Exercise identity: healthy and unhealthy outcomes in a population-based study of young adults.
Although high exercise identity is often associated with positive attributes, studies have also observed that high exercise identity may be accompanied by a compulsion to exercise (Gapin & Petruzzello, 2011; Lantz, Rhea, & Mesnier, 2004). Compulsive or obligatory exercise cognitions and behaviors are characterized by a firm and inflexible exercise schedule, perceptions of exercise activities as superior to other events, continuation of activities despite health complications, and anxiety or guilt due to missed exercise opportunities (Adams, Miller, & Kraus, 2003; Adkins & Keel, 2005; Mond, Myers, Crosby, Hay, & Mitchell, 2008). Due to the obligatory nature of exercise for some individuals, postponement or the cessation of exercise activities has been linked to symptoms of physical and psychological withdrawal (Pasman & Thompson, 1988). Compulsive exercise behaviors have also been associated with feelings of guilt in relation to eating habits when individuals who believe they have eaten too much feel intensely compelled to exercise in order to rid their bodies of the excess calories consumed (Hubbard, Gray, & Parker, 1998). However, the generalizability of these previous studies that link exercise identity with exercise compulsion and explore the implications of having a high compulsion to exercise is limited given that previous studies of the relationship between exercise identity and exercise compulsion have primarily been conducted among college students (Downs & Ashton, 2011; Miller, 2009) and specific athlete groups (Gapin & Petruzello, 2011; Lantz et al., 2004).
As previous studies have only examined a limited range of behaviors associated with exercise identity and compulsion, and have been conducted among specific population groups (Downs & Ashton, 2011; Gapin & Petruzello, 2011; Lantz et al., 2004; Miller, 2009), a complete picture of both the benefits and potential harms of having an exercise identity for the general population is lacking. Thus, the purpose of the current study was to examine a wide range of behavioral and psychological correlates of exercise identity and exercise compulsion in a large, demographically diverse population-based sample of young adults. If exercise identity is indeed associated with both healthy and unhealthy outcomes, public health goals may be strengthened to not only promote exercise activities, but also to recognize that too much of a good thing may be linked with adverse health consequences, such as exercise compulsion.
Study Design and Sample
Data utilized for this cross-sectional analysis were drawn from Project EAT (Eating and Activity in Teens and Young Adults)-III, the third wave of a 10-year longitudinal study designed to examine eating, activity, and weight-related variables among young people. At baseline (1998-1999), junior and senior high school students at 31 public schools in the Minneapolis/St. Paul metropolitan area of Minnesota completed surveys and anthropometric measures (Neumark-Sztainer et al., 2002a; Neumark-Sztainer, Story, Hannan, & Moe, 2002b). Ten years later (2008-2009), original participants were mailed letters inviting them to complete online or paper versions of the Project EAT-III survey. A total of 1,030 men and 1,257 women completed the Project EAT-III survey, representing 66.4% of participants who could be contacted (48.2% of the original school-based sample). One third of participants (31%) were early young adults aged 20-25 years and two thirds (69%) were middle young adults aged 26-31 years. All study protocols were approved by the University of Minnesota's Institutional Review Board Human Subjects Committee. Additional details of the study design have been reported elsewhere (Eisenberg, Berge, Fulkerson, & Neumark-Sztainer, 2011; Larson et al., 2011a; Neumark-Sztainer, Wall, Larson, Eisenberg, & Loth, 2011).
Survey Development and Measures
The Project EAT III survey was developed to include a greater focus on physical activity among young adults than in previous waves (i.e., Project EAT, Project EAT II); questions on exercise identity and compulsion, the focus of the current analysis, were added to the survey in the third study wave (Larson, Neumark-Sztainer, Story, van den Berg, & Hannan, 201 lb). The revised survey was pre-tested by 27 young adults in focus groups and test-retest reliability over a 1-3 week period was examined in a sample of 66 young adults.
