Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Sports Medicine
Published in: Sports Medicine 2/2019

01-02-2019 | Systematic Review

Prevalence of Risk for Exercise Dependence: A Systematic Review

Authors: Adilson Marques, Miguel Peralta, Hugo Sarmento, Vânia Loureiro, Élvio R. Gouveia, Margarida Gaspar de Matos

Published in: Sports Medicine | Issue 2/2019

Login to get access

Abstract

Background

Exercise dependence (EXD) can be considered an addictive behaviour because it presents signs typical of other addictive behaviours. Despite possible health problems related to EXD, the prevalence of risk for EXD has never been systematically reviewed.

Objective

This article aimed to systematically review the prevalence of risk for EXD.

Methods

Studies were identified from searches in the ERIC, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science electronic databases up to June 2018. Empirical studies were selected if (1) they included the outcomes of the prevalence of EXD; (2) participants were regular exercisers; and (3) they were published in either the English, French, Portuguese, or Spanish languages. A total of 34 articles met the inclusion criteria.

Results

The prevalence of risk for EXD was estimated to be between 3 and 7% of regular exercisers and the university student population, and between 6 and 9% of the athlete population.

Conclusion

The results of this review indicated that the prevalence of risk for EXD varies with the characteristics of the exerciser, but an overall prevalence of 3–9% is estimated. Risk for EXD is a cause for concern and, from a public health point of view, is a problem that has to be addressed.
Literature
1.
Caspersen C, Powell K, Christenson G. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100:126–31.PubMedPubMedCentral
2.
Hardman A, Stensel D. Physical activity and health. The evidence explained. 2nd ed. Oxon: Routledge; 2009.CrossRef
3.
Egorov AY, Szabo A. The exercise paradox: an interactional model for a clearer conceptualization of exercise addiction. J Behav Addict. 2013;2(4):199–208.CrossRef
4.
Hausenblas HA, Downs DS. Exercise dependence: a systematic review. Psychol Sport Exerc. 2002;3(2):89–123.CrossRef
5.
Hausenblas HA, Giacobbi PR. Relationship between exercise dependence symptoms and personality. Pers Indiv Differ. 2004;36(6):1265–73.CrossRef
6.
7.
Freimuth M, Moniz S, Kim SR. Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. Int J Environ Res Public Health. 2011;8(10):4069–81.CrossRef
8.
Szabo A, Griffiths MD, de La Vega Marcos R, Mervo B, Demetrovics Z. Methodological and conceptual limitations in exercise addiction research. Yale J Biol Med. 2015;88(3):303–8.PubMedPubMedCentral
9.
Baekeland F. Exercise deprivation. Sleep and psychological reactions. Arch Gen Psychiatry. 1970;22(4):365–9.CrossRef
10.
Weinstein A, Weinstein Y. Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues. Curr Pharm Des. 2014;20(25):4062–9.CrossRef
11.
Szabo A. Addiction to exercise: a symptom or a disorder?. New York: Nova Science Publishers; 2010.
12.
Cook B, Luke R. Primary and secondary exercise dependence in a sample of cyclists. Int J Ment Health Addict. 2017;15(2):444–51.CrossRef
13.
Bruno A, Quattrone D, Scimeca G, Cicciarelli C, Romeo VM, Pandolfo G, et al. Unraveling exercise addiction: the role of narcissism and self-esteem. J Addict. 2014;2014:987841.CrossRef
14.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Arlington: American Psychiatric Association; 2013.CrossRef
15.
Muller A, Loeber S, Sochtig J, Te Wildt B, De Zwaan M. Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers. J Behav Addict. 2015;4(4):273–80.CrossRef
16.
