Background: The highly driven and often excessive exercise seen in eating disorder patients can be defined as a compulsive behaviour, and is often performed for weight control reasons, as well as for mood regulatory purposes. Compulsive exercisers often exercise in a rigid and rule-driven manner and predominantly report no enjoyment from the activity. Importantly, compulsive exercise has negative clinical implications, such as prolonging eating disorder treatment and representing a key factor in eating disorder relapse. However, despite these negative clinical implications and the large percentage of patients that may experience these harmful and detrimental behaviours, the body of literature examining the aetiology of compulsive exercise is relatively scarce and lacks a coherent theoretical underpinning. Objectives: This thesis aimed to provide the first known investigations into the possible correlates and risk factors for compulsive exercise in adolescent boys and girls. Main Findings: The key prospective predictors of compulsive exercise found in this thesis were self-perfectionism and obsessive-compulsiveness for boys. For girls, internal dysfunctional emotion regulation and a perceived media pressure to be thin were the key risk factors for compulsive exercise. Implications: The results from the thesis suggest that psychological factors are important in the development of compulsive exercise in boys, whereas in girls, a combination of dysfunctional emotion regulation and socio-cultural pressure to be thin could lead to the development of compulsive exercise cognitions and attitudes. Further research is needed to replicate and extend these results, although these thesis findings still provide useful empirical evidence to inform prevention and early intervention programmes for compulsive exercise in adolescents.

Background: The incidence of eating psychopathology in athletes is considerably higher than in the general population. Facilitating the early identification and successful management of eating problems in this group is therefore essential. Objectives: The thesis aimed to improve our empirical understanding of the identification and management of eating problems in athletes. Three areas were investigated. First, a measure of compulsive exercise was evaluated as a method of identification of eating psychopathology in athletes. Second, the thesis explored coach methods of identification and management of eating problems among their athletes. Finally, athlete experiences of disclosing and seeking treatment for eating disorders were explored. Main findings: The Compulsive Exercise Test was found to be a useful measure in screening for eating psychopathology in athletes. Track and field coaches relied heavily on the physical symptoms of disordered eating when identifying potential eating problems in athletes. Coaches described difficulties in identifying eating psychopathology in athletes, and in signposting athletes to appropriate support. Individual differences in the perceived value of disclosing an eating disorder were discovered among athletes currently seeking treatment. Lastly, athletes described struggling to engage with their eating disorder treatment programme, particularly where exercise was restricted or reduced. Implications: The findings suggest a need for greater support, education and resources for coaches and sports professionals in identifying and facilitating treatment access among their athletes. The Compulsive Exercise Test may be one way to assist sports professionals in identifying athletes with elevated levels of eating psychopathology. Athletes may be more willing to engage with treatment programmes when they are closely involved in goal setting and their exercise and sporting commitments are incorporated where possible.

Over the past two decades, a large body of research has examined the issues of eating disorders as well as compensatory behaviors in collegiate competitive athletes. Up to 49.1% of student-athletes engage in disordered eating and compensatory behaviors, while up to 7.1% of athletes have symptoms that reach the threshold of formal psychiatric diagnoses. Greater symptoms are linked to reduced athletic and academic performance, both of which may impact physical and psychosocial functioning later in adulthood. However, most athletes suffer from these symptoms in isolation, as these behaviors are often undetected by athletic trainers and coaches. The purpose of the current study was: (a) to examine the prevalence of both formal eating disorders and disordered eating symptomatology in a sample of collegiate student-athletes; (b) to explore the frequency of compulsive exercise occurrence; (c) to investigate the differences in athletes’ disordered eating, compulsive exercise, and body image concerns by gender, sport type, and level of athletic participation; and (d) to assess the relationships among athletes’ disordered eating, compulsive exercise, and body image concerns, as well as associations between athletes’ age and each of these three variables. In total, 128 NCAA Division I varsity and club athletes completed the Eating Disorder Examination Questionnaire (EDE-Q), Compulsive Exercise Test (CET), and Multidimensional Body Self-Relations Questionnaire – Appearance Scales (MBSRQ-AS). Correlational analysis, Independent two-sample, and