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      Incorporating interventions for unhealthy exercise into eating disorders treatment : A survey of attitudes in those with lived experience of an eating disorder

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          Abstract

          Abstract. Introduction: There is little consensus on the treatment of unhealthy exercise in eating disorders. Many treatment programmes do not offer any interventions at all. This study explored the attitudes of those with lived experience towards incorporating treatments for unhealthy exercise in eating disorders. Methods: An online survey was created using onlinesurveys.ac.uk and distributed through social media. Analyses included calculation of descriptive statistics and inductive thematic analysis of free text responses. Results: One hundred and forty-six respondents completed the survey, over 50% identified as having lived experience of an eating disorder. Thematic analysis of free text responses from those with lived experience identified themes around the benefits of incorporating exercise into the treatment of eating disorders including the benefits of exercise on mental and physical health and the opportunity to develop a healthier relationship with exercise. The themes around the risks of incorporating exercise included slowing or limiting recovery and physical risks of exercising at low weight. The themes around the risks of not addressing exercise included leaving part of the disorder untreated and how this could affect recovery. Conclusion: Those with lived experience of eating disorders feel unhealthy exercise is an important part of the disorder to treat. There is recognition of the risks of doing so, but also benefits in helping people to learn a new healthy relationship with exercise.

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          Most cited references19

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          Compulsive exercise and eating disorders.

          The aim of this review was to develop an empirically supported cognitive behavioural model of compulsive exercise within the context of the eating disorders. A systematic review of the correlates and predictors of compulsive exercise among eating disordered patients identified four key correlates. These were subsequently validated by a second review, incorporating both the clinical and non-clinical as well as the exercise science literatures. A proposed model is presented which is both evidence-based and testable. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.
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            Successful qualitative research: a practical guide for beginners

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              Exercise caution: over-exercise is associated with suicidality among individuals with disordered eating.

              We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3-4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations.
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                Author and article information

                Contributors
                Journal
                spp
                Sports Psychiatry
                Journal of Sports and Exercise Psychiatry
                Hogrefe AG, Bern
                2674-0052
                May 18, 2022
                August 2022
                : 1
                : 3
                : 100-106
                Affiliations
                [ 1 ]Child and Adolescent Psychiatry, Oxford Health NHS Foundation Trust, Nottingham, United Kingdom
                [ 2 ]Institute of Mental Health, University of Nottingham, United Kingdom
                Author notes
                Dr Carolyn Nahman, MbChB, PhD, Child and Adolescent Psychiatry, Oxford Health NHS Foundation Trust, 42 Lucknow Drive, Nottingham NG3 5EU, United Kingdom caz.nahman@ 123456oxfordhealth.nhs.uk
                Article
                spp_1_3_100
                10.1024/2674-0052/a000020
                53c96f27-f063-465f-9a4a-7a82e8df1dd8
                Distributed as a Hogrefe OpenMind article under the license CC BY-ND 4.0 (https://creativecommons.org/licenses/by-nd/4.0)

                Distributed as a Hogrefe OpenMind article under the license CC BY-ND 4.0 ( https://creativecommons.org/licenses/by-nd/4.0)

                History
                : December 24, 2021
                : April 16, 2022
                Categories
                Original article

                Psychology,Sports medicine,Clinical Psychology & Psychiatry
                unhealthy exercise,lived experience,eating disorders treatment,compulsive exercise,excessive exercise

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