Compulsive exercise: Cross-sectional and longitudinal associations with disordered eating and muscle-enhancing behaviors in a diverse population-based sample of young adults.

Abstract

Objective: To examine cross-sectional and longitudinal associations between compulsive exercise and disordered eating and muscle-enhancing behaviors in a socioeconomically and ethnically/racially diverse sample of young adults. Method: Using data from 1,441 participants of EAT 2010-2018 (Eating and Activity over Time), gender-stratified analyses were conducted to examine compulsive exercise during adolescence and young adulthood in relation to muscle-enhancing and disordered eating behaviors during young adulthood. Results: Cross-sectionally, compulsive exercise was positively associated with binge-eating, unhealthy and extreme weight control behaviors and use of muscle-enhancing substances in male and female young adults in analyses adjusted for age, socioeconomic status, and ethnicity/race. In longitudinal models controlling for baseline outcome measures, a one standard deviation increase in compulsive exercise during adolescence was associated with 37% greater prevalence of binge-eating in young adult males. In females, a one standard deviation higher level of compulsive exercise during adolescence was associated with 10%, 22%, and 50% greater prevalence of unhealthy weight control behaviors, binge-eating, and use of steroids or other muscle-enhancing substances during young adulthood, respectively. Discussion: Cross-sectional analyses indicate that compulsive exercise is associated with muscle-enhancing and disordered eating behaviors, suggesting that compulsive exercise may be used as a compensatory behavior in attempt to achieve an ideal physique. Longitudinal analyses suggest that compulsive exercise during adolescence may be a risk factor for unhealthy muscle-enhancing and disordered eating behaviors during young adulthood. Public health messaging regarding increasing exercise, while important, should consider the potential risks associated with compulsive exercise for some.