Welch’s t-tests were conducted to establish statistical significance for the relationships of interest. Out of 128 athletes, 11 athletes (8.6%) scored in the clinically significant range on at least one EDE-Q subscale. Four athletes (3.2%) met criteria for Bulimia Nervosa, 3 athletes (2.4%) met criteria for Binge Eating Disorder, and 2 athletes (1.6%) met criteria for Unspecified Feeding or Eating Disorder. In addition, 40 athletes (31.3%) reported subclinical symptoms of an eating disorder. Nineteen athletes (14.85%) scored above the clinical cut-off score for compulsive exercise behavior. Female athletes reported greater disordered eating symptomatology and body image dissatisfaction than males. In addition, lean-sport athletes had a higher prevalence of maladaptive eating behaviors than non-lean sport athletes. Age was not associated with athletes’ disordered eating, compulsive exercise, and body image scores. Also, no differences were found between club and varsity athletes for the same variables. Positive correlations were found between athletes’ eating pathology and their compulsive exercise behaviors, suggesting that greater eating disorder symptoms were associated with greater excessive exercise engagement. In contrast to athletes with no symptoms of an eating disorder, athletes with symptoms of an eating disorder reported using exercise as a weight control measure. Higher levels of body image dissatisfaction were also associated with greater eating pathology. This study addressed a number of methodological shortcomings across the body of eating disorder research (e.g., studies with insufficient sample sizes, lack of group comparisons by age and level of athletic participation, and suboptimal psychometric measures) and underscored the need for a new generation of studies. The study also explored the frequency of compulsive exercise, a compensatory behavior which is highly prevalent, but often overlooked among athletes. The study findings may aid coaches, athletic administration, and mental health professionals in identifying at-risk athletes. The study findings also inform the development of prevention and treatment efforts. / Kinesiology

Exercise is an important part of well-being. However, when performed excessively, it can lead to negative consequences such as anxiety, depression and feelings of guilt. This study aimed to qualitatively investigate what motivational regulations, defined by the Self-determination theory, that may provide an insight into why young women engage in excessive exercise. Data from seven participants was analyzed through a thematic analysis and resulted in four themes: Exercise affected by social influence, Ambivalence toward the amount of exercise, Benefits of exercise and Exercise affecting the sense of self. All of the motivational regulations belonged to the extrinsic type of motivation, ranging from external to integrated regulation, with social influence and health benefits being the most frequently mentioned reasons for exercise. Also, the informants were able to explain why they exercise, but less so in regard to the amount of exercise. / Träning är en förutsättning för välbefinnande. När träning utförs i en överdriven mängd kan det dock leda till negativa konsekvenser som ångest, depression och skuldkänslor. Syftet med denna studie var att kvalitativt undersöka vilka motivationsregleringar definierade av Självbestämmande teori som kan ge en inblick i varför unga kvinnor tränar i en överdriven omfattning. Materialet från sju deltagare analyserades genom en tematisk analys och resulterade i fyra teman: Social påverkan på träning, Ambivalens till träningsmängden, Fördelar med träning och Träning påverkar uppfattningen om sig själv. Alla motivationsregleringar tillhörde den yttre typen av motivation och sträckte sig från extern till integrerad reglering, där social påverkan och hälsofördelar var de mest frekvent nämnda anledningarna till träning. Informanterna kunde ge en förklaring till varför de tränar, men inte avseende deras träningsmängd.

The subject of this study is the recognition of the link between service in the Police of the Czech Republic (PCR) and abuse of substances for supporting muscle growth and anabolic steroids. The service of PCR officer is often been connected to physical strenght and psychical resistence, which is given by training, personality and self-confidence of the officer. Masculinity and muscular body is seen by some officers as essential for this job and the standard there is shifted when compared to the other people. Anabolic Steroids - substances accesible on the illicit market - can be abused for fast muscle growth and outreaching the limits of ordinary man. The first part of this study is theoretical part, in which the aspects of police service are described, as they are risk factors for development of exercise addiction and abuse of substances for supporting muscle growth. The second part is practical part, where the research is described among the PCR officers, who are exercising regularly and are ranked in the Public Order Police Service. This research is searching for similarities between usage of supplements and Anabolic Steroids and subjectively viewed professional requirements. Also the amount of subjectively seen medical problems was compared between group of steroid-using officers and those...

