04 APR 2019 KATINKA VAN DE VEN AND ORNELLA CORAZZA

We usually associate addiction with bad things like smoking, alcohol and gambling. But new research shows it’s possible to be potentially dangerously addicted to exercise, too.

Physical activity feels good and it’s great for your health. It can reduce your risk of developing chronic conditions like type 2 diabetes, strengthen your bones, muscles and joints, and can even help with certain mental health conditions, such as depression.

While exercise has clear benefits, it can cause problems if your love of working out crosses over into an addiction.

If you constantly cancel activities with friends or family in favour of exercise – so you plan your life around your gym workouts – you might have a problem. If you exercise in spite of pain or injury, and feel obsessively guilty when you miss a session, it could be that you’re addicted to exercise.

And it’s likely our increasingly image-focused culture may be partly to blame.

Exercise addiction is not a clinically recognised mental disorder, but researchers have developed a variety of questionnaires and other tools to get an idea of its prevalence and who might be at risk.

Around one in 200 people in the general population have an exercise addiction. But our new research shows among people who exercise regularly, factors including their attitudes towards exercise and perceptions of themselves mean more than one in ten could be at risk of becoming addicted.

Committed or addicted?

The concept of exercise addiction is fairly novel and still requires more evidence to define its specific characteristics.

Whether exercise becomes an addiction can be related to the amount and frequency of training, appropriate nutrition, and motivation for exercising.

Over time, researchers have proposed several diagnostic criteria for primary exercise addiction. These include:

  • constant preoccupation with exercise, with significant withdrawal symptoms in the absence of exercise (mood swings, irritability and insomnia)
  • this preoccupation causes clinically significant distress or impairment in one’s physical, social, occupational or other areas of functioning
  • the above is not better accounted for by another mental disorder (such as a means of losing weight or controlling calorie intake as part of an eating disorder).

Secondary exercise addiction may come as part of another disorder, such as anorexia and/or bulimia nervosa.

How common is exercise addiction?

Estimates of prevalence vary according to the population studied, the type of physical activity, the level of competition (whether participants are professional, amateur or recreational athletes), and the tools used to measure exercise addiction.

For example, the prevalence of exercise addiction in the general population has been found to be around just 0.3–0.5% (3 to 5 per 1000 people).

But on the more extreme end of the scale, recent research among elite Australian athletesclassified 34% as having an exercise addiction.

Since exercise addiction is not an official mental health disorder and is not listed yet in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it’s difficult to know exactly how common it is.

But even if we don’t know how many people are addicted to exercise, we know many people who exercise are at risk of becoming addicted. Our Keep Fit study, published today in PLOS One, looked at 1,711 gym users across Europe. We found 11.7% of the exercising population are at risk of exercise addiction.

To measure this, we used what’s called the Exercise Addiction Inventory, as well as Rosenberg’s Self-esteem Scale and the Appearance Anxiety Inventory to measure related disorders. Participants who scored above certain markers on these scales were classified as “at risk”.