Exercise identity was assessed with the item: "Exercising is an important part of who I am". This statement was adapted from previous investigations of exercise identity and exercise commitment (Anderson et al., 1998; Storer et al., 1997). Response options included strongly disagree, somewhat disagree, somewhat agree, and strongly agree (test-retest r = 0.80). These levels of agreement were interpreted to reflect the degree of exercise identity: very low exercise identity, low exercise identity, moderate exercise identity, and high exercise identity.
Exercise compulsion was measured with a shortened version of the Obligatory Exercise Questionnaire (Thompson & Pasman, 1991). Attitudes toward exercise were assessed by asking participants to indicate how often three statements were true: 1) "When I don't exercise, I feel guilty"; 2) "When I miss a scheduled exercise session, I may feel tense, irritable, or depressed"; and 3) "If I feel I have overeaten, I will try to make up for it by increasing the amount I exercise". Participants were given four response options ranging from never to always. Responses to the three items were summed to form a composite score (range: 3-12; Cronbach's a = .75; test-retest r = 0.78), with higher values indicating a greater level of exercise compulsion.
Physical activity was assessed across two levels of intensity (moderate, vigorous) based on a modified version of the Godin Leisure-Time Exercise Questionnaire (GLTEQ, 1997; Godin & Shephard, 1985; test-retest r = 0.80). Participants responded to the following question for each level of intensity: "In a usual week, how many hours do you spend doing the following activities?" Moderate physical activity was characterized as activities that were not exhausting, such as walking quickly, dancing, and playing volleyball (test-retest r = 0.68). Vigorous physical activity was defined as activity during which the heart beats rapidly; example activities included aerobics, jogging, and swimming (test-retest r = 0.83). Response options included: none, less than 'A hour,' A hour to 2 hours, 2 1/2 hours to 4 hours, 4 1/2 hours to 6 hours, and more than 6 hours. Self-report of physical activity was validated in a subsample of 121 participants in Project EAT-III who wore accelerometers for one week (Sirard, Hannan, Cutler, Graham, & Neumark-Sztainer, 2012). Results showed the modified GLTEQ is a valid tool for ranking physical activity at the group level among young adults.
Body dissatisfaction was measured using a modified form of the Body Shape Satisfaction Scale (Pingitore, Spring, & Garfield, 1997), and represents ratings for 13 body regions (e.g., waist, hips, thighs, stomach). Participant response options included five Likert-type categories ranging from very dissatisfied to very satisfied. Item responses were summed with higher scores indicative of greater levels of body dissatisfaction (score range: 13-65; Cronbach's [alpha] = .93; test-retest r = 0.89).
Weight concern was assessed by participants' responses to the following four statements: "I think a lot about being thinner"; "I am worried about gaining weight"; "I weigh myself often"; and "I sometimes skip meals since I am concerned about my weight". Four response options ranged from strongly disagree to strongly agree. Summed scores ranged from 4 to 16, and higher scores were indicative of greater weight concern (Cronbach's [alpha] = .75; test-retest r = 0.88).
Unhealthy weight control behaviors were assessed through participant responses to the question: "Have you done any of the following things in order to lose weight or keep from gaining weight during the past year?" (yes/no for each method). Unhealthy weight control behaviors included: fasting, eating very little food, using a food substitute (powder/special drink), skipping meals, and smoking cigarettes. Participants who reported using any of these methods were coded as using unhealthy weight control behaviors (test-retest agreement = 83%). Extreme unhealthy weight control behaviors included: took diet pills, made myself vomit, used laxatives, and used diuretics. Those who reported using any of these four behaviors were coded as using extreme unhealthy weight control behaviors (test-retest agreement = 97%).
Self-reported lifetime diagnosis of an eating disorder was investigated with items modified from the College Student Health Survey (2011). Participants were asked to respond to the following question: "For each condition, indicate whether you have been diagnosed in your lifetime" (yes/no for anorexia nervosa, bulimia nervosa, and binge eating disorder). Participant responses were compiled in order to determine the prevalence of eating disorders within the study population (test-retest agreement = 95%).
Body mass index (BMI, kg/[m.sup.2]) was calculated using self-reported height and weight values. Self-report of height and weight were validated in a subsample of 63 male and 62 female participants in Project EAT-III for whom height and weight measurements were completed by trained research staff. Results showed very high correlations between self-reported BMI and measured BMI in males (r = .95) and females (r = .98).
