Abstract
Purpose:
Exercise can enhance health and well-being. Exercise can also, when it is highly-driven and compulsive, reflect eating-disorder psychopathology. The current study examined associations of compulsive exercise and youth athletics with child disordered-eating behaviors (overeating, binge eating, and secretive eating) and with parenting practices related to eating and weight, including how parents talk to their children about weight.
Methods:
Participants were parents (N=875) who completed an online cross-sectional survey. Parents reported whether their child was an athlete and how often their child exercised in a “driven” or “compulsive” way to control their weight. Four groups were compared: child athletes with compulsive exercise (Group-AE; 3.9%, n=34), athletes without compulsive exercise (Group-A; 35.9%, n=314), non-athletes with compulsive exercise (Group-E; 4.6%, n=40), and non-athletes without compulsive exercise (Group-X; 55.7%, n=487).
Results:
There was a significant, graded association of eating/weight-related parenting: parents of Group-E children had the most negative eating/weight-related parenting, followed by parents of Group-AE children, followed by both non-compulsive exercise groups (Group-A and Group-X). Parents reported significantly more “fat talk” in both compulsive exercise groups (Group-AE and Group-E) than non-compulsive exercise groups (Group-A and Group-X). Significantly more youth had regular disordered-eating behaviors (overeating, binge eating, secretive eating) in compulsive exercise groups (Group-AE and Group-E) compared to non-compulsive exercise groups (Group-A and Group-X).
Conclusions:
Overall, relatively few youth were categorized as engaging in compulsive exercise. However, compulsive exercise, particularly among non-athletes, was consistently associated with both disordered-eating behaviors and eating/weight-related parenting practices. Stronger associations emerged for compulsive exercise than child athletics.
Keywords: obesity, parenting, fat talk, binge eating, exercise, disordered eating
Introduction
Exercise has social, physical, cognitive, and mental health benefits (1–3). Involvement in organized sports can increase positive health behaviors in adolescents, such as greater leisure time away from entertainment media and fewer risky behaviors (4). Sports participation can also enhance well-being, such as having fewer medical problems and better interpersonal functioning (4). Although exercise can have broad positive effects on physical and psychosocial health, certain forms of exercise can become pathological when individuals exercise in a driven or compulsive manner intended as a compensatory method to control weight (5–8).
Compulsive exercise is rigid and highly-driven with perceived inability or unwillingness to stop despite awareness of possible harm, such as physical injuries (8, 9). In addition, compulsive exercise can be a part of the “Relative Energy Deficiency in Sport (RED-S)” syndrome, formerly known as the “female athlete triad” (10), which describes health impairments that result from an energy deficit compared to physiological requirements of athletics and daily living. Associated problems arising from RED-S are both physiological (e.g., menstrual dysfunction, decreased bone density, immunological and cardiovascular health problems) and psychological (e.g., eating disorders, depression, judgment and concentration problems). Finally, compulsive exercise on its own can also be an unhealthy weight-compensatory behavior intended to control weight and can reflect a feature of eating-disorder psychopathology (7, 9).
It is important to improve our understanding of exercise behaviors in athletics. Participation in sports and identifying as an athlete has numerous health and social benefits and is not inherently problematic. However, sports may become problematic and interfere with important life domains if the sports environment promotes exercise that is out of control—highly-driven or compulsive—or if children develop rules or maladaptive thoughts about food, appearance, or fitness because of toxic elements in the sports environment (7, 8, 10, 11).
An important related issue to understanding exercise and athletics concerns the myriad of potential messages that youth receive. For example, the sports environment may include critical comments about athletes’ weight or shape, public weighing, and classification based on body weight (12). Additionally, weight-related comments can influence how individuals view themselves and their capabilities, but little is known pertaining to athletes about this kind of “fat talk.”
“Fat talk” (13) refers to disparaging comments about body image and weight, and can focus on weight, eating, exercise habits, fear of overweight, appearance and behavior comparisons, or strategies to change appearance (14–16). Fat talk is associated with decreased self-confidence and body satisfaction and increased eating-disorder behaviors such as fasting and vomiting (16, 17). While fat talk was originally conceptualized as occurring among peers, it occurs in families as well (17, 18). For example, when families engage in weight-related criticism, children are more likely to develop unhealthy and extreme weight-control behaviors and disordered eating (19). When understanding the role fat talk has on an athlete, it is important to consider the comments people may make about themselves, the athlete, or others. Comments associated with controlling weight through exercise can contribute to exercise becoming an overemphasized source self-esteem (6, 20, 21).
