Excessive exercise: From quantitative categorisation to a qualitative continuum approach

Olwyn Johnston; Jacqueline Reilly; John Kremer

Excessive exercise: From quantitative categorisation to a qualitative continuum approach

Olwyn Johnston, Jacqueline Reilly, John Kremer

Ulster University Doctoral College

Research output: Contribution to journal › Article › peer-review

34 Citations (Scopus)

Abstract

Researchers have yet to reach a consensus on the definition of excessive exercise, and many questions remain about the relationship between excessive exercise and eating disorders. Understanding of excessive exercise may be furthered by adoption of a broader, dimensional perspective. The current qualitative (grounded theory) study explored the continuum of women's exercise experiences, ranging from casual to more extreme regimens. Thirty-two women were interviewed, aged 16–77. Participants described stages in a continuum of exercise experiences. Overlaps were described between participant perceptions of ‘normal’ exercise, excessive exercise and exercise addiction. Excessive exercise and disturbed eating were described as arising from common concerns about the need to control the body, with exercise viewed as a more acceptable alternative to disturbed eating. The results provide support for a continuum approach to the understanding of excessive exercise, and highlight the utility of qualitative methods in this area.

Original language	English
Pages (from-to)	237-248
Journal	European Eating Disorders Review
Volume	19
Issue number	3
Publication status	Published (in print/issue) - 1 Jun 2011

