Measuring Compulsive Exercise in Individuals with Eating Disorders

Abstract

Compulsive exercise is a transdiagnostic eating disorder symptom which affects symptom severity and treatment outcome. Despite its impact, compulsive exercise has long taken a back seat in the assessment and treatment of eating disorders. This research aims to gain a multi-informant perspective on the definition and measurement of compulsive exercise to increase awareness and improve access to assessment and treatment.

This thesis is comprised of seven chapters, including four empirical studies. A systematic review was conducted to identify measures of compulsive exercise for individuals with eating disorders, and examine their psychometric properties (Chapter 3). In Chapter 4, a Delphi study was carried out to investigate the perspectives of eating disorder researchers and clinicians on the definition and assessment of compulsive exercise.

In Chapter 5, the Compulsive Exercise Test was further investigated to strengthen its position as an evidence-based instrument for compulsive exercise in eating disorders. Further support was lent to the Compulsive Exercise Test as a valid instrument for compulsive exercise in eating disorders while some suggestions for improvement were offered.

The final study (Chapter 6) collected data from individuals with eating disorders and lived experience of compulsive exercise. Qualitative data analysis indicates that compulsive exercise is a debilitating symptom, and does not attract enough attention in eating disorder assessment and treatment. Suggestions were made to improve accessibility to assessment and treatment for compulsive exercise. Results are discussed in terms of improving existing standardised measures for compulsive exercise, and increasing access to assessment and interventions for compulsive exercise in eating disorder treatment (Chapter 7).