The current study sought to examine two forms of physical activity, compulsive exercise and youth athletics, and their association with child disordered-eating behaviors and eating/weight-related parenting practices. Parenting practices were a focus of the current study because parents are key stakeholders in children’s health, can influence children’s body image and eating behaviors, and can facilitate or hinder sports participation and exercise. Despite this important potential influence of parents, the extent to which parenting practices are associated with child athletics and compulsive exercise has not been examined.
Methods
Participants
Participants were parents (N=875) recruited from the Mechanical Turk website to complete an online survey on “parents’ opinions about weight and eating.” To be eligible, parents had to be primary caregivers (i.e., their child lived in their household more than half the time) of a child between ages 5 and 15. Mechanical Turk provides convenient, high-quality data with psychometric properties of measures that do not differ in reliability or validity from participants recruited using traditional sources (22). Mechanical Turk yields samples with greater diversity in geography and demographic characteristics than undergraduate samples (22–24), and has been used in psychological research (25) including eating and weight research (26, 27). The survey for the current study included several validation items that parents needed to pass to have data included.
Participants were mothers (n=560, 64.0%) and fathers (n=312, 35.7%; n=3 gender not reported), most of whom were biological parents (n=777, 88.8%). Parents self-identified as White (n=707, 80.8%), Black (n=51, 5.8%), Hispanic (n=43, 4.9%), Asian (n=33, 3.8%), or Other (n=41, 4.7%). On average, parents were 35.65 years old (SD=7.78) and had BMIs of 29.14 kg/m2 (SD=8.01). Parents answered items about one child. Responses pertained to daughters (n=437, 49.9%) and sons (n=427, 48.8%). On average, children’s BMI z-scores (age- and sex-specific) were in the 66.18th percentiles (SD=32.46; BMI z-score M=0.59, SD=1.40). Average child age was 10.11 years (SD=3.02). This study was reviewed and approved by the local institutional review board; all participants provided informed consent electronically prior to surveys.
Measures
Body Mass Index (BMI).
Parents reported their child’s age, height and weight, which were used to calculate child BMI z-score and child BMI percentile. Parents also reported their own height and weight, which were used to calculate BMI.
Eating Disorder Examination Questionnaire (EDE-Q).
The EDE-Q assesses eating-disorder psychopathology over the past 28 days on seven-point scales ranging from 0 through 6 (28); the current study used a brief empirically-supported version of the full scale, which has reliably been shown to demonstrate superior psychometric properties in both clinical and non-clinical samples (29, 30) compared with the psychometric properties of the full questionnaire. Parents also completed an adapted “parenting” version (EDE-Q-PV; adapted by changing “you” to “your child”) to assess parenting practices around eating and weight. Additionally, we adapted the behavioral items (compulsive exercise, overeating, binge-eating episodes, secretive eating) for parents to report about their child. Behaviors were dichotomized into at least weekly and less than weekly. In this study, items yielded internally consistent subscale scores (α=.66–.95).
Fat Talk Questionnaire (FTQ).
This 16-item measure of negative conversations about weight (“fat talk”), with response options ranging from 1=never through 5=always (31), was adapted to assess how parents talk in front of their child about themselves, people with obesity, and their child. For example, “When I’m with my child, I comment that my arms are too flabby”; “When I’m with my child and see an obese person, I comment that the obese person’s arms are too flabby”; “When I notice that my child has gained weight, I comment that his/her arms are too flabby.” The FTQ had excellent internal consistency in the original FTQ study (α=.93) (31) and in the current study (self α=.96, obesity α=.97, child α=.96).
Study Groups
Parents reported whether their child was an athlete. Using the compulsive exercise item from the EDE-Q-PV, parents also reported how often their child exercised in a “driven” or “compulsive” way for the purpose of controlling weight or shape. Compulsive exercise was dichotomized as weekly or more frequent, or less than weekly, within the past month. Four study groups were created based on these variables: (1) child athlete with compulsive exercise (Group-AE), (2) child athlete without compulsive exercise (Group-A), (3) non-athlete with compulsive exercise (Group-E), and (4) non-athlete without compulsive exercise (Group-X).
