Exercise addiction: A narrative overview of research issues

Figures & data

Figure 1. Exercise addiction abstracts PUBMED

Table 1. Prevalence of exercise addiction among athletes (arranged chronologically).

Study (year and reference number)	Country and study population	Number	Prevalence rates	EA definition and assessment
Lichtenstein and Jensen (2016)	Denmark	603 Cross-fit	5%	EAI – An online survey using Facebook groups.
Bueno-Antequera et al. (2020)	Spain	1014 Indoor cyclists	13.3%, high risk	EAI using a web-based experiment.
Zandonai et al. (2021)	Italy and Japan	229 Italian and 198 Japanese runners	4.4% among Italian runners and 0% among Japanese runners	EDS-R using an interview.
Collado-Boira et al. (2021)	Italy	317 Runners, 31.9% road marathon, 28.7% mountain marathon, 39.4% ultra-trail	15.4%	EDS-R and observation.
Lichtenstein et al. (2021)	Denmark	417 Elite athletes from 15 sports disciplines	7.6%	EAI using an online survey.
Ganson et al. (2022)	USA	8251 Participants of the national (USA) Healthy Minds Study	11% of men and 17% of women	Compulsive exercise was measured based on number of occurrences in the past 28 days (analyzed continuously and among those who reported ≥1 and ≥20 occurrences). Using a national survey.
Bueno-Antequera et al. (2022)	Spain	330 Adult cyclists (30 women)	6.1%	EAI using a survey from pre- to 6-month post-competition.
Lassner et al. (2022)	Germany	72 Marathon runners (19.4% female)	6.94%	EAI, using a survey with physiological measures.

Abbreviations and references: EAI: Griffiths et al. (2005); EDS-R: Downs et al. (2009).

Table 2. Co-occurrence of exercise addiction and psychiatric symptoms and disorders (arranged chronologically).

Study (year and reference number)	Country	Number	Co-occurring disorders/symptoms and rates or association with psychopathology	Assessment method
Weinstein et al. (2015)	Israel	20 Professional regular exercisers	Anxiety, depression	CES, BDI, STAI
		51 Recreational regular exercisers
Li et al. (2015)	China	1601 College students	State anxiety, depression	EAI, STAI, CES-D, SWB.
Levit et al. (2018)	Israel	100 Competitive and amateur athletes (67 males and 35 females)	Depression and abnormal eating attitudes	EAI, EAT, STAI, BDI.
Lichtenstein et al. (2018)	Denmark	1083 Recreational exercisers	Depression, stress	EAI youth version
				SCOFF
				EA prevalence of 21% in patients with eating disorders.
Pinto et al. (2019)	Israel	288 Combat reserves, non-combat reserves and control participants	Stress	EDS-R, EAI-Revised, PSS
Rogers et al. (2019)	USA	540 Participants from the general public	Depression, suicide attempts	EDS, ACSS
				History of suicidal behaviour.
Meyer et al. (2021)	Switzerland	156 Individuals who exercise more than 10 h a week	Depressive disorders, personality disorders and OCD	EDS, SCID-5-CV, SCID-5-PD. An interview based on the DSM-5 criteria of non-substance-related addictive disorders to explore the severity of exercise addiction symptoms.
Bueno-Antequera et al. (2020)	Spain	330 Cyclists	Depression and anxiety	IPAQ short form, EDI and health outcomes through a web-based experiment.
Lassner et al. (2022)	Germany	72 Marathon runners (20% female)	Depression	EAI, GAF, IPAQ, BDI, PANAS
Gunnarsson et al. (2022)	Sweden	3029 responders to fitness media	Social phobia, eating disorders and OCD	EAI, AUDIT-C, Yes/no questions regarding a variety of psychiatric disorders
Alcaraz-Ibáñez, Paterna, Griffiths, et al. (2022)	Spain	691 Undergraduate leisure exercisers	Depression	EAI, the Depression sub-scale of the BSI-18, SCOFF
Colledge et al. (2022)	Switzerland	123 Individuals exercising for more than 10 h a week	Depression, ADHD and childhood trauma	EDS, BDI, HASE, ADHS, CTQ
Habelt et al. (2022)	Austria and Germany	335 Participants, 88 with mountaineering addiction and 247 control participants	Depression, anxiety, eating disorders, alcohol abuse or dependence, illicit drug abuse	EAI, EDS adapted version for mountaineering, PHQ-4, PHQ-9, body mass index BMI.

Abbreviations and references: ACSS: Bender et al. (2011); ADHS: Schmidt et al. (2018); AUDIT-C: Bush et al. (1998); BDI: Beck et al. (1996); BSI-18: Derogatis (2000); CES: Tuttle (1992); CES-D: Lewinsohn et al. (1997); CTQ: Bernstein et al. (1994); EAI: Griffiths et al. (2005); EDS: Hausenblas and Downs (2002); EDS-R: Downs et al. (2009); GAF: Start-up et al. (2002); EAT: Garner and Garfinkel (1979); IPAQ: Craig et al. (2003); PANAS: Watson et al. (1998); PHQ-4: Löwe et al. (2010); PHQ-9: Levis et al. (2019); PSS: Cohen et al. (1983); SCID-5-CV: First et al. (2016); SCID-5-PD: First et al. (2015); SCOFF: Morgan et al. (1999); STAI: Spielberger et al. (1983); SWB: Ji and Li (2006).

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