Lejoyeux M, Avril M, Richoux C, Embouazza H, Nivoli F. Prevalence of exercise dependence and other behavioral addictions among clients of a Parisian fitness room. Compr Psychiatry. 2008;49(4):353–8.CrossRef
17.
Carnes PJ, Murray RE, Charpentier L. Bargains with chaos: sex addicts and addiction interaction disorder. Sex Addict Compulsivity. 2005;12(2–3):79–120.CrossRef
18.
Lichtenstein MB, Christiansen E, Bilenberg N, Stoving RK. Validation of the exercise addiction inventory in a Danish sport context. Scand J Med Sci Sports. 2014;24(2):447–53.CrossRef
19.
Mayolas-Pi C, Simon-Grima J, Penarrubia-Lozano C, Munguia-Izquierdo D, Moliner-Urdiales D, Legaz-Arrese A. Exercise addiction risk and health in male and female amateur endurance cyclists. J Behav Addict. 2017;6(1):74–83.CrossRef
20.
Bamber D, Cockerill IM, Carroll D. The pathological status of exercise dependence. Br J Sports Med. 2000;34(2):125–32.CrossRef
21.
Lichtenstein MB, Emborg B, Hemmingsen SD, Hansen NB. Is exercise addiction in fitness centers a socially accepted behavior? Addict Behav Rep. 2017;6:102–5.CrossRef
22.
23.
Monok K, Berczik K, Urban R, Szabo A, Griffiths MD, Farkas J, et al. Psychometric properties and concurrent validity of two exercise addiction measures: a population wide study. Psychol Sport Exerc. 2012;13(6):739–46.CrossRef
24.
Griffiths MD, Szabo A, Terry A. The exercise addiction inventory: a quick and easy screening tool for health practitioners. Br J Sports Med. 2005;39(6):e30.CrossRef
25.
Griffiths M. Exercise addiction: a case study. Addict Res. 1997;5(2):161–8.CrossRef
26.
Allegre B, Souville M, Therme P, Griffiths M. Definitions and measures of exercise dependence. Addict Res Theory. 2006;14(6):631–46.CrossRef
27.
Szabo A, Griffiths MD. Exercise addiction in British sport science students. Int J Ment Health Addict. 2007;5(1):25–8.CrossRef
28.
Terry A, Szabo A, Griffiths M. The exercise addiction inventory: a new brief screening tool. Addict Res Theory. 2004;12(5):489–99.CrossRef
29.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRef
30.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.CrossRef
31.
32.
Lejoyeux M, Guillot C, Chalvin F, Petit A, Lequen V. Exercise dependence among customers from a Parisian sport shop. J Behav Addict. 2012;1(1):28–34.CrossRef
33.
Guidi J, Pender M, Hollon SD, Zisook S, Schwartz FH, Pedrelli P, et al. The prevalence of compulsive eating and exercise among college students: an exploratory study. Psychiatry Res. 2009;165(1–2):154–62.CrossRef
34.
Cunningham HE, Pearman S, Brewerton TD. Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise. Int J Eat Disord. 2016;49(8):778–92.CrossRef
35.
Cook B, Karr TM, Zunker C, Mitchell JE, Thompson R, Sherman R, et al. Primary and secondary exercise dependence in a community-based sample of road race runners. J Sport Exerc Psychol. 2013;35(5):464–9.CrossRef
36.
Magee CA, Buchanan I, Barrie L. Profiles of exercise dependence symptoms in Ironman participants. Psychol Sport Exerc. 2016;24:48–55.CrossRef
37.
Latorre Román PÁ, Obra AJ, Montilla JP, Pinillos FG. Dependency on physical exercise and body dissatisfaction in various endurance sports and their relation with the motivation to do sports. Rev Psicol Deporte. 2016;25(1):113–20.
38.
García CR, Martínez-Rodríguez A, Ortín Montero FJ. Exercise dependence and mood states indicators in university athletes. C Psicol Deport. 2015;15(2):21–6.CrossRef
39.
Meulemans S, Pribis P, Grajales T, Krivak G. Gender differences in exercise dependence and eating disorders in young adults: a path analysis of a conceptual model. Nutrients. 2014;6(11):4895–905.CrossRef
40.
Downs DS, Hausenblas DH, Nigg C. Factorial validity and psychometric examination of the exercise dependence scale-revised. Meas Phys Educ Exerc Sci. 2004;8(4):183–201.CrossRef