Statistical analyses
ANOVAs compared study groups (Group-AE, Group-A, Group-E, and Group-X) on eating/weight-related parenting and fat talk. ANOVA post-hoc tests, using a Tukey correction for multiple comparisons, evaluated pairwise differences. Parallel ANCOVAs compared study groups while covarying for child BMI z-score. Chi-square tests compared disordered eating behaviors across the four study groups.
Results
Overall, a small proportion of children engaged in regular compulsive exercise: 4.6% (n=40) of children were classified as Group-E, 3.9% (n=34) of children were Group-AE, 55.7% (n=487) of children were Group-X, and 35.9% (n=314) of children were Group-A. Parents’ gender and race differed by study group; other parent characteristics, including ethnicity, education level, BMI, and parents’ personal eating-disorder psychopathology, did not differ significantly across groups (see Table 1).
Table 1.
Parent Characteristics
| Group-X | Group-A | Group-E | Group-AE | |||
|---|---|---|---|---|---|---|
| non-athlete, no compulsive exercise | athlete, no compulsive exercise | non-athlete, compulsive exercise | athlete, compulsive exercise | |||
| n=487 | n=314 | n=40 | n=34 | Test (p) | Pairwise | |
| Sex | χ2=16.17 (p=.001) | |||||
| Male, n (%) | 164 (33.9%) | 106 (33.8%) | 21 (52.5%) | 21 (61.8%) | E, AE > X, A | |
| Female, n (%) | 320 (66.1%) | 208 (66.2%) | 19 (47.5%) | 13 (38.2%) | X, A > E, AE | |
| Race | χ2=17.61 (p=.01) | |||||
| White, n (%) | 416 (91.4%) | 267 (87.8%) | 31 (77.5%) | 27 (81.8%) | X > E | |
| Black, n (%) | 19 (4.2%) | 28 (9.2%) | 6 (15%) | 5 (15.2%) | A, E, AE > X | |
| Asian, n (%) | 20 (4.4%) | 9 (3.0%) | 3 (7.5%) | 1 (3%) | none | |
| Ethnicity | χ2=4.58 (p=.21) | n/a | ||||
| Hispanic or Latinx, n (%) | 31 (6.6%) | 14 (4.6%) | 5 (12.5%) | 3 (9.1%) | ||
| Education | χ2=10.74 (p=.10) | n/a | ||||
| High School or Less, n (%) | 76 (15.6%) | 38 (12.1%) | 6 (15%) | 4 (12.1%) | ||
| Some College, n (%) | 209 (43%) | 111 (35.4%) | 15 (37.5%) | 11 (33.3%) | ||
| College or More, n (%) | 201 (41.4%) | 165 (52.5%) | 19 (47.5%) | 18 (54.5%) | ||
| Age, M (SD) | 35.25 (7.41) | 36.23 (8.00) | 35.13 (9.29) | 36.53 (8.92) | F=1.23 (p=.30) | n/a |
| BMI, M (SD) kg/m2 | 29.29 (8.23) | 28.97 (7.64) | 29.4 (9.76) | 28.6 (5.82) | F=0.17 (p=.92) | n/a |
| EDE-Q Brief | ||||||
| Dietary Restraint, M (SD) | 2.82 (2.21) | 3.02 (2.22) | 2.65 (1.74) | 2.85 (1.68) | F=0.70 (p=.55) | n/a |
| Overvaluation, M (SD) | 3.34 (2.09) | 3.32 (2.05) | 3.68 (1.52) | 3.82 (1.47) | F=0.98 (p=.40) | n/a |
| Body Dissatisfaction, M (SD) | 3.68 (2.08) | 3.59 (2.04) | 3.91 (1.65) | 3.76 (1.72) | F=0.39 (p=.76) | n/a |
Significant ANOVAs/Chi-squares are bolded. Study groups were compared pairwise when the main statistical test was significant; significant pairwise comparisons are listed.
Parents’ restraint of their child’s diet (F(3,870)=50.42, p<.001, ηp2=.148) and over-investment in their child’s weight and shape (“overvaluation”) (F(3, 870)=33.94, p<.001, ηp2=.105) significantly differed across study groups, as portrayed in Table 2. Parents of Group-E children reported significantly higher restraint of their child’s diet and over-investment in their child’s weight and shape than all other groups; parents of Group-AE were higher than parents of children without compulsive exercise who were (Group-A) and were not (Group-X) athletes. Parents also significantly differed across study groups in dissatisfaction with their child’s weight/shape (F(3, 870)=39.82, p<.001, ηp2=.121). Parents of Group-E children reported the greatest dissatisfaction with their child’s weight/shape, followed by parents of Group-AE children, followed by parents of Group-X children, followed by parents of Group-A children. All pairwise comparisons were significant except athletes and non-athletes without compulsive exercise for dietary restraint and over-investment; all pairwise comparisons were significant for dissatisfaction with the child’s body. Analyses revealed the same pattern of significance in parallel ANCOVAs that accounted for child BMI z-score.
