# Ecological Momentary Assessment of Unhealthy Exercise and Affect in Eating Disorders

> **NIH NIH R36** · UNIVERSITY OF KANSAS LAWRENCE · 2021 · $40,837

## Abstract

PROJECT SUMMARY
Over 65 million people in the U.S. have an eating disorder (ED), and almost 20,000 individuals will die per year
from ED-related health complications or suicide. Unhealthy (excessive) exercise is an ED symptom present in
approximately 50% of people with EDs. When present, excessive exercise is associated with more severe ED
psychopathology, slower rates-of-recovery, and faster rates-of-relapse. If left untreated, individuals with EDs
engaging in unhealthy exercise are at greater risk for negative physical and psychiatric health outcomes and
excess mortality, which, in turn, increase societal costs associated with healthcare utilization. There is a critical
need to use objective measures of physical activity in “real-time” across the weight spectrum in persons with
EDs to understand the function of unhealthy physical activity. The scientific premise that guides the proposed
research is that the identification of antecedents and consequences associated with unhealthy exercise among
persons with EDs will lead to the development of personalized, just-in-time, mHealth interventions that can be
sent to individuals with EDs anytime and anywhere. As a first step toward testing our scientific premise, the
objectives of this study are to: 1) quantify the frequency of different forms of unhealthy exercise; 2) identify the
function of unhealthy exercise relative to temporal changes in affect; and 3) assess individual variation in the
function of unhealthy exercise. We will achieve our objectives through a 7-day ecological momentary
assessment (EMA) study of non-treatment seeking women with EDs (N=90) recruited from our active ED
registry. Participants will: 1) wear a research-grade Actigraph to measure objective physical activity; 2) self-
report restricting and loss-of-control eating episodes through PiLR Health, a free mobile phone app designed to
collect EMA data; and 3) respond to 6 daily, semi-random and exercise contingent surveys to measure levels
of positive and negative affect through the PiLR Health app. Specific aims include: 1) identify the frequency of
different unhealthy exercise patterns among women with EDs using real-time objective assessments of
physical activity; and 2) examine moment-to-moment between- and within-person antecedents and
consequences of unhealthy exercise among women with EDs using real-time assessments of affect and
eating. We aim to identify within-person (i.e., personalized) temporal relationships between affect and
unhealthy exercise. Knowing an individual’s triggers for impending unhealthy exercise will allow for
individualized treatment efforts that do not take a one-size-fits-all approach. By closely monitoring triggers of
unhealthy exercise and current physical activity (via smartwatches), automatic and tailored text messages
could be sent to persons with EDs to intervene when disordered exercise has occurred or is likely to occur.

## Key facts

- **NIH application ID:** 10120732
- **Project number:** 5R36MH120943-02
- **Recipient organization:** UNIVERSITY OF KANSAS LAWRENCE
- **Principal Investigator:** Danielle April Nicole Iverson-Chapa
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $40,837
- **Award type:** 5
- **Project period:** 2020-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10120732

## Citation

> US National Institutes of Health, RePORTER application 10120732, Ecological Momentary Assessment of Unhealthy Exercise and Affect in Eating Disorders (5R36MH120943-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10120732. Licensed CC0.

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