Participant demographic characteristics, including gender, race/'ethnicity, and socioeconomic status (SES) were recorded on the baseline Project EAT survey. Race/ethnicity was characterized across five representative categories: white, African American, Hispanic, Asian, and mixed/other. SES was determined by an algorithm with the primary determinant being parental educational level, defined by the highest level of educational attainment of either parent. Also taken into account were family eligibility for public assistance, eligibility for free or reduced-cost school meals, and employment status of the mother and the father (Sherwood, Wall, Neumark-Sztainer, & Story, 2009).
Chi-square tests were used to examine differences in participants' socio-demographic characteristics by level of exercise identity. For the outcomes of BMI, moderate and vigorous physical activity, exercise compulsion, body dissatisfaction, and weight concern, gender-specific linear regression models were built to examine associations between exercise identity and exercise compulsion and these outcomes. Gender-specific logistic regression models were developed to examine associations between both exercise identity and exercise compulsion and the probability of participants reporting use of any unhealthy weight control behaviors, any extreme weight control behaviors, or a lifetime diagnosis of an eating disorder. Participants' race/ethnicity, SES, and age were included as covariates in all regression models, and BMI was included as a covariate in models where BMI was not the outcome. Adjusted means and adjusted prevalences for each level of exercise identity were calculated from the regression models.
Attrition from the baseline sample did not occur at random. Thus, in all analyses, the data were weighted using the response propensity method (Little, 1986). Response propensities (i.e., the probability that a Project EAT-I participant responded to the Project EAT-III survey) were estimated using a logistic regression of response at EAT-III on a large number of predictor variables from the Project EAT-I survey. Weights were additionally calibrated so that the weighted total sample sizes used in analyses accurately reflect the actual observed sample sizes for men and women. The weighting method resulted in estimates representative of the demographic make-up of the original school-based sample, thereby allowing results to be more fully generalizable to the population of young people in the Minneapolis/St. Paul metropolitan area. Specifically, the weighted sample was 48.4% white, 19.6% Asian, 18.6% Black/African American, 7.5% mixed or other race/ethnicity, and 5.9% Hispanic. The sample was well-distributed across three categories of SES: 37.0% low, 26.2% middle, and 36.8% high.
Demographic Characteristics for Exercise Identity
Approximately 23% of men and 16% of women reported a high exercise identity (p [less than or equal to] .001, see Table 1). Levels of exercise identity varied by participants' race/ethnicity (p = .022) and socio-economic status (p < .001). For example, a greater percentage of high-SES young adults reported that they had a high exercise identity compared to young adults from the lower SES categories. Significant differences in level of exercise identity were not found between the two age groups in the study (p = .456).
Exercise identity was positively associated with several healthy outcomes including greater amounts of time (i.e., hours) spent engaging in moderate and vigorous physical activity among both men (Table 2) and women (Table 3). Participants who reported high exercise identity also reported lower body dissatisfaction and a lower BMI than those with lower levels of exercise identity (p [less than or equal to] .001). Among women, but not men, high exercise identity was related to greater use of unhealthy weight control behaviors (p = .015). For both men and women, exercise identity was not associated with the use of extreme weight control behaviors or a lifetime diagnosis of an eating disorder. Individuals who reported high exercise identity were also likely to report the highest levels of exercise compulsion (p [less than or equal to] .001).
For both men and women, greater exercise compulsion was related to a number of unhealthy outcomes in the study including higher BMI, greater weight concern, greater use of unhealthy and extreme weight control behaviors, and higher likelihood of having a lifetime diagnosis of an eating disorder (p [less than or equal to] .05, see Table 4). High exercise compulsion was also associated with more hours of moderate and vigorous physical activity among men and women (p [less than or equal to] .001). For women only, a positive association was also observed between exercise compulsion and body dissatisfaction (p [less than or equal to] .001).