Bibliographical note

Reference text: Ackard, D. M., Brehm, B. J., & Steffen, J. J. (2002). Exercise and eating disorders in college-aged women: Profiling excessive exercisers. Eating Disorders, 10, 31–47.
CrossRef,PubMedAdkins, E. C., & Keel, P. K. (2005). Does “excessive” or “compulsive” best describe exercise as a symptom of bulimia nervosa? International Journal of Eating Disorders, 38, 24–29.
Direct Link:AbstractPDF(79K)References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Bamber, D., Cockerill, I. M., Rodgers, S., & Carroll, D. (2000a). “It's exercise or nothing”: A qualitative analysis of exercise dependence. British Journal of Sports Medicine, 34, 423–430.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 13Bamber, D., Cockerill, IM., & Carroll, D. (2000b). The pathological status of exercise dependence. British Journal of Sports Medicine, 34, 125–132.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 27Bamber, D. J., Cockerill, I. M., Rodgers, S., & Carroll, D. (2003). Diagnostic criteria for exercise dependence in women. British Journal of Sports Medicine, 37, 393–400.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 19Banister, P., Burman, E., Parker, I., Taylor, M., & Tindall, C. (1994). Qualitative methods in psychology: A research guide. Buckingham: Open University Press.
Beumont, P. J. V., Arthur, B., Russell, J. D., & Touyz, S. W. (1994). Excessive physical activity in dieting disorder patients: Proposals for a supervised exercise program. International Journal of Eating Disorders, 15, 21–36.
Direct Link:AbstractPDF(1273K)References
Blumenthal, J. A., O'Toole, L. C., & Chang, J. L. (1984). Is running an analogue of anorexia nervosa: An empirical study of obligatory running and anorexia nervosa. Journal of the American Medical Association, 252, 520–523.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 61Brehm, B. J., & Steffen, J. J. (1998). Relation between obligatory exercise and eating disorders. American Journal of Health Behavior, 22, 108–119.
Web of Science® Times Cited: 10Brown, R. I. F. (1991). Gaming, gambling and other addictive play. In J. H.Kerr, & M. J.Apter (Eds.), Adult play: A reversal theory approach (pp. 101–118). Amsterdam: Swets & Zeitlinger.
Button, E. J., & Whitehouse, A. (1981). Subclinical anorexia nervosa. Psychological Medicine, 11, 509–516.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 249Cockerill, I. M., & Riddington, M. E. (1996). Exercise dependence and associated disorders: A review. Counselling Psychology Quarterly, 9, 119–129.
CrossRefCoen, S. P., & Ogles, B. M. (1993). Psychological characteristics of the obligatory runner: A critical examination of the anorexia analogue hypothesis. Journal of Sport and Exercise Psychology, 15, 338–354.
Web of Science® Times Cited: 33Cohen, R. (1995). Video interviews: “Hooked” on exercise. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise (pp. 54–60). Leicester: The British Psychological Society.
Conrad, P. (1994). Wellness as virtue: morality and the pursuit of health. Culture, Medicine and Psychiatry, 18, 385–401.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 32Corstorphine, E. (2006). Cognitive-emotional-behavioural therapy for the eating disorders: Working with beliefs about emotions. European Eating Disorders Review, 14, 448–461.
Direct Link:AbstractPDF(297K)References
Cox, R., & Orford, J. (2004). A qualitative study of the meaning of exercise for people who could be labelled as ‘addicted’ to exercise—can ‘addiction’ be applied to high frequency exercising? Addiction Research and Theory, 12, 167–188.
CrossRef,Web of Science® Times Cited: 4Cripps, B. (1995). Exercise addiction and chronic fatigue syndrome: Case study of a mountain biker. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise. Leicester: The British Psychological Society.
Davis, C., Brewer, H., & Ratusny, D. (1993). Behavioral frequency and psychological commitment: Necessary concepts in the study of excessive exercising. Journal of Behavioral Medicine, 16, 611–628.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 45Davis, C., Katzman, D. K., Kaptein, S., Kirsh, C., Brewer, H., & Kalmbach, K., et al.(1997). The prevalence of high-level exercise in the eating disorders: etiological implications. Comprehensive Psychiatry, 38, 321–326.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 77Davis, C., Kennedy, S. H., Ralevski, E., Dionne, M., Brewer, H., Neitzert, C., & Ratusny, D. (1995). Obsessive compulsiveness and physical activity in anorexia nervosa and high-level exercising. Journal of Psychosomatic Research, 39, 967–976.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 43De Coverley Veale, D.M.W. (1987). Exercise dependence. British Journal of Addiction, 82, 735–740.
Direct Link:AbstractPDF(460K)References
De la Torre, J. (1995). Mens sana in corpore sano, or exercise abuse? Clinical considerations. Bulletin of the Menninger Clinic, 59, 15–31.
PubMed,CASDenzin, N. K. (1970). The research act: A theoretical introduction to sociological methods. New Jersey: Prentice Hall.
Eisler, I., & LeGrange, D. (1990). Excessive exercise and anorexia nervosa. International Journal of Eating Disorders, 9, 377–386.
Direct Link:AbstractPDF(697K)References
Elbourne, K. E., & Chen, J. (2007). The continuum model of obligatory exercise: A preliminary investigation. Journal of Psychosomatic Research, 62, 73–80.
CrossRef,PubMed,Web of Science® Times Cited: 1Emerson, R. M., & Pollner, M. (1988). On the uses of members' responses to researcher's accounts. Human Organization, 47, 189–198.
Web of Science® Times Cited: 15Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. London: Guilford Press.
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528.
CrossRef,PubMed,Web of Science® Times Cited: 346Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34.
Direct Link:AbstractPDF(1118K)References