41.
Menczel Z, Kovács E, Eisinger A, Magi A, Vingender I, Demetrovics Z, et al. Exercise dependence among hungariane fitness center users: preliminary results. New Med. 2014;2014(3):103–8.
42.
Soler PT, Fernandes HM, Damasceno VO, Novaes JS. Vigorexy and levels of exercise dependence in gym goers and bodybuilders. Rev Bras Med Esporte. 2013;19(5):343–8.CrossRef
43.
Costa S, Hausenblas HA, Oliva P, Cuzzocrea F, Larcan R. The role of age, gender, mood states and exercise frequency on exercise dependence. J Behav Addict. 2013;2(4):216–23.CrossRef
44.
Lindwall M, Palmeira A. Factorial validity and invariance testing of the exercise dependence scale-revised in Swedish and Portuguese exercisers. Meas Phys Educ Exerc Sci. 2009;13(3):166–79.CrossRef
45.
46.
Villella C, Martinotti G, Di Nicola M, Cassano M, La Torre G, Gliubizzi MD, et al. Behavioural addictions in adolescents and young adults: results from a prevalence study. J Gambl Stud. 2011;27(2):203–14.CrossRef
47.
Lichtenstein MB, Jensen TT. Exercise addiction in CrossFit: prevalence and psychometric properties of the Exercise Addiction Inventory. Addict Behav Rep. 2016;3:33–7.CrossRef
48.
Lichtenstein MB, Larsen KS, Christiansen E, Stoving RK, Bredahl TVG. Exercise addiction in team sport and individual sport: prevalences and validation of the exercise addiction inventory. Addict Res Theory. 2014;22(5):431–7.CrossRef
49.
Szabo A, De La Vega R, Ruiz-Barquin R, Rivera O. Exercise addiction in Spanish athletes: investigation of the roles of gender, social context and level of involvement. J Behav Addict. 2013;2(4):249–52.CrossRef
50.
Sicilia A, Alias-Garcia A, Ferriz R, Moreno-Murcia JA. Spanish adaptation and validation of the Exercise Addiction Inventory (EAI). Psicothema. 2013;25(3):377–83.PubMed
51.
Pallanti S, Bernardi S, Quercioli L. The Shorter PROMIS Questionnaire and the Internet Addiction Scale in the assessment of multiple addictions in a high-school population: prevalence and related disability. CNS Spectr. 2006;11(12):966–74.CrossRef
52.
Alcaraz-Ibanez M, Aguilar-Parra J, Alvarez-Hernandez JF. Exercise addiction: preliminary evidence on the role of psychological inflexibility. Int J Ment Health Addict. 2018;16(1):199–206.CrossRef
53.
Valenzuela PL, Arriba-Palomero F. Risk of exercise addiction among male amateur triathletes and its relationship with training variables. Rev Int Cienc Deporte. 2017;13(48):162–71.CrossRef
54.
Rocks T, Pelly F, Slater G, Martin LA. Prevalence of exercise addiction symptomology and disordered eating in Australian students studying nutrition and dietetics. J Acad Nutr Diet. 2017;117(10):1628–36.CrossRef
55.
Sicilia A, Bracht V, Penha V, Almeida UR, Ferriz R, Alcaraz-Ibanez M. Psychometric properties of the Exercise Addiction Inventory (EAI) in a sample of Brazilian university students. Univ Psychol. 2017;16(2).
56.
Lichtenstein MB, Griffiths MD, Hemmingsen SD, Stoving RK. Exercise addiction in adolescents and emerging adults: validation of a youth version of the Exercise Addiction Inventory. J Behav Addict. 2018;7(1):117–25.CrossRef
57.
Rudolph S. The connection between exercise addiction and orthorexia nervosa in German fitness sports. Eating Weight Disord. 2018;23(5):581–6.CrossRef
58.
Hammond CJ, Mayes LC, Potenza MN. Neurobiology of adolescent substance use and addictive behaviors: treatment implications. Adolesc Med State Art Rev. 2014;25(1):15–32.PubMedPubMedCentral
59.
Potenza MN. Biological contributions to addictions in adolescents and adults: prevention, treatment, and policy implications. J Adolesc Health. 2013;52(2 Suppl 2):S22–32.CrossRef