The purpose of the current study was to examine a broad range of correlates of exercise identity and exercise compulsion among young adults. To our knowledge, no studies have examined this combination of factors, including physical activity (i.e., physical activity intensity) and weight-related factors (i.e., BMI, body dissatisfaction, weight concern, unhealthy weight control behaviors, lifetime eating disorder diagnoses) with regard to exercise identity and exercise compulsion, in a diverse, population-based study sample. The findings showed that having a moderate or high exercise identity is common among young adults as reported by approximately two-thirds of young adult men and half of young adult women. Overall, exercise identity was associated with a number of positive attitudes and behaviors including more time engaging in physical activity, lower BMI, and lower body dissatisfaction. However, exercise identity was also strongly correlated with exercise compulsion, which itself was associated with many concerning behaviors including frequent use of unhealthy weight control behaviors and greater likelihood of having been diagnosed with an eating disorder. Additionally, among women, high exercise identity was associated with a greater prevalence of unhealthy weight control behaviors such as skipping meals and eating very little food.
Findings from the present study showing that young adults with higher levels of exercise identity are more likely to engage in moderate and vigorous physical activity add to the growing body of literature that suggests that exercise identity is associated with behavioral consistency in relation to physical activity (Anderson et al., 1998, 2001; Anderson & Cychosz, 1995; Cardinal & Cardinal, 1997; Miller et al., 2002; Stets & Burke, 2000; Strachan et al., 2009). Moreover, for both men and women, high exercise identity was linked with lower BMI and lower body dissatisfaction. These findings align with those of Downs and Ashton (2011), who conducted a study with college students and found that athletic identity was linked with both positive physical and mental health.
Nevertheless, similar to the findings of Lantz et al. (2004) and Gapin and Petruzzello (2011), results of the current study showed high exercise identity was also associated with an unhealthy outcome for both men and women: high exercise compulsion. Among young adults participating in Project EAT, exercise compulsion was related to several unhealthy
outcomes including weight concern and higher prevalences of unhealthy and extreme weight control behaviors and lifetime eating disorder diagnoses. Also, for women, high exercise compulsion was linked with high body dissatisfaction. These findings add to previous research by demonstrating that, in this population-based sample of young adults, exercise compulsion is connected with unhealthy weight control practices and efforts to cope with weight and shape concerns (Adkins & Keel, 2005; Hubbard et al., 1998; Mond et al., 2008; Mond, Hay, Rodgers, & Owen, 2006; Taranis & Meyer, 2011).
In light of both the positive and concerning outcomes related to exercise identity among this socio-demographically diverse sample of young adults, health professionals should continue to acknowledge that there are many benefits to an individual identifying as an exerciser and feeling the impetus to engage in exercise behavior; however, it should also be acknowledged that when the desire to exercise intensifies and becomes compulsive, a variety of unhealthy outcomes may arise. Although exercise activities have been associated with both physical and psychological health benefits (Downs & Ashton, 2011; Perez et al., 2011; Telama & Yang, 2000), the present study and others (Gapin & Petruzello, 2011; Lantz et al., 2004), have also linked such activities with disordered eating attitudes and behaviors. If individuals such as parents, coaches, and clinicians continue to promote exercise activities, but also monitor compulsive exercise cognitions and behaviors, young adults may be better protected from developing unhealthy outcomes associated with exercise identity. Findings from other studies, including previous analyses from Project EAT (Graham, Sirard, & Neumark-Sztainer, 2011) show a decline in physical activity as young people enter young adulthood. Therefore it is crucial to find ways to help young people become more physically active and more motivated to remain active. Our findings suggest that the development of a strong exercise identify may be helpful. However, findings also suggest that programs need to be careful in presenting balanced messages and letting individuals know that excessive compulsion about physical activity may be harmful. Thus it may be important to also encourage a flexible routine and enjoyment of exercise, rather than obligation. Further research is needed to guide the development of the most effective messages regarding physical activity. Furthermore, evaluations of physical activity programs should include measures of exercise compulsion to ensure that harmful side effects are not occurring.