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 1179Garner, D. M., Rockert, W., Olmsted, M. P., Johnson, C., & Coscina, D. V. (1985). Psychological principles in the treatment of bulimia and anorexia nervosa. In D. M.Garner, & P. E.Garfinkel (Eds.), Handbook for psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. NY: Aldine de Gruyter.
Glasser, W. (1976). Positive Addiction. New York: Harper and Row.
Hausenblas, H. A., & Symons Downs, D. (2002). Exercise dependence: A systematic review. Psychology of Sport and Exercise, 3, 89–123.
CrossRef,Web of Science® Times Cited: 35Henwood, K. L., & Pidgeon, N. F. (1992). Qualitative research and psychological theorizing. British Journal of Psychology, 83, 97–111.
Direct Link:AbstractPDF(1093K)
Hubbard, S. T., Gray, J. J., & Parker, S. (1998). Differences among women who exercise for ‘food related’ and ‘non-food related’ reasons. European Eating Disorders Review, 6, 255–265.
Direct Link:AbstractPDF(86K)References
Iannos, M., & Tiggemann, M. (1997). Personality of the excessive exerciser. Personality and Individual Differences, 22, 775–778.
CrossRef,Web of Science® Times Cited: 9Jones, S. (1985). The analysis of depth interviews. In R.Walker (Ed.), Applied qualitative research (pp. 56–70). Aldershot, Hants: Gower.
Kirkby, R. J., & Adams, J. (1996). Exercise dependence: The relationship between two measures. Perceptual and Motor Skills, 82, 366.
PubMed,CAS,Web of Science® Times Cited: 2Laverie, D. A. (1998). Motivations for ongoing participation in a fitness activity. Leisure Sciences, 20, 277–302.
CrossRef,Web of Science® Times Cited: 10Le Grange, D., & Eisler, I. (1993). The link between anorexia nervosa and excessive exercise: A review. Eating Disorders Review, 1, 100–119.
Direct Link:AbstractPDF(1302K)References
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverley Hills, CA: Sage.
Loumidis, K. S., & Roxborough, H. (1995). A cognitive-behavioural approach to excessive exercising. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise (pp. 45–53). Leicester: The British Psychological Society.
Madill, A., Jordan, A., & Shirley, C. (2000). Objectivity and reliability in qualitative analysis: Realist, contextualist and radical constructionist epistemologies. British Journal of Psychology, 91, 1–20.
Direct Link:AbstractPDF(222K)
Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006). An update on the definition of “excessive exercise” in eating disorders research. International Journal of Eating Disorders, 39, 147–153.
Direct Link:AbstractPDF(95K)References
Morris, M., Steinberg, H., Sykes, E. A., & Salmon, P. (1990). Effects of temporary withdrawal from regular running. Journal of Psychosomatic Research, 34, 493–500.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 36Ogden, J., Veale, D., & Summers, Z. (1997). The development and validation of the exercise dependence questionnaire. Addiction Research, 5, 343–355.
CrossRefPasman, L., & Thompson, J. K. (1988). Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. International Journal of Eating Disorders, 7, 759–769.
Direct Link:AbstractPDF(728K)References
Patton, M. Q. (1987). How to use qualitative methods in evaluation. London: Sage.
Pierce, E. F., Eastman, N. W., Tripathi, H. L., Olson, K. G., & Dewey, W. L. (1993). B-Endorphin response to endurance exercise: Relationship to exercise dependence. Perceptual and Motor Skills, 77, 767–770.
PubMed,CAS,Web of Science® Times Cited: 12Rennie, D. L., Phillips, J. R., & Quartaro, G. K. (1988). Grounded theory: A promising approach to conceptualization in psychology? Canadian Psychology, 29, 139–150.
Web of Science® Times Cited: 141Sachs, M. L., & Pargman, D. (1979). Running addiction: A depth interview examination. Journal of Sport Behavior, 2, 143–155.
Scanlan, T. K., Ravizza, K., & Stein, G. L. (1989). An in-depth study of former elite figure skaters: I. Introduction to the project. Journal of Sport and Exercise Psychology, 11, 54–64.
Web of Science® Times Cited: 72Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). London: Sage.
Strong, K. G., & Huon, G. F. (1997). The development and evaluation of a stage-based dieting status measure (DiSM). Eating Disorders: The Journal of Treatment and Prevention, 5, 97–104.
Stunkard, A. J., & Messick, S. (1988). Eating inventory manual. London: Psychological Corporation.
Tchanturia, K., Davies, H., & Campbell, I. C. (2007). Cognitive remediation therapy for patients with anorexia nervosa: Preliminary findings. Annals of General Psychiatry, 6, 14.
CrossRef,PubMedThompson, J. K., & Pasman, L. (1991). The obligatory exercise questionnaire. The Behavior Therapist, 14, 137.
Thorne, J. L., & Espelage, D. L. (2007). Obligatory exercise and eating pathology in college females: Replication and development of a structural model. Eating Behaviors, 8, 334–349.
CrossRef,PubMedVeale, D. (1995). Does primary exercise dependence really exist? In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise. Leicester: The British Psychological Society.
Walker, R. (1985). An introduction to applied qualitative research. In R.Walker (Ed.), Applied qualitative research (pp. 3–26). Aldershot, Hants: Gower.
Waller, G., Cordery, H., Corstorphine, E., Hinrichsen, H., Lawson, R., & Mountford, V., et al. (2007). Cognitive behavioral therapy for eating disorders: A comprehensive treatment guide. Cambridge: Cambridge University Press.
Wiseman, C. V., Gray, J. J., Mosimann, J. E., & Ahrens, A. H. (1992). Cultural expectations of thinness in women: An update. International Journal of Eating Disorders, 11, 85–89.
Direct Link:AbstractPDF(334K)References
Yates, A. (1991). Compulsive exercise and the eating disorders: Toward an integrated theory of activity. NY: Brunner/Mazel.
Yates, A., Leehey, K., & Shisslak, C. M. (1983). Running—an analogue of anorexia? New England Journal of Medicine, 308, 251–255.
CrossRef,PubMed,CAS,Web of Science® Times Cited: 216

