*3.4. Links between Problematic Use of Physical Activity and ED Symptomatology in AN (18*/*47)*

ED symptomatology was studied either globally or focused on one aspect, such as weight preoccupation, drive for thinness, body dissatisfaction or eating behaviors.

Group 1 included eight studies. Three examined general eating disorder pathology and found no association with either locomotor activity [62], actimetry [75], or levels of physical activity [73,76]. When taking into account peak activity (highest per minute level of activity in a 5 min period), PPA was correlated to EDE-Q higher scores [75].

However, significant associations were reported when the core ED symptoms were studied separately. In fact, Davis et al. [45] found that weight preoccupation was positively related to AN patients' level of physical activity. Two studies [40,51] focused on comparing ED symptoms between AN patients and healthy controls and found that PPA in AN patients was significantly associated with greater body dissatisfaction and drive for thinness than controls. Nevertheless, Carrera et al. [67] found that body dissatisfaction subscale scores of the Eating Disorders Inventory (2nd version) were not a significant predictor of PPA in AN.

Group 2 included seven studies with mainly the following results: (1) Weight preoccupation was found positively related to PPA among AN patients [58]; (2) Greater levels of general eating symptoms and bulimic scores were found in AN outpatients who exercised than in those who did not [54]; (3) Drive for thinness was found to be positively associated with PPA in AN [74]; (4) Quantitative food restriction was found to be positively related to PPA in AN patients, even when anxiety was taken into account [56]; (5). PPA was positively correlated with general eating pathology scores of AN outpatients [75,77] and AN inpatients [81]. In fact, Keyes et al. [75] found that ED pathology, along with exercising to improve mood, contributed the most to the variance in PPA in these patients (25.3% and 26.5%, respectively).
