Exercise addiction – cases, possible indicators and open questions

While addictive disorders involving substances are well researched, the field of behavioral addictions, including exercise addiction, is in its infancy. Although exercise addiction is not yet recognized as a psychiatric disorder, evidence for the burden it imposes has gained attention in the last decade. Characterised by a rigid exercise schedule, the prioritization of exercise over one’s own health, family and professional life, and mental wellbeing, and extreme distress when exercise is halted, the phenomenon shares many feature with substance use disorders. While prevalence is thought to be low, affecting one in every 1000 exercisers, current research suggests that the symptoms are extremely burdensome, and may often be accompanied by other psychiatric disorders. It is no longer thought to be the case that only endurance athletes are at risk. While disease history and neural substrates are still to be clarified, there are a number of indicators which may help clinicians and sports physicians identify a possible case of exercise addiction.