A major strength of the current study was the use of a large and demographically diverse sample of young adults not recruited from a college or university. Whereas other studies have noted the difficulty in drawing conclusions from limited (Lantz et al., 2004) or unrepresentative samples specific to athletes or college students (Downs & Ashton, 2011; Miller, 2009), results of the present study are generalizable to the population of young adults living within the Midwestern region of the U.S. Additionally, the current study assessed a wide range of both healthy and unhealthy potential outcomes of both exercise identity and exercise compulsion in an effort to thoroughly describe implications of young adults having high exercise identity.
Along with the strengths of the investigation, limitations of the study must also be considered. First, the assessment of exercise identity was a single-item indicator, which may have narrowed the definition of the broader construct. Second, the study utilized a cross-sectional design with self-reported measures, and therefore it is not possible to determine causal relationships within our data. Future prospective studies with young adults that monitor changes in exercise identity, exercise compulsion, and the occurrence of body dissatisfaction, weight concern, and unhealthy weight control behaviors, may provide crucial information for identifying temporal relationships among these factors.
The results from the present study indicate that among a large and diverse sample of young adults, exercise identity appears to facilitate healthy outcomes including lower BMI, lower body dissatisfaction, and engagement in physical activity. However, high levels of exercise identity also co-exist with negative factors such as exercise compulsion. Among the current study population, exercise compulsion was correlated with several negative attributes including higher BMI, greater body dissatisfaction, more weight concern, and greater prevalence of eating disorder diagnoses. While further research is needed to identify the temporal relationships between exercise identity, exercise compulsion, and both healthy and unhealthy attitudes and behaviors, the current study suggests that the promotion of exercise identity among young adults may be beneficial. Yet, coaches, clinicians, and others who work to promote physical activity among young adults need to be aware of the potential for exercise compulsion and among women, unhealthy weight control behaviors, to co-occur with exercise identity.
Role of the Funding Source
This project was supported by the National Heart, Lung, and Blood Institute (R01HL084064). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.
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Trisha M. Karr
Saint Mary's University of Minnesota
Katherine W. Bauer
Dan J. Graham
Colorado State University
University of Minnesota
Address correspondence to: Trisha M. Karr, Department of Psychology, Saint Mary's University, 700 Terrace Heights #1479, Winona, MN 55987-1399, Email: email@example.com
Table 1 Strength of Exercise Identity by Participant Demographics Very Low Low Exercise Exercise Total Identity Identity Variable n % (n) % (n) Gender Male 1017 12.8 (130) 21.9 (223) Female 1251 16.8 (210) 29.7(372) Race/Ethnicity White 1091 14.0 (152) 27.1 (296) Asian 434 11.3 (49) 27.2(118) Black/African American 418 19.9 (83) 26.1 (109) Mixed/Other 169 20.1 (34) 21.3 (36) Hispanic 131 12.2(16) 26.0(34) Age Early Young 1590 14.6 (233) 25.6 (407) Adulthood (20-25) Middle Young 678 15.8(107) 27.9(189) Adulthood (26-31) Socioeconomic Status Low 806 15.0(121) 27.3 (220) Middle 571 18.6 (106) 26.8(153) High 808 13.0(105) 25.0(202) Moderate High Exercise Exercise Identity Identity P Variable % (n) % (n) Gender