Examining interactions between exercise duration/frequency and maladaptive qualities in predicting eating pathology: a 20-year longitudinal cohort study

Prior research supports concurrent associations between exercise quantity, maladaptive qualities of exercise, and eating pathology. However, limited research has examined prospective associations, and no study has investigated how exercise quantity and quality jointly influence eating pathology over the long term. This study examined exercise quantity, qualities, and their interaction as prospective risk factors for eating pathology at 20-year follow-up. Men (N = 547) and women (N = 1,339) who endorsed exercise completed surveys at Time 1 [mean (SD) age = 29.42 (8.55)] and Time 2 [mean (SD) age = 50.92 (8.30)] assessing exercise duration, frequency, whether exercise was intended to influence appearance, compensate for eating, and was distressing if missed, and eating pathology, including drive for thinness and bulimic symptoms. Higher exercise duration/frequency prospectively predicted lower drive for thinness (β = -.06, p = .002) and bulimic symptoms (β = -.10, p < .001). Additionally, lower exercise duration/frequency predicted higher bulimic symptoms among individuals reporting greater distress when missing exercise (β = -.05, p = .02). Findings support multidimensional assessments of exercise to inform eating disorder interventions, including potential benefits of regular exercise. A mismatch between intended and fulfilled exercise may prompt maladaptive coping in the form of bulimic symptoms. More prospective research is needed to support the utility of exercise in reducing eating disorder risk.