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Exercise “Addiction” in Anorexia Nervosa: Model Development and Pilot Data

Published online by Cambridge University Press:  07 November 2014

Diane A. Klein ,
Andrew S. Bennett ,
Janet Schebendach ,
Richard W. Foltin ,
Michael J. Devlin  and
B. Timothy Walsh
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Abstract

Background:

Excessive exercise has long been observed to be a problematic behavior of many patients with anorexia nervosa (AN). However, many questions remain as to the exact role exercise plays in this disorder. In particular, it has been suggested that exercise holds “addictive” properties in persons with AN, but that remains to be demonstrated.

Objective:

The aim of this study was to adapt and apply a scale used in addictions research to determine whether symptoms of “dependence” to exercise could be measured in a group of women with AN.

Results:

Forty-eight percent of individuals assessed endorsed symptoms consistent with exercise dependence in the previous month. The number of criteria met for exercise dependence was directly correlated with a clinical measure of anxiety.

Conclusion:

Results support further investigation into addictive properties for exercise in individuals with AN and its relationship to anxiety.

Type
Original Research
Information
CNS Spectrums , Volume 9 , Issue 7 , July 2004 , pp. 531 - 537
Copyright
Copyright © Cambridge University Press 2004

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References

REFERENCES

1.Walsh, BT, Devlin, MJ. Eating disorders: progress and problems. Science. 1998;280:1387–1390.CrossRefGoogle ScholarPubMed
2.Kron, L, Katz, JL, Gorzynski, G, Weiner, H. Hyperactivity in anorexia nervosa: a fundamental clinical feature. Compr Psychiatry. 1978;19:433–440.CrossRefGoogle ScholarPubMed
3.Kaye, WH, Gwirtsman, HE, Obarzanek, E, George, DT. Relative importance of calorie intake needed to gain weight and level of physical activity in anorexia nervosa. Am J Clin Nutr. 1988;47:989–994.CrossRefGoogle ScholarPubMed
4.LaBan, MM, Wilkins, JC, Sackeyfio, AH, Taylor, RS. Osteoporotic stress fractures in anorexia nervosa: etiology, diagnosis, and review of four cases. Arch Phys Med Rehabil. 1995;76:884–887.CrossRefGoogle ScholarPubMed
5.Strober, M, Freeman, R, Morrell, W. The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10-15 years in a prospective study. Int J Eat Disord. 1997;22:339–360.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
6.Davis, C, Katzman, DK, Kaptein, S, et al.The prevalence of high-level exercise in the eating disorders: etiological implications. Compr Psychiatry. 1997;38:321–326.CrossRefGoogle ScholarPubMed
7.Epling, WF, Pierce, WD. Activity anorexia. In: Boulton, A, Baker, G, Martin-Iverson, M, eds. Neuromethods. vol 18: Animal models in psychiatry New York, NY: Humana Press Inc.; 1991:267–311.Google Scholar
8.Davis, C, Woodside, DB. Sensitivity to the rewarding effects of food and exercise in the eating disorders. Compr Psychiatry. 2002;43:189–194.CrossRefGoogle Scholar
9.Davis, C, Claridge, G. The eating disorders as addiction: a psychobiological perspective. Addict Behav. 1998;23:463–475.CrossRefGoogle ScholarPubMed
10.Pierce, WD, Epling, WF. Theoretical developments in activity anorexia. In: Epling, WF, Pierce, WD, eds. Activity Anorexia: Theory, Research and Treatment. Malwah, NJ: Lawrence Erlbaum Associates; 1996:23–41.Google Scholar
11.Bahrke, MS. Exercise, meditation and anxiety reduction: a review. Am Correct Ther J. 1979;33:41–44.Google ScholarPubMed
12.Morris, M, Salmon, P. Qualitative and quantitative effects of running on mood. J Sports Med Phys Fitness. 1994;34:284–291.Google ScholarPubMed
13.Blumenthal, JA, Babyak, MA, Moore, KA, et al.Effects of exercise training on older patients with major depression. Arch Intern Med. 1999;159:2349–2356.CrossRefGoogle ScholarPubMed
14.Ernst, E, Rand, JI, Stevinson, C. Complementary therapies for depression: an overview. Arch Gen Psychiatry. 1998;55:1026–1032.CrossRefGoogle ScholarPubMed
15.Wagemaker, H, Goldstein, L. The runner's high. J Sports Med Phys Fitness. 1980;20:227–229.Google ScholarPubMed
16.Adams, J, Kirkby, R. Exercise dependence: a problem for sports physiotherapists. Aust J Physiother. 1997;43:53–58.CrossRefGoogle ScholarPubMed
17.Hurst, R, Hale, B, Smith, D, Collins, D. Exercise dependence, social physique anxiety, and social support in experienced and inexperienced bodybuilders and weightlifters. Br J Sports Med. 2000;34:431–435.CrossRefGoogle ScholarPubMed
18.Pierce, EF, Daleng, ML, McGowan, RW. Scores on exercise dependence among dancers. Percept Mot Skills. 1993;76:531–535.CrossRefGoogle ScholarPubMed
19.Pierce, EF, Morris, JT. Exercise dependence among competitive power lifters. Percept Mot Skills. 1998;86(3 pt 1):1097–1098.CrossRefGoogle ScholarPubMed