Há evidências que associam a prática de atividade física (AF) nos transtornos alimentares (TA) como método compensatório na busca do controle do peso e apetite. O objetivo da pesquisa foi determinar o perfil de AF dos pacientes atendidos no Programa de Transtornos Alimentares (AMBULIM) do Instituto de Psiquiatria da Faculdade de Medicina da USP. A amostra foi composta por pacientes com diagnóstico de anorexia nervosa (AN, n=27), bulimia nervosa (BN, n=31) e um grupo controle (GC, n=13). A coleta de dados envolveu avaliar as variáveis da AF por meio de uma medida objetiva (acelerômetro), atividades físicas autorreferidas, e o grau de compromisso com o exercício. Variáveis nutricionais e psicológicas foram mensuradas por meio de escalas de atitudes alimentares, de insatisfação corporal, depressão e ansiedade para análise de associações. A comparação entre os grupos de AN, BN e GC, foi feita por meio de Kruskal Wallis. Para analisar as prevalências e os possíveis fatores relacionados à prática de AF foram realizados o teste Quiquadrado, a razão de prevalências (RP) e a medida de Odds Ratio (OR). Nas variáveis antropométricas, nutricionais e psicológicas o grupo controle apresentou resultados adequados, dentro das faixas limítrofes à saúde, com baixo risco para TA, níveis de depressão e de ansiedade em comparação aos grupos de TA (p<0,05). Na medida objetiva, a BN apresentou o maior tempo de duração na AF leve, em comparação aos demais grupos (p<0,001). Nas associações de RP, ao assumir uma nota de corte pela mediana, aquelas que permaneceram na AF leve no acelerômetro, por um tempo superior a 973 minutos apresentaram 2,1 vezes a prevalência de ter BN, quando comparado com quem ficou um tempo igual ou inferior; na AN a medida de risco não foi significativa. Limitações da pesquisa exigem cautela na observação dos resultados. A prática compulsiva, baseada no escore total do grau de compromisso com o exercício, não interferiu na prevalência de TA na amostra estudada. Também não foram encontradas associações entre a prática de AF e as variáveis antropométricas, nutricionais e psicológicas, exceto a insatisfação corporal. Aquelas que apresentaram insatisfação corporal tiveram 3,4 vezes mais chances de praticar AF. É necessário aprofundar os estudos e buscar instrumentos validados que auxiliem na investigação da prática excessiva e/ou compulsiva nos TA / Evidence shows that physical activity (PA) for eating disorder (ED) individuals is a compensatory behavior seeking weight and appetite control. The purpose of this research was to determine the PA of the patients from the Eating Disorders Program (AMBULIM) at the Sao Paulo Universitys Psychiatric Institute. The sample was composed of patients diagnosed with Anorexia Nervosa (AN, n=27), Bulimia (BN, n=31) and a control group (CG, n=13). The data collection involved assessing PA by using an objective instrument (accelerometer), self-reported physical activities, and commitment to exercise. Nutritional and psychological variables were measured with scales of eating attitudes, body dissatisfaction, depression, and anxiety. Comparison between AN, BN and CG groups, was tested by Kruskal Wallis. In order to analyze the prevalence and the possible factors related to PA, Chi Square, Prevalence Ratio (RP), and Odds Ratio (OR) were performed. In the anthropometric, nutritional and psychological variables, CG presented the expected low risk for ED, depression and anxiety levels when compared to the ED groups (p<.05). In the objective instrument, BN presented the longer duration time of light PA, when compared to the other groups (p<.001). Considering the median as the cutoff for RP associations, those who exercised at light intensity measured with by accelerometer for over 973 minutes, presented 2.1 more prevalence of developing BN, when compared to those exercising equally or less time. The risk was negligible for AN. Limitations for this study are warranted: the compulsive exercise, based on the degree of the commitment to exercising, did not interfere in the prevalence of ED. Associations between the practice of PA and the anthropometric, nutritional and psychological variables, except for body dissatisfaction were not found. Those who presented dissatisfaction had 3.4 more chances of practicing PA. It is necessary to further study this population and use validated tools to investigate ED and levels of PA

