Pre-Treatment Fear of Weight Gain Is Associated With Engagement in a Greater Degree of Pre-Treatment Maladaptive Exercise Among Individuals With Binge-Spectrum Eating Disorders

Objective: Individuals with binge-spectrum eating disorders (EDs) engage in varying degrees of maladaptive and adaptive exercise. Elevated shape/weight concern is associated with engagement in maladaptive and adaptive exercise. No research has examined whether specific facets of shape/weight concern (e.g., fear of weight gain) are associated with degree of maladaptive versus adaptive exercise engagement. Method: Participants were 124 adults with binge-spectrum EDs enroled in outpatient trials of Enhanced Cognitive Behaviour Therapy. Linear regression models examined associations between each facet of shape and weight concern concurrently at pre-treatment and degree of maladaptive versus adaptive exercise at pre-treatment (i.e., percentage maladaptive exercise episodes of total exercise episodes). We explored these relationships across treatment and diagnostic groups. Results: Greater pre-treatment fear of weight gain was associated with a greater degree of pre-treatment maladaptive exercise (p = 0.027). This pattern was marginally significant in the longitudinal model (p = 0.057) and was upheld within the BN-spectrum (p's < 0.041) but not the BED-spectrum group. Discussion: Accounting for all other facets, fear of weight gain may function as a risk factor for engagement in a greater degree of maladaptive exercise pre- and post-treatment. Future research should examine the mechanisms underlying associations between fear of weight gain and maladaptive exercise engagement.