exist to assess current maladaptive exercise, there are no validated self-report tools to assess maladaptive exercise history-an important symptom domain among individuals with lifetime EDs.

Using data from a large sample of individuals with at least one lifetime ED diagnosis across four countries (N = 31,670), the current study aimed to validate and refine the Eating Disorders 100,000 Questionnaire-version 3 exercise items to create a brief measure of lifetime and current maladaptive exercise, suitable for large-scale epidemiological research and clinical screenings.

Five non-redundant operationalisations of maladaptive exercise were identified ('Any Maladaptive Exercise', 'Regular Maladaptive Exercise', 'Compensatory Exercise', 'Excessive Exercise', 'Current Maladaptive Exercise'). Maladaptive exercise history was present across all lifetime ED presentations assessed, though endorsement levels varied based on scoring operationalisation. Individuals reporting a history of anorexia nervosa reported the highest levels of endorsement of most constructs, closely followed by bulimia nervosa. Compensatory exercise was endorsed most frequently among those reporting a history of bulimia nervosa relative to other diagnostic groups.

Six key items were recommended as a brief screening assessment to capture maladaptive exercise history in EDs.

EDGI is a registered clinical trial (clinicaltrials.gov ID: NCT04378101).