60.
McElhaney KB, Antonishak J, Allen JP. “They like me, they like me not”: popularity and adolescents’ perceptions of acceptance predicting social functioning over time. Child Dev. 2008;79(3):720–31.CrossRef
61.
Hausenblas HA, Fallon EA. Relationship among body image, exercise behavior, and exercise dependence symptoms. Int J Eat Disord. 2002;32(2):179–85.CrossRef
62.
Babic MJ, Morgan PJ, Plotnikoff RC, Lonsdale C, White RL, Lubans DR. Physical activity and physical self-concept in youth: systematic review and meta-analysis. Sports Med. 2014;44(11):1589–601.CrossRef
63.
Hausenblas HA, Fallon EA. Exercise and body image: a meta-analysis. Psychol Health. 2006;21(1):33–47.CrossRef
64.
Szabo A, Griffiths DM, Demetrovics Z. Neuropathology of drug addictions and substance misuse. In: Preedy VR, editor. Neuropathology of drug addictions and substance misuse. General processes and mechanisms, prescription medications, caffeine and areca, polydrug misuse, emerging addictions and non-drug addictions. London: Academic Press; 2016. p. 984–92.
65.
Fisher J, Sales A, Carlson L, Steele J. A comparison of the motivational factors between CrossFit participants and other resistance exercise modalities: a pilot study. J Sports Med Phys Fitness. 2017;59(9):1227–34.
66.
Pierce EF, Daleng ML, McGowan RW. Scores on exercise dependence among dancers. Percept Mot Skills. 1993;76(2):531–5.CrossRef
67.
Hale BD, Roth AD, DeLong RE, Briggs MS. Exercise dependence and the drive for muscularity in male bodybuilders, power lifters, and fitness lifters. Body Image. 2010;7(3):234–9.CrossRef
68.
69.
70.
Szabo A. Addiction, passion, or confusion? New theoretical insights on exercise addiction research from the case study of a female body builder. Eur J Psychol. 2018;14(2):296–316.CrossRef
71.
Mageau GA, Vallerand RJ, Charest J, Salvy SJ, Lacaille N, Bouffard T, et al. On the development of harmonious and obsessive passion: the role of autonomy support, activity specialization, and identification with the activity. J Pers. 2009;77(3):601–46.CrossRef
72.
Vallerand RJ, Blanchard C, Mageau GA, Koestner R, Ratelle C, Leonard M, et al. Les passions de l’ame: on obsessive and harmonious passion. J Pers Soc Psychol. 2003;85(4):756–67.CrossRef
73.
Pontes HM, Macur M, Griffiths MD. Internet gaming disorder among Slovenian primary schoolchildren: findings from a nationally representative sample of adolescents. J Behav Addict. 2016;5(2):304–10.CrossRef
Metadata
Title
Prevalence of Risk for Exercise Dependence: A Systematic Review
Authors
Adilson Marques
Miguel Peralta
Hugo Sarmento
Vânia Loureiro
Élvio R. Gouveia
Margarida Gaspar de Matos
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 2/2019
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-018-1011-4

Other articles of this Issue 2/2019

Sports Medicine 2/2019 Go to the issue

Review Article

The Muscle Protein Synthetic Response to Meal Ingestion Following Resistance-Type Exercise

Systematic Review

Effects of Evening Exercise on Sleep in Healthy Participants: A Systematic Review and Meta-Analysis

Systematic Review

Aerobic Training Protects Cardiac Function During Advancing Age: A Meta-Analysis of Four Decades of Controlled Studies

Letter to the Editor

Comment on: “The Effectiveness of Resisted Sled Training (RST) for Sprint Performance: A Systematic Review and Meta-analysis”

Commentary

Reflecting on Eliud Kipchoge’s Marathon World Record: An Update to Our Model of Cooperative Drafting and Its Potential for a Sub-2-Hour Performance

Letter to the Editor

Authors’ Reply to Carling et al: Comment on: “The Use of Microtechnology to Quantify the Peak Match Demands of the Football Codes: A Systematic Review”