Table 2.
Parenting Practices by Study Group
| Group-X | Group-A | Group-E | Group-AE | ||||
|---|---|---|---|---|---|---|---|
| non-athlete, no compulsive exercise | athlete, no compulsive exercise | non-athlete, compulsive exercise | athlete, compulsive exercise | ANOVA (p) | ANCOVA (p) with Child BMI-Z as covariate | Pairwise | |
| n=487 | n=314 | n=40 | n=34 | ||||
| EDE-Q-PV | |||||||
| F=50.42 | F=46.66 | ||||||
| Restraint of Child’s Diet, M (SD) | 0.54 (0.05) | 0.39 (0.06) | 2.37 (0.17) | 1.6 (0.18) | (p<.001) | (p<.001) | E > AE > X, A |
| Overvaluation based on Child’s | F=33.94 | F=29.90 | |||||
| Weight/Shape, M (SD) | 0.94 (0.07) | 0.66 (0.09) | 3.04 (0.24) | 2.06 (0.26) | (p<.001) | (p<.001) | E > AE > X, A |
| Dissatisfaction with Child’s | F=39.82 | F=36.11 | |||||
| Weight/Shape, M (SD) | 0.82 (0.06) | 0.44 (0.08) | 2.85 (0.22) | 1.68 (0.24) | (p<.001) | (p<.001) | E > AE > X > A |
| Parent FTQ | |||||||
| F=20.96 | F=20.12 | ||||||
| Self | 1.62 (0.73) | 1.63 (0.76) | 2.4 (1.15) | 2.44 (1.22) | (p<.001) | (p<.001) | E, AE > X, A |
| F=42.39 | F=40.81 | ||||||
| People with Obesity | 1.28 (0.54) | 1.33 (0.63) | 2.18 (1.25) | 2.32 (1.35) | (p<.001) | (p<.001) | E, AE > X, A |
| F=68.26 | F=62.54 | ||||||
| Child | 1.18 (0.40) | 1.15 (0.41) | 2.13 (1.07) | 2.03 (1.26) | (p<.001) | (p<.001) | E, AE > X, A |
| F=3.35 | |||||||
| Child BMI z-score | 0.65 (0.06) | 0.42 (0.08) | 0.98 (0.22) | 0.87 (0.24) | (p=.019) | none |
Eating Disorder Examination Questionnaire, Parenting Version (EDE-Q-PV): Mean levels of parents’ restraint of their child’s diet, parents’ over-investment in their child’s weight and shape (overvaluation), and parents’ dissatisfaction with their child’s weight and shape by study group. Parent Fat Talk Questionnaire (FTQ): mean levels of parent-reported fat talk about themselves, people with obesity, and their child. Bolded analysis of variance (ANOVA) and analysis of covariance (ANCOVA) results are significant.
Significant pairwise comparisons are listed in the last column.
Parents’ fat talk about themselves, people with obesity, and their child all significantly differed across study groups, as depicted in Table 2. Parents’ fat talk about themselves in front of their child (F(3,839)=20.96, p<.001, ηp2=.070) was significantly higher amongst parents of Group-AE and Group-E children compared to Group-A and Group-X children. Likewise, parents’ fat talk about people with obesity (F(3,839)=42.39, p<.001, ηp2=.132) was significantly higher amongst parents of Group-AE and Group-E children compared to those without compulsive exercise. Also likewise, parents’ fat talk about their child (F(3,839)=68.26, p<.001, ηp2=.196) was significantly higher amongst parents of Group-AE and Group-E children compared to those without compulsive exercise. Parallel ANCOVAs that included child BMI z-score as a covariate had the same pattern of significance.
