(PS7-6) Association Between Trait Cravings and Maladaptive Exercise

Anorexia Nervosa (AN) disproportionately affects adolescent and young adult women and is a highly lethal disorder. For adults with AN, no intervention has been shown to have clear efficacy. In some individuals, presentation of AN is dominated by maladaptive exercise while for others, it is dominated by dietary restriction. Maladaptive exercise is characterized by persistence of exercise to avoid negative emotions despite injury, fatigue, and its negative impact upon relationships and adaptive functioning. Nonetheless, the interaction of food restriction and maladaptive exercise and how this leads to the extreme weight loss observed in AN is poorly understood. Activity-based AN animal models have highlighted the importance of the interaction between appetite regulating neurons and maladaptive exercise. Greater understanding of the relationship between maladaptive exercise and self-reported appetite where both of these variables are assessed on a continuum is needed. 

We hypothesized that reduced state and trait appetite as assessed by the Food Craving Questionnaire (FCQ) is associated with greater self-reported maladaptive exercise as assessed by the Compulsive Exercise Test (CET). This was assessed with online questionnaires in 317 female undergraduates (25.2% African-American, 14.8% Asian, .3% Hawaiian, .3% American Indian, and 56.2% White, and 12.6% Hispanic) with a mean age of 19.79 years from a large inner-city college.  

A series of multiple regressions showed that Trait FCQ was significantly associated with the avoidance and rule driven subscale scores of the CET (adjusted R² = 7.72%); mood improvement scores (adjusted R² = 6.68%); weight control and exercise scores (adjusted R² = 20.9%); and lack of exercise enjoyment scores (adjusted R² = 6.50%), where p< .01. Each multiple regression controlled for body mass index, age, race, ethnicity, and excluded college athletes. Higher Trait FCQ scores were significantly associated with greater: avoidance and rule driven behavior scores, mood improvement scores, weight control and exercise scores, and lack of exercise enjoyment scores on the CET, where p< .01. Higher State FCQ scores were significantly associated with greater weight control and exercise scores on the CET, where p< .01.        

While the study was conducted with college females, this represents a group who may be particularly vulnerable to the onset of eating disorders. The results are consistent with our hypothesis that greater frequency and intensity of food craving experiences are significantly associated with greater maladaptive exercise. Future studies should explore this relationship longitudinally with objective measures to untangle how extreme weight loss may develop from the interaction of poor appetite regulation and maladaptive exercise.