20.Morris, M, Steinberg, H, Sykes, EA, Salmon, P. Effects of temporary withdrawal from regular running. J Psychosom Res. 1990;34:493–500.CrossRefGoogle ScholarPubMed
21.Chan, CS, Grossman, HY. Psychological effects of running loss on consistent runners. Percept Mot Skills. 1988;66:875–883.CrossRefGoogle ScholarPubMed
22.Belke, TW, Belliveau, J. The general matching law describes choice on concurrent variable-interval schedules of wheel-running reinforcement. J Exp Anal Behav. 2001;75:299–310.CrossRefGoogle ScholarPubMed
23.Brewerton, TD, Stellefson, EJ, Hibbs, N, Hodges, EL, Cochrane, CE. Comparison of eating disorder patients with and without compulsive exercising. Int J Eat Disord. 1995;17:413–416.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
24.Davis, C. Eating disorders and hyperactivity: a psychobiological perspective. Can J Psychiatry. 1997;42:168–175.CrossRefGoogle ScholarPubMed
25.Davis, C, Kennedy, SH, Ravelski, E, Dionne, M. The role of physical acitivity in the development and maintance of eating disorders. Psychol Med. 1994;24:957–967.CrossRefGoogle Scholar
26.Hebebrand, J, Exner, C, Hebebrand, K, et al.Hyperactivity in patients with anorexia nervosa and in semistarved rats: evidence for a pivotal role of hypoleptinemia. Physiol Behav. 2003;79:25–37.CrossRefGoogle ScholarPubMed
27.Holtkamp, K, Herpertz-Dahlmann, B, et al.Elevated physical activity and low leptin levels co-occur in patients with anorexia nervosa. J Clin Endocrinol Metab. 2003;88:5169–5174.CrossRefGoogle ScholarPubMed
28.Favaro, A, Caregaro, L, Burlina, AB, Santonastaso, P. Tryptophan levels, excessive exercise, and nutritional status in anorexia nervosa. Psychosom Med. 2000;62:535–538.CrossRefGoogle ScholarPubMed
29.Miele, GM, Carpenter, KM, Smith Cockerham, M, Trautman, KD, Blaine, J, Hasin, DS. Substance Dependence Severity Scale (SDSS): reliability and validity of a clinician-administered interview for DSM-IV substance use disorders. Drag Alcohol Depend. 2000;59:63–75.CrossRefGoogle ScholarPubMed
30.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
31.International Classification of Diseases. 10th ed. Geneva, Switzerland: World Health Organization; 1993.Google Scholar
32.Miele, GM, Carpenter, KM, Smith Cockerham, M, Trautman, KD, Blaine, J, Hasin, DS. Substance Dependence Severity Scale: reliability and validity for ICD-10 substance use disorders. Addict Behav. 2001;26:603–612.CrossRefGoogle ScholarPubMed
33.Beck, AT, Epstein, N, Brown, G, Steer, RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893–897.CrossRefGoogle ScholarPubMed
34.Steer, RA, Beck, AT. Beck Depression Inventory. Manual for the Beck Depression Inventory. San Antonio, Tex: Psychological Corporation; 1993:100–103.Google Scholar
35.Sunday, SR, Halmi, KA, Einhorn, AM. The Yale-Brown-Cornell Eating Disorder Scale: a new scale to assess eating disorder symptomatology. Int J Eat Disord. 1995;18:237–245.3.0.CO;2-1>CrossRefGoogle Scholar
36.Mazure, CM, Halmi, KA, Sunday, SR, Romano, SJ, Einhorn, AM. The Yale-Brown-Cornell Eating Disorder Scale: development, use, reliability and validity. J Psychiat Res. 1994;28:425–445.CrossRefGoogle ScholarPubMed
37.Davis, C, Brewer, H, Ratusny, D. Behavioral frequency and psychological commitment: necessary concepts in the study of excessive exercising. J Behav Med. 1993;16:611–628.CrossRefGoogle Scholar
38.Penas-Lledo, E, Vaz Leal, FJ, Waller, G. Excessive exercise in anorexia nervosa and bulimia nervosa: relation to eating characteristics and general psychopathology. Int J Eat Disord. 2002;31:370–375.CrossRefGoogle ScholarPubMed
39.Derogatis, LR. SCL-90-RL Administration, Scoring, and Procedures Manual II–for the revised version. 1st ed. Towson, Calif: Clinical Psychometric Research; 1983.Google Scholar
40.Davis, C, Kennedy, SH, Ralevski, E, Dionne, M, Brewer, H, Neitzert, C, Ratusny, D. Obsessive compulsiveness and physical activity in anorexia nervosa and high-level exercising. J Psychosom Res. 1995;39:967–976.CrossRefGoogle ScholarPubMed
41.Koob, GF, Le Moal, M. Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmocology. 2001;24:97–129.CrossRefGoogle ScholarPubMed
42.Koob, GF, Le Moal, M. Drug abuse: hedonic homeostatic dysregulation. Science. 1997;278:52–58.CrossRefGoogle ScholarPubMed
43.Koob, GF. Neurobiology of addiction: toward the development of new therapies. Ann N Y Acad Sci. 2000;909:170–185.Google Scholar
44.de Cabeza, V, Carr, KD. Food restriction enhances the central rewarding effect of abused drugs. J Neurosci. 1998;18:7502–7510.CrossRefGoogle Scholar
45.Carr, KD. Augmentation of drug reward by chronic food restriction, behavioral evidence and underlying mechanisms. Physiol Behav. 2002;76:353–364.CrossRefGoogle ScholarPubMed