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To date, no comprehensive theoretical model exists to describe pathological exercise in the context of AN, and as such, few treatments are effective at promoting direct and sustained pathological exercise extinction. Using a framework put forth by Wise &amp; Koob (2014), debating the relative importance of positive and negative reinforcement in substance use, we present three hypotheses of behavioral reinforcement of exercise, encompassing biological, psychological, and environmental influences. Specifically, we argue that exercise is positively reinforced through receipt of biological and behavioral rewards, negatively reinforced through avoidance of aversive emotions, and that these two systems work in tandem over time to engrain pathological exercise as a habit. We then present suggestions for testing each of these hypotheses as future directions for the field.<\/jats:p>","DOI":"10.1002\/eat.23626","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T15:56:08Z","timestamp":1633881368000},"page":"184-192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Behavioral reinforcement of pathological exercise in anorexia nervosa"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8549-2790","authenticated-orcid":false,"given":"Kathryn A.","family":"Coniglio","sequence":"first","affiliation":[{"name":"Department of Psychology, Rutgers The State University of New Jersey  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3822-5809","authenticated-orcid":false,"given":"Marita","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A.","family":"Selby","sequence":"additional","affiliation":[{"name":"Department of Psychology, Rutgers The State University of New Jersey  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10578310210395"},{"issue":"2","key":"e_1_2_6_3_1","first-page":"32","article-title":"Rat park chronicle","volume":"22","author":"Alexander B. 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