Keywords

exercise addiction
excessive exercise
eating disorders
grounded theory
interview

Cite this

@article{2af9f0f3c2f645d6aebf8519633e8efc,

title = "Excessive exercise: From quantitative categorisation to a qualitative continuum approach",

abstract = "Researchers have yet to reach a consensus on the definition of excessive exercise, and many questions remain about the relationship between excessive exercise and eating disorders. Understanding of excessive exercise may be furthered by adoption of a broader, dimensional perspective. The current qualitative (grounded theory) study explored the continuum of women's exercise experiences, ranging from casual to more extreme regimens. Thirty-two women were interviewed, aged 16–77. Participants described stages in a continuum of exercise experiences. Overlaps were described between participant perceptions of {\textquoteleft}normal{\textquoteright} exercise, excessive exercise and exercise addiction. Excessive exercise and disturbed eating were described as arising from common concerns about the need to control the body, with exercise viewed as a more acceptable alternative to disturbed eating. The results provide support for a continuum approach to the understanding of excessive exercise, and highlight the utility of qualitative methods in this area.",

keywords = "exercise addiction, excessive exercise, eating disorders, grounded theory, interview",

author = "Olwyn Johnston and Jacqueline Reilly and John Kremer",

note = "Reference text: Ackard, D. M., Brehm, B. J., & Steffen, J. J. (2002). Exercise and eating disorders in college-aged women: Profiling excessive exercisers. Eating Disorders, 10, 31–47. CrossRef,PubMedAdkins, E. C., & Keel, P. K. (2005). Does “excessive” or “compulsive” best describe exercise as a symptom of bulimia nervosa? International Journal of Eating Disorders, 38, 24–29. Direct Link:AbstractPDF(79K)References American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. Bamber, D., Cockerill, I. M., Rodgers, S., & Carroll, D. (2000a). “It's exercise or nothing”: A qualitative analysis of exercise dependence. British Journal of Sports Medicine, 34, 423–430. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 13Bamber, D., Cockerill, IM., & Carroll, D. (2000b). The pathological status of exercise dependence. British Journal of Sports Medicine, 34, 125–132. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 27Bamber, D. J., Cockerill, I. M., Rodgers, S., & Carroll, D. (2003). Diagnostic criteria for exercise dependence in women. British Journal of Sports Medicine, 37, 393–400. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 19Banister, P., Burman, E., Parker, I., Taylor, M., & Tindall, C. (1994). Qualitative methods in psychology: A research guide. Buckingham: Open University Press. Beumont, P. J. V., Arthur, B., Russell, J. D., & Touyz, S. W. (1994). Excessive physical activity in dieting disorder patients: Proposals for a supervised exercise program. International Journal of Eating Disorders, 15, 21–36. Direct Link:AbstractPDF(1273K)References Blumenthal, J. A., O'Toole, L. C., & Chang, J. L. (1984). Is running an analogue of anorexia nervosa: An empirical study of obligatory running and anorexia nervosa. Journal of the American Medical Association, 252, 520–523. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 61Brehm, B. J., & Steffen, J. J. (1998). Relation between obligatory exercise and eating disorders. American Journal of Health Behavior, 22, 108–119. Web of Science{\textregistered} Times Cited: 10Brown, R. I. F. (1991). Gaming, gambling and other addictive play. In J. H.Kerr, & M. J.Apter (Eds.), Adult play: A reversal theory approach (pp. 101–118). Amsterdam: Swets & Zeitlinger. Button, E. J., & Whitehouse, A. (1981). Subclinical anorexia nervosa. Psychological Medicine, 11, 509–516. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 249Cockerill, I. M., & Riddington, M. E. (1996). Exercise dependence and associated disorders: A review. Counselling Psychology Quarterly, 9, 119–129. CrossRefCoen, S. P., & Ogles, B. M. (1993). Psychological characteristics of the obligatory runner: A critical examination of the anorexia analogue hypothesis. Journal of Sport and Exercise Psychology, 15, 338–354. Web of Science{\textregistered} Times Cited: 33Cohen, R. (1995). Video interviews: “Hooked” on exercise. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise (pp. 54–60). Leicester: The British Psychological Society. Conrad, P. (1994). Wellness as virtue: morality and the pursuit of health. Culture, Medicine and Psychiatry, 18, 385–401. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 32Corstorphine, E. (2006). Cognitive-emotional-behavioural therapy for the eating disorders: Working with beliefs about emotions. European Eating Disorders Review, 14, 448–461. Direct Link:AbstractPDF(297K)References Cox, R., & Orford, J. (2004). A qualitative study of the meaning of exercise for people who could be labelled as {\textquoteleft}addicted{\textquoteright} to exercise—can {\textquoteleft}addiction{\textquoteright} be applied to high frequency exercising? Addiction Research and Theory, 12, 167–188. CrossRef,Web of Science{\textregistered} Times Cited: 4Cripps, B. (1995). Exercise addiction and chronic fatigue syndrome: Case study of a mountain biker. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise. Leicester: The British Psychological Society. Davis, C., Brewer, H., & Ratusny, D. (1993). Behavioral frequency and psychological commitment: Necessary concepts in the study of excessive exercising. Journal of Behavioral Medicine, 16, 611–628. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 45Davis, C., Katzman, D. K., Kaptein, S., Kirsh, C., Brewer, H., & Kalmbach, K., et al.(1997). The prevalence of high-level exercise in the eating disorders: etiological implications. Comprehensive Psychiatry, 38, 321–326. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 77Davis, C., Kennedy, S. H., Ralevski, E., Dionne, M., Brewer, H., Neitzert, C., & Ratusny, D. (1995). Obsessive compulsiveness and physical activity in anorexia nervosa and high-level exercising. Journal of Psychosomatic Research, 39, 967–976. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 43De Coverley Veale, D.M.W. (1987). Exercise dependence. British Journal of Addiction, 82, 735–740. Direct Link:AbstractPDF(460K)References De la Torre, J. (1995). Mens sana in corpore sano, or exercise abuse? Clinical considerations. Bulletin of the Menninger Clinic, 59, 15–31. PubMed,CASDenzin, N. K. (1970). The research act: A theoretical introduction to sociological methods. New Jersey: Prentice Hall. Eisler, I., & LeGrange, D. (1990). Excessive exercise and anorexia nervosa. International Journal of Eating Disorders, 9, 377–386. Direct Link:AbstractPDF(697K)References Elbourne, K. E., & Chen, J. (2007). The continuum model of obligatory exercise: A preliminary investigation. Journal of Psychosomatic Research, 62, 73–80. CrossRef,PubMed,Web of Science{\textregistered} Times Cited: 1Emerson, R. M., & Pollner, M. (1988). On the uses of members' responses to researcher's accounts. Human Organization, 47, 189–198. Web of Science{\textregistered} Times Cited: 15Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. London: Guilford Press. Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528. CrossRef,PubMed,Web of Science{\textregistered} Times Cited: 346Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34. Direct Link:AbstractPDF(1118K)References Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 1179Garner, D. M., Rockert, W., Olmsted, M. P., Johnson, C., & Coscina, D. V. (1985). Psychological principles in the treatment of bulimia and anorexia nervosa. In D. M.Garner, & P. E.Garfinkel (Eds.), Handbook for psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. NY: Aldine de Gruyter. Glasser, W. (1976). Positive Addiction. New York: Harper and Row. Hausenblas, H. A., & Symons Downs, D. (2002). Exercise dependence: A systematic review. Psychology of Sport and Exercise, 3, 89–123. CrossRef,Web of Science{\textregistered} Times Cited: 35Henwood, K. L., & Pidgeon, N. F. (1992). Qualitative research and psychological theorizing. British Journal of Psychology, 83, 97–111. Direct Link:AbstractPDF(1093K) Hubbard, S. T., Gray, J. J., & Parker, S. (1998). Differences among women who exercise for {\textquoteleft}food related{\textquoteright} and {\textquoteleft}non-food related{\textquoteright} reasons. European Eating Disorders Review, 6, 255–265. Direct Link:AbstractPDF(86K)References Iannos, M., & Tiggemann, M. (1997). Personality of the excessive exerciser. Personality and Individual Differences, 22, 775–778. CrossRef,Web of Science{\textregistered} Times Cited: 9Jones, S. (1985). The analysis of depth interviews. In R.Walker (Ed.), Applied qualitative research (pp. 56–70). Aldershot, Hants: Gower. Kirkby, R. J., & Adams, J. (1996). Exercise dependence: The relationship between two measures. Perceptual and Motor Skills, 82, 366. PubMed,CAS,Web of Science{\textregistered} Times Cited: 2Laverie, D. A. (1998). Motivations for ongoing participation in a fitness activity. Leisure Sciences, 20, 277–302. CrossRef,Web of Science{\textregistered} Times Cited: 10Le Grange, D., & Eisler, I. (1993). The link between anorexia nervosa and excessive exercise: A review. Eating Disorders Review, 1, 100–119. Direct Link:AbstractPDF(1302K)References Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverley Hills, CA: Sage. Loumidis, K. S., & Roxborough, H. (1995). A cognitive-behavioural approach to excessive exercising. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise (pp. 45–53). Leicester: The British Psychological Society. Madill, A., Jordan, A., & Shirley, C. (2000). Objectivity and reliability in qualitative analysis: Realist, contextualist and radical constructionist epistemologies. British Journal of Psychology, 91, 1–20. Direct Link:AbstractPDF(222K) Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006). An update on the definition of “excessive exercise” in eating disorders research. International Journal of Eating Disorders, 39, 147–153. Direct Link:AbstractPDF(95K)References Morris, M., Steinberg, H., Sykes, E. A., & Salmon, P. (1990). Effects of temporary withdrawal from regular running. Journal of Psychosomatic Research, 34, 493–500. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 36Ogden, J., Veale, D., & Summers, Z. (1997). The development and validation of the exercise dependence questionnaire. Addiction Research, 5, 343–355. CrossRefPasman, L., & Thompson, J. K. (1988). Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. International Journal of Eating Disorders, 7, 759–769. Direct Link:AbstractPDF(728K)References Patton, M. Q. (1987). How to use qualitative methods in evaluation. London: Sage. Pierce, E. F., Eastman, N. W., Tripathi, H. L., Olson, K. G., & Dewey, W. L. (1993). B-Endorphin response to endurance exercise: Relationship to exercise dependence. Perceptual and Motor Skills, 77, 767–770. PubMed,CAS,Web of Science{\textregistered} Times Cited: 12Rennie, D. L., Phillips, J. R., & Quartaro, G. K. (1988). Grounded theory: A promising approach to conceptualization in psychology? Canadian Psychology, 29, 139–150. Web of Science{\textregistered} Times Cited: 141Sachs, M. L., & Pargman, D. (1979). Running addiction: A depth interview examination. Journal of Sport Behavior, 2, 143–155. Scanlan, T. K., Ravizza, K., & Stein, G. L. (1989). An in-depth study of former elite figure skaters: I. Introduction to the project. Journal of Sport and Exercise Psychology, 11, 54–64. Web of Science{\textregistered} Times Cited: 72Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). London: Sage. Strong, K. G., & Huon, G. F. (1997). The development and evaluation of a stage-based dieting status measure (DiSM). Eating Disorders: The Journal of Treatment and Prevention, 5, 97–104. Stunkard, A. J., & Messick, S. (1988). Eating inventory manual. London: Psychological Corporation. Tchanturia, K., Davies, H., & Campbell, I. C. (2007). Cognitive remediation therapy for patients with anorexia nervosa: Preliminary findings. Annals of General Psychiatry, 6, 14. CrossRef,PubMedThompson, J. K., & Pasman, L. (1991). The obligatory exercise questionnaire. The Behavior Therapist, 14, 137. Thorne, J. L., & Espelage, D. L. (2007). Obligatory exercise and eating pathology in college females: Replication and development of a structural model. Eating Behaviors, 8, 334–349. CrossRef,PubMedVeale, D. (1995). Does primary exercise dependence really exist? In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise. Leicester: The British Psychological Society. Walker, R. (1985). An introduction to applied qualitative research. In R.Walker (Ed.), Applied qualitative research (pp. 3–26). Aldershot, Hants: Gower. Waller, G., Cordery, H., Corstorphine, E., Hinrichsen, H., Lawson, R., & Mountford, V., et al. (2007). Cognitive behavioral therapy for eating disorders: A comprehensive treatment guide. Cambridge: Cambridge University Press. Wiseman, C. V., Gray, J. J., Mosimann, J. E., & Ahrens, A. H. (1992). Cultural expectations of thinness in women: An update. International Journal of Eating Disorders, 11, 85–89. Direct Link:AbstractPDF(334K)References Yates, A. (1991). Compulsive exercise and the eating disorders: Toward an integrated theory of activity. NY: Brunner/Mazel. Yates, A., Leehey, K., & Shisslak, C. M. (1983). Running—an analogue of anorexia? New England Journal of Medicine, 308, 251–255. CrossRef,PubMed,CAS,Web of Science{\textregistered} Times Cited: 216",

