Unhealthy cognitive–emotional relationships with exercise can hinder positive treatment outcomes when left unaddressed. However, clinicians lack validated tools to monitor this aspect of treatment. This study examined the 14-item Intuitive Exercise Scale with 165 patients in the United States (M age = 26.48 years) who were receiving treatment for an eating disorder. The original factor structure was inadequate for the current sample, and exploratory factor analysis generated three factors—emotional exercise, body intuition, and exercise variety. The three-factor solution yielded strong internal consistency and partial support for the scale’s validity. Furthermore, patients scored lowest in body intuition, confirming low awareness of bodily cues common in patients with eating disorders. This study informs how clinicians may integrate and monitor patients’ cognitive–emotional relationship with exercise as part of holistic and intuitive eating disorder treatment approaches.