Male 42.8 (435) 22.5 (229) <.001 Female 38.0 (475) 15.5(193) <.001 Race/Ethnicity White 39.2 (428) 19.7(215) Asian 43.1 (187) 18.4 (80) Black/African American 36.1(151) 17.9(75) Mixed/Other 44.4 (75) 14.2 (24) Hispanic 42.7(56) 19.1 (25) .022 Age Early Young 41.1(653) 18.7(297) Adulthood (20-25) Middle Young 37.7 (256) 18.6(126) .456 Adulthood (26-31) Socioeconomic Status Low 41.7(336) 16.0 (129) Middle 38.7(221) 15.9 (91) High 39.4 (318) 22.6(183) <.001 Note. Level of exercise identity was determined by participant responses to the item: "Exercising is an important part of who I am." Total sample sizes were determined using the response propensity method based on logistic regression analyses with a large number of predictor variables. Weights were calibrated so that the weighted total sample sizes reflect the demographic make-up of the original Project EAT sample. Table 2 Exercise Identity: Associations with Body Mass Index, Exercise Compulsion, Frequency of Physical Activity, Body Dissatisfaction, Weight Concern, Weight Control Behaviors (Unhealthy, Extreme), and Eating Disorder Diagnoses Among Men Very Low Low Exercise Moderate Exercise Identity (n Exercise Identity (n = 223) Identity (n = 130) = 435) Mean (SE) Mean (SE) Mean (SE) Body Mass Index 29.0 (0.48) 27.3 (0.37) 26.5 (0.27) (kg/[m.sup.2]) Exercise Compulsion 4.6(0.18) 4.6 (0.14) 5.2 (0.10) (range: 3-12) Moderate Physical 2.3 (0.23) 2.0 (0.17) 2.6 (0.13) Activity (hours/week) Vigorous Physical 2.0(0.21) 1.3(0.16) 2.2 (0.12) Activity (hours/week) Body Dissatisfaction 34.5 (0.93) 34.6 (0.72) 34.2 (0.51) (range: 13-65) Weight Concern 7.7 (0.23) 7.5 (0.18) 8.2 (0.13) (range: 4-16) n (%) n (%) n (%) Unhealthy Weight 36(27.4) 53 (23.5) 134 (30.6) Control Behaviors Extreme Weight 5(3.7) 11(4.8) 27(6.1) Control Behaviors Reported Lifetime 2 (0.9) 2 (0.8) 8(1.8) Diagnosis of anorexia, bulimia, or binge eating disorder High Exercise Identity (n = 229) Mean (SE) p for trend Body Mass Index 25.4 (0.34) <.001 (kg/[m.sup.2]) Exercise Compulsion 5.9 (0.13) <.001 (range: 3-12) Moderate Physical 3.6 (0.17) <.001 Activity (hours/week) Vigorous Physical 3.8(0.15) <.001 Activity (hours/week) Body Dissatisfaction 29.8 (0.70) <.001 (range: 13-65) Weight Concern 7.9 (0.18) .225 (range: 4-16) n (%) p for trend Unhealthy Weight 75 (32.6) .182 Control Behaviors Extreme Weight 15(6.5) .180 Control Behaviors Reported Lifetime 5(2.1) .203 Diagnosis of anorexia, bulimia, or binge eating disorder Note. Mean and standard error values denote the level of body mass index, exercise compulsion, fre-quency of physical activity, body dissatisfaction, weight concern, weight control behaviors, and eating disorder diagnoses across each level of exercise identity. Level of exercise identity was determined by participant responses to the item: "Exercising is an important part of who I am." Total sample sizes were determined using the response propensity method based on logistic regression analyses with a large number of predictor variables. Weights were calibrated so that the weighted total sample sizes reflect the demographic make-up of the original Project EAT sample. Table 3 Exercise Identity: Associations with Body Mass Index. Frequency of Physical Activity, Exercise Compulsion. Body Dis-satisfaction. Weight Concern. Weight Control Behaviors (Unhealthy, Extreme), and Eating Disorder Diagnoses Among Women Very Low Low Exercise Exercise Identity Identity (n = 372) (n = 210) Mean (SE) Mean (SEj Body Mass Index 28.2 (0.46) 26.3 (0.34) (kg/[m.sup.2]) Exercise Compulsion 5.2 (0.16) 5.3 (0.12) (range: 3-12) Moderate Physical 1.6 (0.16) 1.5 (0.12) Activity (hours/week) Vigorous Physical 0.9 (0.12) 0.6 (0.09) Activity (hours/week) Body Dissatisfaction 41.2(0.75) 42.0 (0.55) (range: 13-65) Weight