SIGNS A RELATIONSHIP WITH EXERCISE IS BECOMING UNHEALTHY
Physical activity can be an amazing way to support our mental health and help us feel good. But it isn’t helpful for everyone all the time, and can lead to problems for some of us.
It’s important to recognise that sometimes our relationship with being physically active can become unhealthy. Look to help people manage this and get the support they need to develop and maintain a healthy relationship. What are the signs?
Signs can include:
• changes in personality, appearance or how often they exercise
• feeling guilty or anxious when they aren’t doing enough exercise
• exercising in secret
• regular injuries (which can be a sign of over-exercising)
• making excuses to be active
• appearing constantly tired and exhausted
• exercising even when unwell or injured
• exercising instead of connecting with others
• feeling physical activity is the most important thing in their life
• exercising even when they want to stop.
Spotting the signs of over-exercising can be difficult among people who are already very active. Elite Athletes are also at risk of over-exercising (or overtraining) if they are training without enough time to rest and recover between training sessions.
What do I do next?
You can make a real difference. By starting conversations with people about the problem, or letting them know where to get help, you can support them towards developing a healthy relationship with exercise.
It may feel difficult, but asking if someone feels OK can be an important first step.
Remember it’s not your responsibility to fix the problem.
Listening to what they say and letting them know you hear/understand them can be really helpful.
Introduce the benefits of rest. Talk about how it can help physical and mental health.
Show how alternative activities like meditation and massage can become a healthy part of their routine.
Identify a person’s motivation for doing exercise and how it’s making them feel. Physical activity is personal – we all have different preferences, tolerances and fitness levels. Some of us find short sessions suit us best, others enjoy being active for longer. These may differ at different times. Signposting to help and support can help too.
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if you need help working out if you have a problem with exercise, or if you're worried about your exercise, get in touch
The Compulsive Exercise Test
(CET)
The CET is the first measure of problematic exercise that has been developed specifically for use in eating disorders research and assessment, and within a cognitive-behavioural framework.
The following references are the key publications: 1. Taranis, L., Touyz, S., & Meyer, C. (2011). Disordered eating and exercise: Development and preliminary validation of the Compulsive Exercise Test (CET.) European Eating Disorders Review, 19, 256-268 2. Goodwin, H., Haycraft, E., Taranis, L. & Meyer, C. (2011). Psychometric evaluation of the Compulsive Exercise Test (CET) in an adolescent population: Links with eating psychopathology. European Eating Disorders Review.19, 269-279. 3. Meyer, C., Taranis, L., Goodwin, H., & Haycraft, E. (2011). Compulsive exercise and eating disorders. European Eating Disorders Review, 19 174-189.
The CET is a 24-item self-report measure designed to assess the core features of excessive exercise in the eating disorders; compulsivity (e.g. continuing to exercise despite illness or injury, lack of exercise enjoyment, the experience of extreme guilt when unable to exercise, making up for missed exercise sessions), affect regulation (e.g. the positive and negative reinforcement properties of exercise), weight and shape driven exercise (e.g. exercising solely to burn calories, compensatory exercise such as debting), and exercise rigidity (rigid adherence to a strict and repetitive exercise routine).
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Items were generated from a comprehensive appraisal of the eating disorder and excessive exercise literature, consultation with clinical eating disorder specialists, interviews with eating disorder patients, and a critical review of existing scales, and were included based on theoretical relevance and clinical specificity.
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The CET uses a 6-point Likert scale anchored by 0 (never true) and 5 (always true) with higher scores indicative of greater pathology. Factor analysis revealed 5 factors explaining 63.5% of the variance. These were used to construct the 5 subscales of: avoidance and rule-driven behaviour, weight control exercise, mood improvement, lack of exercise enjoyment, and exercise rigidity. Initial validation results are encouraging with good internal consistency, content validity, and concurrent validity of the CET. The CET also demonstrates strong positive associations with measures of eating pathology and known correlates of disordered eating. It is concluded that the CET could be a reliable and valid instrument for use in both clinical and research settings.
CET Scoring Criteria: • Items 8 and 12 are reverse scored. • Subscale scores are obtained by summing the scores for all items in the subscale and dividing by the number of items (mean score). •
CET total score is calculated by summing the mean scores for all subscales.
Subscale Items
Avoidance and rule-driven behaviour 9, 10, 11, 15, 16, 20, 22, 23
Weight control exercise 2, 6, 8, 13, 18
Mood improvement 1, 4, 14, 17, 24
Lack of exercise enjoyment 5, 12, 21
Exercise rigidity 3, 7, 19
CET
Instructions
Listed below are a series of statements regarding exercise. Please read each statement carefully and circle the number that best indicates how true each statement is of you. Please answer all the questions as honestly as you can.
Never true Rarely true Sometimes true Often true Usually true Always true
0 1 2 3 4 5
1) I feel happier and/or more positive after I exercise. 0 1 2 3 4 5
2) I exercise to improve my appearance. 0 1 2 3 4 5
3) I like my days to be organised and structured of which exercise is just one part. 0 1 2 3 4 5
4) I feel less anxious after I exercise. 0 1 2 3 4 5
5) I find exercise a chore. 0 1 2 3 4 5
6) If I feel I have eaten too much, I will do more exercise. 0 1 2 3 4 5
7) My weekly pattern of exercise is repetitive. 0 1 2 3 4 5
8) I do not exercise to be slim. 0 1 2 3 4 5
9) If I cannot exercise I feel low or depressed. 0 1 2 3 4 5
10) I feel extremely guilty if I miss an exercise session. 0 1 2 3 4 5
11) I usually continue to exercise despite injury or illness, unless I am very ill or too injured. 0 1 2 3 4 5
12) I enjoy exercising. 0 1 2 3 4 5
13) I exercise to burn calories and lose weight. 0 1 2 3 4 5
14) I feel less stressed and/or tense after I exercise. 0 1 2 3 4 5
15) If I miss an exercise session, I will try and make up for it when I next exercise. 0 1 2 3 4 5
16) If I cannot exercise I feel agitated and/or irritable. 0 1 2 3 4 5
17) Exercise improves my mood. 0 1 2 3 4 5
18) If I cannot exercise, I worry that I will gain weight. 0 1 2 3 4 5
19) I follow a set routine for my exercise sessions e.g. walk or run the same route, particular exercises, same amount of time, and so on. 0 1 2 3 4 5
20) If I cannot exercise I feel angry and/or frustrated. 0 1 2 3 4 5
21) I do not enjoy exercising. 0 1 2 3 4 5
22) I feel like I’ve let myself down if I miss an exercise session. 0 1 2 3 4 5
23) If I cannot exercise I feel anxious. 0 1 2 3 4 5
24) I feel less depressed or low after I exercise. 0 1 2 3 4 5