Chi-square tests compared child disordered eating behaviors across the four study groups; results are summarized in Table 3. Regular disordered eating behaviors were dichotomized as weekly or greater (presence) or less than weekly (absence). Regular overeating significantly differed by compulsive exercise (χ2(3) = 58.92, p < .001): 60.0% (n=24) of Group-E and 38.2% (n=13) of Group-AE had regular overeating compared with 15.8% (n=77) of Group-X and 15.3% (n=48) of Group-A (ps<.05). Regular binge eating also significantly differed by compulsive exercise (χ2(3) = 63.46, p < .001): 42.5% (n=17) of Group-E and 26.5% (n=9) of Group-AE had regular binge-eating episodes compared to 8.4% (n=41) of Group-X and 6.4% (n=20) of Group-A (ps<.05). Regular secretive eating also significantly differed by compulsive exercise (χ2(3) = 113.95, p < .001): 38.5% (n=15) of Group-E and 35.3% (n=12) of Group-AE had regular secretive eating compared to 5.2% (n=25) of Group-X and 2.6% (n=8) of Group-A (ps<.05).
Table 3.
Child Weight and Disordered Eating Behaviors by Study Group
| Group-X | Group-A | Group-E | Group-AE | |
|---|---|---|---|---|
| non-athlete, no compulsive exercise n=487 | athlete, no compulsive exercise n=314 | non-athlete, compulsive exercise n=40 | athlete, compulsive exercise n=34 | |
| n (%) | n (%) | n (%) | n (%) | |
| Regular Overeating | 77 (15.8%)E,AE | 48 (15.3%)E,AE | 24 (60.0%)X,A | 13 (38.2%) X,A |
| Regular Binge Eating | 41 (8.4%)E,AE | 20 (6.4%)E,AE | 17 (42.5%) X,A | 9 (26.5%) X,A |
| Regular Secret Eating | 25 (5.2%)E,AE | 8 (2.6%)E,AE | 15 (38.5%) X,A | 12 (35.3%) X,A |
| Child Overweight/ Obesity | 224 (47.1%)A | 103 (33.3%) X,E | 22 (56.4%) A | 14 (42.4%) |
significantly different p<.05 from non-athletes without compulsive exercise
significantly different p<.05 from athletes without compulsive exercise
significantly different p<.05 from non-athletes with compulsive exercise
significantly different p<.05 from athletes with compulsive exercise
Chi-square tests also compared child weight status (presence or absence of overweight/obesity) across the four study groups, which are reported in Table 3. Overweight/obesity significantly differed by sports participation (χ2(3) = 17.77, p < .001): a higher proportion of youth in Group-X (47.1%, n=224) and Group-E (56.4%, n=22) had overweight or obesity compared with youth in Group-A (33.3%, n=103), but Group-AE (42.4%, n=14) did not differ significantly from all other groups.
Discussion
The current study is an initial investigation of associations of disordered eating behaviors, fat talk, and parenting practices related to eating/weight with compulsive exercise among child athletes and non-athletes. The findings suggest that compulsive exercise is more strongly associated with youth disordered eating behaviors than is youth athletics. Findings also suggest a graded pattern of associations for eating/weight-related parenting practices. Specifically, parents of children who engaged in regular compulsive exercise but were not athletes had the most negative eating/weight-related parenting, followed by parents of children who engaged in regular compulsive exercise and were athletes. Notably, both groups with compulsive exercise (athletes and non-athletes) had higher scores than both groups without compulsive exercise (athletes and non-athletes) on eating/weight-related parenting scales, which was also true for all three forms of parental fat talk. Conversely, more non-athletes had overweight/obesity than athletes. Importantly, these results remained essentially the same when we adjusted for child weight. Associations of compulsive exercise with disordered eating behaviors and parenting practices that reflect eating-disorder attitudes, and consistency of findings in analyses that co-vary for child BMI z-score, support that compulsive exercise does reflect psychopathology.
Findings should be considered in the context of the study’s methodology and limitations. There were few children with compulsive exercise in our study, which used a convenience sample of parents who completed an online survey anonymously. We also did not measure the amount or intensity of exercise but relied on whether parents perceived their child’s exercise to be driven or compulsive and for the purpose of weight control, and we relied on parents’ perceptions of whether their child was an “athlete” (without specific guidance or definitions). We also dichotomized behaviors as weekly or less than weekly, for consistency with clinically-significant disordered eating behavior frequencies in the DSM-5 (9) and in the ICD-11 (32). Future research should evaluate different thresholds at which compulsive exercise and disordered eating become clinically-significant. Operationalizing these constructs and using multi-modal approaches to assessment (e.g., child interviews, co-reports from teachers or coaches, observational data) would advance this research. Specifically, the use of parent-reported measures is a limitation of the current work. There is evidence of acceptable agreement between parent-report, child-report and child interview measures of disordered eating (33–35); however, parents appear to be better at knowing when disordered eating is not occurring than when it is occurring (33–35). Other limitations of our study include that we did not assess for past medical history of the parent or child, which could influence how parents responded to questions about weight or eating. Future research should examine whether health history influences the associations among disordered eating behaviors, compulsive exercise, youth athletics, and parenting practices. It would be valuable to extend these findings further by evaluating the prevalence of compulsive exercise in a population-based sample and in clinical samples, and by including children’s perspectives on whether they felt highly-compelled to exercise. It would also be valuable to understand motivations for exercise and whether there are causal relationships between compulsive exercise and disordered eating behaviors or between compulsive exercise and parenting related to eating and weight.