year = "2011",

month = jun,

day = "1",

language = "English",

volume = "19",

pages = "237--248",

journal = "European Eating Disorders Review",

issn = "1099-0968",

publisher = "John Wiley & Sons, Inc.",

number = "3",

}

TY - JOUR

T1 - Excessive exercise: From quantitative categorisation to a qualitative continuum approach

AU - Johnston, Olwyn

AU - Reilly, Jacqueline

AU - Kremer, John

N1 - Reference text: Ackard, D. M., Brehm, B. J., & Steffen, J. J. (2002). Exercise and eating disorders in college-aged women: Profiling excessive exercisers. Eating Disorders, 10, 31–47. CrossRef,PubMedAdkins, E. C., & Keel, P. K. (2005). Does “excessive” or “compulsive” best describe exercise as a symptom of bulimia nervosa? International Journal of Eating Disorders, 38, 24–29. Direct Link:AbstractPDF(79K)References American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. Bamber, D., Cockerill, I. M., Rodgers, S., & Carroll, D. (2000a). “It's exercise or nothing”: A qualitative analysis of exercise dependence. British Journal of Sports Medicine, 34, 423–430. CrossRef,PubMed,CAS,Web of Science® Times Cited: 13Bamber, D., Cockerill, IM., & Carroll, D. (2000b). The pathological status of exercise dependence. British Journal of Sports Medicine, 34, 125–132. CrossRef,PubMed,CAS,Web of Science® Times Cited: 27Bamber, D. J., Cockerill, I. M., Rodgers, S., & Carroll, D. (2003). Diagnostic criteria for exercise dependence in women. British Journal of Sports Medicine, 37, 393–400. CrossRef,PubMed,CAS,Web of Science® Times Cited: 19Banister, P., Burman, E., Parker, I., Taylor, M., & Tindall, C. (1994). Qualitative methods in psychology: A research guide. Buckingham: Open University Press. Beumont, P. J. V., Arthur, B., Russell, J. D., & Touyz, S. W. (1994). Excessive physical activity in dieting disorder patients: Proposals for a supervised exercise program. International Journal of Eating Disorders, 15, 21–36. Direct Link:AbstractPDF(1273K)References Blumenthal, J. A., O'Toole, L. C., & Chang, J. L. (1984). Is running an analogue of anorexia nervosa: An empirical study of obligatory running and anorexia nervosa. Journal of the American Medical Association, 252, 520–523. CrossRef,PubMed,CAS,Web of Science® Times Cited: 61Brehm, B. J., & Steffen, J. J. (1998). Relation between obligatory exercise and eating disorders. American Journal of Health Behavior, 22, 108–119. Web of Science® Times Cited: 10Brown, R. I. F. (1991). Gaming, gambling and other addictive play. In J. H.Kerr, & M. J.Apter (Eds.), Adult play: A reversal theory approach (pp. 101–118). Amsterdam: Swets & Zeitlinger. Button, E. J., & Whitehouse, A. (1981). Subclinical anorexia nervosa. Psychological Medicine, 11, 509–516. CrossRef,PubMed,CAS,Web of Science® Times Cited: 249Cockerill, I. M., & Riddington, M. E. (1996). Exercise dependence and associated disorders: A review. Counselling Psychology Quarterly, 9, 119–129. CrossRefCoen, S. P., & Ogles, B. M. (1993). Psychological characteristics of the obligatory runner: A critical examination of the anorexia analogue hypothesis. Journal of Sport and Exercise Psychology, 15, 338–354. Web of Science® Times Cited: 33Cohen, R. (1995). Video interviews: “Hooked” on exercise. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise (pp. 54–60). Leicester: The British Psychological Society. Conrad, P. (1994). Wellness as virtue: morality and the pursuit of health. Culture, Medicine and Psychiatry, 18, 385–401. CrossRef,PubMed,CAS,Web of Science® Times Cited: 32Corstorphine, E. (2006). Cognitive-emotional-behavioural therapy for the eating disorders: Working with beliefs about emotions. European Eating Disorders Review, 14, 448–461. Direct Link:AbstractPDF(297K)References Cox, R., & Orford, J. (2004). A qualitative study of the meaning of exercise for people who could be labelled as ‘addicted’ to exercise—can ‘addiction’ be applied to high frequency exercising? Addiction Research and Theory, 12, 167–188. CrossRef,Web of Science® Times Cited: 4Cripps, B. (1995). Exercise addiction and chronic fatigue syndrome: Case study of a mountain biker. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise. Leicester: The British Psychological Society. Davis, C., Brewer, H., & Ratusny, D. (1993). Behavioral frequency and psychological commitment: Necessary concepts in the study of excessive exercising. Journal of Behavioral Medicine, 16, 611–628. CrossRef,PubMed,CAS,Web of Science® Times Cited: 45Davis, C., Katzman, D. K., Kaptein, S., Kirsh, C., Brewer, H., & Kalmbach, K., et al.(1997). The prevalence of high-level exercise in the eating disorders: etiological implications. Comprehensive Psychiatry, 38, 321–326. CrossRef,PubMed,CAS,Web of Science® Times Cited: 77Davis, C., Kennedy, S. H., Ralevski, E., Dionne, M., Brewer, H., Neitzert, C., & Ratusny, D. (1995). Obsessive compulsiveness and physical activity in anorexia nervosa and high-level exercising. Journal of Psychosomatic Research, 39, 967–976. CrossRef,PubMed,CAS,Web of Science® Times Cited: 43De Coverley Veale, D.M.W. (1987). Exercise dependence. British Journal of Addiction, 82, 735–740. Direct Link:AbstractPDF(460K)References De la Torre, J. (1995). Mens sana in corpore sano, or exercise abuse? Clinical considerations. Bulletin of the Menninger Clinic, 59, 15–31. PubMed,CASDenzin, N. K. (1970). The research act: A theoretical introduction to sociological methods. New Jersey: Prentice Hall. Eisler, I., & LeGrange, D. (1990). Excessive exercise and anorexia nervosa. International Journal of Eating Disorders, 9, 377–386. Direct Link:AbstractPDF(697K)References Elbourne, K. E., & Chen, J. (2007). The continuum model of obligatory exercise: A preliminary investigation. Journal of Psychosomatic Research, 62, 73–80. CrossRef,PubMed,Web of Science® Times Cited: 1Emerson, R. M., & Pollner, M. (1988). On the uses of members' responses to researcher's accounts. Human Organization, 47, 189–198. Web of Science® Times Cited: 15Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. London: Guilford Press. Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528. CrossRef,PubMed,Web of Science® Times Cited: 346Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34. Direct Link:AbstractPDF(1118K)References Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878. CrossRef,PubMed,CAS,Web of Science® Times Cited: 1179Garner, D. M., Rockert, W., Olmsted, M. P., Johnson, C., & Coscina, D. V. (1985). Psychological principles in the treatment of bulimia and anorexia nervosa. In D. M.Garner, & P. E.Garfinkel (Eds.), Handbook for psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. NY: Aldine de Gruyter. Glasser, W. (1976). Positive Addiction. New York: Harper and Row. Hausenblas, H. A., & Symons Downs, D. (2002). Exercise dependence: A systematic review. Psychology of Sport and Exercise, 3, 89–123. CrossRef,Web of Science® Times Cited: 35Henwood, K. L., & Pidgeon, N. F. (1992). Qualitative research and psychological theorizing. British Journal of Psychology, 83, 97–111. Direct Link:AbstractPDF(1093K) Hubbard, S. T., Gray, J. J., & Parker, S. (1998). Differences among women who exercise for ‘food related’ and ‘non-food related’ reasons. European Eating Disorders Review, 6, 255–265. Direct Link:AbstractPDF(86K)References Iannos, M., & Tiggemann, M. (1997). Personality of the excessive exerciser. Personality and Individual Differences, 22, 775–778. CrossRef,Web of Science® Times Cited: 9Jones, S. (1985). The analysis of depth interviews. In R.Walker (Ed.), Applied qualitative research (pp. 56–70). Aldershot, Hants: Gower. Kirkby, R. J., & Adams, J. (1996). Exercise dependence: The relationship between two measures. Perceptual and Motor Skills, 82, 366. PubMed,CAS,Web of Science® Times Cited: 2Laverie, D. A. (1998). Motivations for ongoing participation in a fitness activity. Leisure Sciences, 20, 277–302. CrossRef,Web of Science® Times Cited: 10Le Grange, D., & Eisler, I. (1993). The link between anorexia nervosa and excessive exercise: A review. Eating Disorders Review, 1, 100–119. Direct Link:AbstractPDF(1302K)References Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverley Hills, CA: Sage. Loumidis, K. S., & Roxborough, H. (1995). A cognitive-behavioural approach to excessive exercising. In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise (pp. 45–53). Leicester: The British Psychological Society. Madill, A., Jordan, A., & Shirley, C. (2000). Objectivity and reliability in qualitative analysis: Realist, contextualist and radical constructionist epistemologies. British Journal of Psychology, 91, 1–20. Direct Link:AbstractPDF(222K) Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006). An update on the definition of “excessive exercise” in eating disorders research. International Journal of Eating Disorders, 39, 147–153. Direct Link:AbstractPDF(95K)References Morris, M., Steinberg, H., Sykes, E. A., & Salmon, P. (1990). Effects of temporary withdrawal from regular running. Journal of Psychosomatic Research, 34, 493–500. CrossRef,PubMed,CAS,Web of Science® Times Cited: 36Ogden, J., Veale, D., & Summers, Z. (1997). The development and validation of the exercise dependence questionnaire. Addiction Research, 5, 343–355. CrossRefPasman, L., & Thompson, J. K. (1988). Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. International Journal of Eating Disorders, 7, 759–769. Direct Link:AbstractPDF(728K)References Patton, M. Q. (1987). How to use qualitative methods in evaluation. London: Sage. Pierce, E. F., Eastman, N. W., Tripathi, H. L., Olson, K. G., & Dewey, W. L. (1993). B-Endorphin response to endurance exercise: Relationship to exercise dependence. Perceptual and Motor Skills, 77, 767–770. PubMed,CAS,Web of Science® Times Cited: 12Rennie, D. L., Phillips, J. R., & Quartaro, G. K. (1988). Grounded theory: A promising approach to conceptualization in psychology? Canadian Psychology, 29, 139–150. Web of Science® Times Cited: 141Sachs, M. L., & Pargman, D. (1979). Running addiction: A depth interview examination. Journal of Sport Behavior, 2, 143–155. Scanlan, T. K., Ravizza, K., & Stein, G. L. (1989). An in-depth study of former elite figure skaters: I. Introduction to the project. Journal of Sport and Exercise Psychology, 11, 54–64. Web of Science® Times Cited: 72Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). London: Sage. Strong, K. G., & Huon, G. F. (1997). The development and evaluation of a stage-based dieting status measure (DiSM). Eating Disorders: The Journal of Treatment and Prevention, 5, 97–104. Stunkard, A. J., & Messick, S. (1988). Eating inventory manual. London: Psychological Corporation. Tchanturia, K., Davies, H., & Campbell, I. C. (2007). Cognitive remediation therapy for patients with anorexia nervosa: Preliminary findings. Annals of General Psychiatry, 6, 14. CrossRef,PubMedThompson, J. K., & Pasman, L. (1991). The obligatory exercise questionnaire. The Behavior Therapist, 14, 137. Thorne, J. L., & Espelage, D. L. (2007). Obligatory exercise and eating pathology in college females: Replication and development of a structural model. Eating Behaviors, 8, 334–349. CrossRef,PubMedVeale, D. (1995). Does primary exercise dependence really exist? In J.Annett, B.Cripps, & H.Steinberg (Eds.), Exercise addiction: Motivation for participation in sport and exercise. Leicester: The British Psychological Society. Walker, R. (1985). An introduction to applied qualitative research. In R.Walker (Ed.), Applied qualitative research (pp. 3–26). Aldershot, Hants: Gower. Waller, G., Cordery, H., Corstorphine, E., Hinrichsen, H., Lawson, R., & Mountford, V., et al. (2007). Cognitive behavioral therapy for eating disorders: A comprehensive treatment guide. Cambridge: Cambridge University Press. Wiseman, C. V., Gray, J. J., Mosimann, J. E., & Ahrens, A. H. (1992). Cultural expectations of thinness in women: An update. International Journal of Eating Disorders, 11, 85–89. Direct Link:AbstractPDF(334K)References Yates, A. (1991). Compulsive exercise and the eating disorders: Toward an integrated theory of activity. NY: Brunner/Mazel. Yates, A., Leehey, K., & Shisslak, C. M. (1983). Running—an analogue of anorexia? New England Journal of Medicine, 308, 251–255. CrossRef,PubMed,CAS,Web of Science® Times Cited: 216

