Screening for compulsive exercise: development of cutoff scores to identify individuals at risk

Compulsive exercise (CE) is proposed to be a unique disorder within the feeding and eating spectrum, with the potential to cause a range of physical and mental health outcomes. However, it often remains undetected, highlighting the need to enhance screening for CE, especially outside of eating disorder (ED) treatment settings. Although CE is commonly assessed using the Compulsive Exercise Test (CET), there are currently no established cutoff scores for identifying CE in community settings or outside of ED populations. This study utilized two samples—a general exercise population and a community sample recruited to capture individuals with elevated mental health symptoms—to identify a suitable cutoff for the CET. Receiver operating characteristic analyses were used, and CE cases were classified in three ways. The area under the curve was moderate to high for detecting CE, and optimal cutoff scores were consistent across CE markers and samples. The present study suggests that a cutoff score of 13.5, which increases sensitivity and balances specificity, can be used to detect possible cases of CE in the community. These results have practical implications for screening across diverse settings and can contribute to further research and understanding of CE.