Mediating Roles of Psychological Distress, Insomnia, and Body Image Concerns in the Association Between Exercise Addiction and Eating Disorders

Abstract

Purpose

Exercising can promote good health. However, excessive exercising may have downsides. This study examined the association between exercise addiction and eating disorders and whether the identified association was mediated by psychological distress, insomnia (including sleep quality), and body image concern.

Methods

A total of 2088 adolescents (mean age of 15.3 years) participated in this cross-sectional study by questions assessing exercise addiction, eating disorders, psychological distress, insomnia, sleep quality, and body image concern.

Results

There were significantly positive relationships between the variables (r=0.12–0.54, p<0.01) with effect sizes from small to large. The four potential mediators (ie, insomnia, sleep quality, psychological distress, and body image concern), individually and in total, significantly mediated the association between exercise addiction and eating disorders.

Conclusion

The findings suggest that exercise addiction in adolescents may influence eating disorders through multiple pathways, such as insomnia, psychological distress, and body image concerns. Future research should examine these relationships longitudinally and use gathered information to inform intervention development. Clinicians and healthcare workers are encouraged to assess exercise addiction when treating individuals with eating disorders.

Keywords:

• addictive behaviour
• exercise
• eating disorder
• insomnia
• stress
• compulsive behaviour
• adolescent

Compliance with Ethical Standards

All the methods were performed in accordance with the Declaration of Helsinki. The study was approved by the Ethical Committee of Qazvin University of medical sciences (protocol code IR.QUMS.REC.1401.098). Informed consent was obtained from one of the parents of adolescents and adolescents themselves who participated in the study.

Acknowledgments

We would also like to thank study participants and their parents.

Disclosure

Dr. Potenza has consulted for Opiant Therapeutics, Game Day Data, Baria-Tek, the Addiction Policy Forum, AXA, and Idorsia Pharmaceuticals; been involved in a patent application with Yale University and Novartis; received research support from Mohegan Sun Casino, Children and Screens and the Connecticut Council on Problem Gambling; participated in surveys, mailings, or telephone consultations related to drug addictions, internet use, impulse-control disorders, and other health topics; consulted for or advised gambling, non-profit and legal entities on issues related to internet use, impulse-control and /addictive disorders; and given academic lectures in grand rounds, continuing medical education events, and other clinical or scientific venues. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was funded by the Qazvin University of Medical Sciences (1401). Hsin-Pao Chen is financially supported by the funding of the E-Da Hospital (EDAPH111043 & EDACHT111007).