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Researchers have yet to reach a consensus on the definition of excessive exercise, and many questions remain about the relationship between excessive exercise and eating disorders. Understanding of excessive exercise may be furthered by adoption of a broader, dimensional perspective. The current qualitative (grounded theory) study explored the continuum of women's exercise experiences, ranging from casual to more extreme regimens. Thirty-two women were interviewed, aged 16–77. Participants described stages in a continuum of exercise experiences. Overlaps were described between participant perceptions of ‘normal’ exercise, excessive exercise and exercise addiction. Excessive exercise and disturbed eating were described as arising from common concerns about the need to control the body, with exercise viewed as a more acceptable alternative to disturbed eating. The results provide support for a continuum approach to the understanding of excessive exercise, and highlight the utility of qualitative methods in this area.

AB - Researchers have yet to reach a consensus on the definition of excessive exercise, and many questions remain about the relationship between excessive exercise and eating disorders. Understanding of excessive exercise may be furthered by adoption of a broader, dimensional perspective. The current qualitative (grounded theory) study explored the continuum of women's exercise experiences, ranging from casual to more extreme regimens. Thirty-two women were interviewed, aged 16–77. Participants described stages in a continuum of exercise experiences. Overlaps were described between participant perceptions of ‘normal’ exercise, excessive exercise and exercise addiction. Excessive exercise and disturbed eating were described as arising from common concerns about the need to control the body, with exercise viewed as a more acceptable alternative to disturbed eating. The results provide support for a continuum approach to the understanding of excessive exercise, and highlight the utility of qualitative methods in this area.

KW - exercise addiction

KW - excessive exercise

KW - eating disorders

KW - grounded theory

KW - interview

UR - http://onlinelibrary.wiley.com/doi/10.1002/erv.970/abstract

M3 - Article

SN - 1099-0968

VL - 19

SP - 237

EP - 248

JO - European Eating Disorders Review

JF - European Eating Disorders Review

IS - 3

ER -

Excessive exercise: From quantitative categorisation to a qualitative continuum approach

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