Concern 9.9 (0.20) 9.8 (0.15) (range: 4-16) n (%) n (%) Unhealthy Weight 109(51.8) 186 (50.0) Control Behaviors (%) Extreme Weight Control 44 (20.7) 64 (17.0) Behaviors (%) Reported Lifetime 19 (9.0) 13 (3.4) Diagnosis Moderate Exer- High Exercise cise Identity Identity (n = 475) (n = 193) Mean (SE) Mean [SE] p for trend Body Mass Index 26.3 (0.31) 24.7 (0.48) <.001 (kg/[m.sup.2]) Exercise Compulsion 5.9 (0.10) 7.5 (0.16) <.001 (range: 3-12) Moderate Physical 2.4 (0.11) 3.0 (0.16) <.001 Activity (hours/week) Vigorous Physical 1.3 (0.08) 3.1 (0.12) <.001 Activity (hours/week) Body Dissatisfaction 39.0 (0.49) 38.1 (0.78) <.001 (range: 13-65) Weight Concern 9.9 (0.13) 10.3 (0.21) .131 (range: 4-16) n (%) n (%) p for trend Unhealthy Weight 275 (57.7) 125 (64.4) .015 Control Behaviors (%) Extreme Weight Control 95 (20.0) 43 (21.9) .622 Behaviors (%) Reported Lifetime 25(5.2) 16 (7.8) .992 Diagnosis Note. Mean and standard error values denote the level of body mass index, exercise compulsion, frequency of physical activity, body dissatisfaction, weight concern, weight control behaviors, and eating disorder diagnoses across each level of exercise identity. Level of exercise identity was determined by participant responses to the item: "Exercising is an important part of who I am." Total sample sizes were determined using the response propensity method based on logistic regression analyses with a large number of predictor variables. Weights were calibrated so that the weighted total sample sizes reflect the demographic make-up of the original Project EAT sample. Table 4 Exercise Compulsion: Associations with Body Mass Index, Frequency of Physical Activity, Body Dissatisfaction, Weight Concern, Weight Control Behaviors (Unhealthy, Extreme), and Eating Disorder Diagnoses Men (n = 1017) Estimate (SE) t p for trend Body Mass Index 0.247 (0.09) 2.86 .004 (kg/[m.sup.2]) Moderate Physical Activity 0.195 (0.04) 4.80 <.001 (hours/week) Vigorous Physical Activity 0.265 (0.04) 6.82 <.001 (hours/week) Body Dissatisfaction 0.265 (0.17) 1.57 .116 (range: 13-65) Weight Concern 0.435 (0.04) 10.92 <.001 (range: 4-16) Estimate (SE) [X.sup.2] p for trend Unhealthy Weight Control 0.295 (0.04) 59.43 <.001 Behaviors Extreme Weight Control 0.342 (0.06) 36.05 <.001 Behaviors Reported Lifetime Diagnosis 0.372 (0.10) 15.17 <.001 of anorexia, bulimia, or binge eating disorder (%) Women (n = 1251) Estimate (SE) t p for trend Body Mass Index 0.180 (0.08) 2.13 .033 (kg/[m.sup.2]) Moderate Physical Activity 0.185 (0.03) 6.36 <001 (hours/week) Vigorous Physical Activity 0.270 (0.02) 12.00 <001 (hours/week) Body Dissatisfaction 0.641 (0.14) 4.72 <001 (range: 13-65) Weight Concern 0.469 (0.03) 13.95 <001 (range: 4-16) Estimate (SE) [X.sup.2] p for trend Unhealthy Weight Control 0.334 (0.03) 96.23 <.001 Behaviors Extreme Weight Control 0.214 (0.03) 40.33 <.001 Behaviors Reported Lifetime Diagnosis 0.226 (0.06) 16.61 <.001 of anorexia, bulimia, or binge eating disorder (%) Note. Estimates reflect positive associations between exercise compulsion and unhealthy outcomes for men and women. Level of exercise identity was determined by participant responses to the item: "Exercising is an important part of who I am." Total sample sizes were determined using the response propensity method based on logistic regression analyses with a large number of predictor variables. Weights were calibrated so that the weighted total sample sizes reflect the demographic make-up of the original Project EAT sample.
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|Author:||Karr, Trisha M.; Bauer, Katherine W.; Graham, Dan J.; Larson, Nicole; Neumark-Sztainer, Dianne|
|Publication:||Journal of Sport Behavior|
|Date:||May 14, 2014|
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