Perfectionism and compulsive exercise: a systematic review and preliminary meta-analysis.

Purpose: There is a consistent link between perfectionism and compulsive exercise, and both are implicated in the maintenance of eating disorders, however no meta-analysis to date has quantified this relationship. We hypothesised that there would be significant, small-moderate pooled correlations between perfectionism dimensions and compulsive exercise.

Methods: Published, peer-reviewed articles with standardised measures of perfectionism and the Compulsive Exercise Test were included. There were 7 studies included (N = 3117 participants, M age = 21.78 years, 49% female).

Results: Total perfectionism (r = 0.37), perfectionistic strivings (r = 0.33), and perfectionistic concerns (r = 0.32) had significant pooled positive associations with compulsive exercise. Most studies (67%) were rated as fair or good quality as an indication of risk of bias. Limitations included the low number of available studies, the inclusion of only one clinical sample, and predominately cross-sectional studies which precluded causal inference.

Conclusion: Higher perfectionism was associated with higher compulsive exercise. More research is needed on compulsive exercise to determine the best intervention approach given its relationship to perfectionism and relevance in the context of eating disorders.

Level of evidence: Level I: Evidence obtained from a systematic review and meta-analysis.