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Driven exercise in the absence of binge eating: Implications for purging disorder

September 06, 2018

Purging disorder occurs when individuals engage in extreme compensatory or weight-control behavior but do not binge eat.

One of the tricky diagnostic questions about purging disorder is whether exercise should be considered as a way individuals purge. Although many people may exercise as a healthy way to control their weight, when exercise for weight loss becomes driven or compulsive (for example, exercising even though you have an injury), it can be part of an eating disorder.

To understand exercise and purging disorder better, a study by Yale researchers Janet Lydecker, PhD, Assistant Professor of Psychiatry, and Carlos Grilo, PhD, Professor of Psychiatry and Psychology, compared people who reported regular driven exercise in the absence of binge eating with people who reported regular vomiting/laxative misuse in the absence of binge eating. The researchers also compared these two “purging” groups with two other groups: individuals with anorexia nervosa, and those without eating disorders.

People who purged with exercise alone had similarly severe eating-disorder psychopathology as those who purged with vomiting/laxatives and those with anorexia nervosa, although they had lower depression. The researchers believe this means clinicians and researchers should recognize the severity of driven exercise as a compensatory behavior, and the need for further study.

The study was published in the International Journal of Eating Disorders. Megan Shea of Yale also contributed.