Há evidências que associam a prática de atividade física (AF) nos transtornos alimentares (TA) como método compensatório na busca do controle do peso e apetite. O objetivo da pesquisa foi determinar o perfil de AF dos pacientes atendidos no Programa de Transtornos Alimentares (AMBULIM) do Instituto de Psiquiatria da Faculdade de Medicina da USP. A amostra foi composta por pacientes com diagnóstico de anorexia nervosa (AN, n=27), bulimia nervosa (BN, n=31) e um grupo controle (GC, n=13). A coleta de dados envolveu avaliar as variáveis da AF por meio de uma medida objetiva (acelerômetro), atividades físicas autorreferidas, e o grau de compromisso com o exercício. Variáveis nutricionais e psicológicas foram mensuradas por meio de escalas de atitudes alimentares, de insatisfação corporal, depressão e ansiedade para análise de associações. A comparação entre os grupos de AN, BN e GC, foi feita por meio de Kruskal Wallis. Para analisar as prevalências e os possíveis fatores relacionados à prática de AF foram realizados o teste Quiquadrado, a razão de prevalências (RP) e a medida de Odds Ratio (OR). Nas variáveis antropométricas, nutricionais e psicológicas o grupo controle apresentou resultados adequados, dentro das faixas limítrofes à saúde, com baixo risco para TA, níveis de depressão e de ansiedade em comparação aos grupos de TA (p<0,05). Na medida objetiva, a BN apresentou o maior tempo de duração na AF leve, em comparação aos demais grupos (p<0,001). Nas associações de RP, ao assumir uma nota de corte pela mediana, aquelas que permaneceram na AF leve no acelerômetro, por um tempo superior a 973 minutos apresentaram 2,1 vezes a prevalência de ter BN, quando comparado com quem ficou um tempo igual ou inferior; na AN a medida de risco não foi significativa. Limitações da pesquisa exigem cautela na observação dos resultados. A prática compulsiva, baseada no escore total do grau de compromisso com o exercício, não interferiu na prevalência de TA na amostra estudada. Também não foram encontradas associações entre a prática de AF e as variáveis antropométricas, nutricionais e psicológicas, exceto a insatisfação corporal. Aquelas que apresentaram insatisfação corporal tiveram 3,4 vezes mais chances de praticar AF. É necessário aprofundar os estudos e buscar instrumentos validados que auxiliem na investigação da prática excessiva e/ou compulsiva nos TA / Evidence shows that physical activity (PA) for eating disorder (ED) individuals is a compensatory behavior seeking weight and appetite control. The purpose of this research was to determine the PA of the patients from the Eating Disorders Program (AMBULIM) at the Sao Paulo Universitys Psychiatric Institute. The sample was composed of patients diagnosed with Anorexia Nervosa (AN, n=27), Bulimia (BN, n=31) and a control group (CG, n=13). The data collection involved assessing PA by using an objective instrument (accelerometer), self-reported physical activities, and commitment to exercise. Nutritional and psychological variables were measured with scales of eating attitudes, body dissatisfaction, depression, and anxiety. Comparison between AN, BN and CG groups, was tested by Kruskal Wallis. In order to analyze the prevalence and the possible factors related to PA, Chi Square, Prevalence Ratio (RP), and Odds Ratio (OR) were performed. In the anthropometric, nutritional and psychological variables, CG presented the expected low risk for ED, depression and anxiety levels when compared to the ED groups (p<.05). In the objective instrument, BN presented the longer duration time of light PA, when compared to the other groups (p<.001). Considering the median as the cutoff for RP associations, those who exercised at light intensity measured with by accelerometer for over 973 minutes, presented 2.1 more prevalence of developing BN, when compared to those exercising equally or less time. The risk was negligible for AN. Limitations for this study are warranted: the compulsive exercise, based on the degree of the commitment to exercising, did not interfere in the prevalence of ED. Associations between the practice of PA and the anthropometric, nutritional and psychological variables, except for body dissatisfaction were not found. Those who presented dissatisfaction had 3.4 more chances of practicing PA. It is necessary to further study this population and use validated tools to investigate ED and levels of PA