Youth disordered eating behaviors showed significant differences where both compulsive exercise groups (athletes and non-athletes) were more likely to engage in regular disordered eating behaviors than both non-compulsive exercise groups (athletes and non-athletes). In the literature, compulsive exercise has been conceptualized as part of RED-S syndrome (formerly the “female athlete triad”), which attributes physical and psychological impairment to energy deficits due to engagement in physical activity (10). Our findings support this new definition, which is not limited to women or to athletes, by suggesting that non-athletes who engage in compulsive exercise have higher levels of disordered eating behaviors. Further research on whether other aspects of RED-S syndrome—such as cardiovascular problems, osteoporosis, or impaired cognitive abilities—are associated with compulsive exercise could help guide pediatricians’ assessment of the health of youth athletes.
Findings related to fat talk are also notable in their association with compulsive exercise rather than athlete status. Minimal research has examined fat talk and sports together, which makes our evaluation of fat talk, athletics, and compulsive exercise novel. The one study that assessed fat talk among college men who were or were not athletes found that athlete status was not related to fat talk or disordered eating (16). Our work extends these findings about college men by demonstrating that parental fat talk is associated with compulsive exercise rather than sports. It is important to note that our study separated out compulsive exercise and sports participation with our four-group design, whereas earlier work on college men examined sports participation but did not assess compulsive exercise (16). Moreover, our findings also suggest that compulsive exercise is an important construct to study for the health and well-being of children, including when it occurs outside the sports environment. This is also supported by work on physical activity that has shown associations between compulsive exercise and eating-disorder psychopathology among adults (8), and associations of compensatory but not non-compensatory exercise with eating-disorder psychopathology (7).
Earlier research has found that when parent-child communication focuses on health rather than weight, children have less eating-disorder psychopathology, whereas weight-related criticism is associated with dieting and disordered eating behaviors (36). This is consistent with our findings that fat talk was associated with compulsive exercise. Screening for compulsive exercise and negative parent-child communication around weight at annual well-child visits could inform pediatricians’ discussions with parents and youth around food and exercise. Health professionals could provide parents with resources about parent-child communication around health and weight, particularly as there are some public misperceptions that criticism and shaming promote weight loss, whereas there is evidence of their association with weight gain (8). Additionally, referrals to mental health clinicians could be provided if eating-disorder psychopathology is suspected. These efforts could improve the prevention of disordered eating and associated health impairment.
The current study benefitted from a large sample of parents, including both mothers and fathers, and assessment of eating/weight-related parenting, parent-child communication in the form of fat talk, and child disordered eating behaviors. The current study also benefitted from examining compulsive exercise in athletes and non-athletes. However, data were cross-sectional, and were reported from parents, which may differ from children’s perceptions of their exercise and engagement in sports. Data were also limited in racial/ethnic diversity, and future research should examine whether compulsive exercise and athletics have similar associations with disordered eating in important groups not well-represented in the current study.
The most compelling finding from our study was that compulsive exercise, to a greater extent than athlete status, had stronger associations with parenting practices and child disordered eating behaviors. As research has focused previously on athletes and the sports culture, this study demonstrated the importance of considering compulsive exercise more broadly.
Acknowledgements:
This research was supported, in part, by National Institutes of Health grants K24 DK70052 (Dr. Grilo) and K23 DK115893 (Dr. Lydecker). Drs. Grilo and Lydecker were supported, in part, by National Institutes of Health grants R01 DK112771, R01 DK49587 and R01 DK114075. Funders played no role in the content of this paper.
Footnotes
Potential Conflicts of Interest: The authors have no conflicts of interest relevant to this article to disclose.
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