Exercise Addiction Prevalence and Correlates in the Absence of Eating Disorder Symptomology: A Systematic Review and Meta-analysis.
Journal
Journal of addiction medicine
ISSN: 1935-3227
Titre abrégé: J Addict Med
Pays: Netherlands
ID NLM: 101306759
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
5
6
2020
medline:
25
6
2021
entrez:
5
6
2020
Statut:
ppublish
Résumé
Exercise addiction (EA) can be debilitating and can be a symptom of an eating disorder. To date, the prevalence rates of EA without indicated eating disorders in the general population and associated correlates remain unreported. Two authors searched major databases from inception to 31/12/2018 to identify studies investigating the prevalence of EA in any population without indicated eating disorders. We conducted a random effects meta-analysis to report (i) prevalence rates of EA using the exercise addiction inventory and exercise dependence scale and compare sub-populations, (ii) compare methods of EA measurement and explore heterogeneity, and (iii) report on correlates. A total of 13 studies including 3635 people were included. The prevalence of EA among general exercisers was 8.1% (95% CI 1.5%-34.2%), amateur competitive athletes was 5.0% (95% CI 1.3%-17.3%), and university students was 5.5% (95% CI 1.4-19.1%%). Overall prevalence rates varied depending on the EA measurement tool. EA subjects were more likely to have lower levels of overall wellbeing (only in amateur competitive athletes), higher anxiety levels, and have greater frontal brain activity. EA is prevalent in the absence of indicated eating disorders across populations but varies depending on measurement tool. Further research is needed to explore EA without indicated eating disorders in different populations using homogenous measurement tools, further determine psychological correlates, and examine which measures of EA without indicated eating disorders predict poor health outcomes.
Sections du résumé
BACKGROUND
Exercise addiction (EA) can be debilitating and can be a symptom of an eating disorder. To date, the prevalence rates of EA without indicated eating disorders in the general population and associated correlates remain unreported.
METHODS
Two authors searched major databases from inception to 31/12/2018 to identify studies investigating the prevalence of EA in any population without indicated eating disorders. We conducted a random effects meta-analysis to report (i) prevalence rates of EA using the exercise addiction inventory and exercise dependence scale and compare sub-populations, (ii) compare methods of EA measurement and explore heterogeneity, and (iii) report on correlates.
RESULTS
A total of 13 studies including 3635 people were included. The prevalence of EA among general exercisers was 8.1% (95% CI 1.5%-34.2%), amateur competitive athletes was 5.0% (95% CI 1.3%-17.3%), and university students was 5.5% (95% CI 1.4-19.1%%). Overall prevalence rates varied depending on the EA measurement tool. EA subjects were more likely to have lower levels of overall wellbeing (only in amateur competitive athletes), higher anxiety levels, and have greater frontal brain activity.
CONCLUSIONS
EA is prevalent in the absence of indicated eating disorders across populations but varies depending on measurement tool. Further research is needed to explore EA without indicated eating disorders in different populations using homogenous measurement tools, further determine psychological correlates, and examine which measures of EA without indicated eating disorders predict poor health outcomes.
Identifiants
pubmed: 32496431
doi: 10.1097/ADM.0000000000000664
pii: 01271255-202012000-00022
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e321-e329Subventions
Organisme : Department of Health
ID : ICA-CL-2017-03-001
Pays : United Kingdom
Références
Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100 (2):126–1126.
Department of Health. Physical Activity Guidelines for Adults (19-64 years). 2011. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/213740/dh_128145.pdf. Accessed January 10, 2019.
Landolfi E. Exercise addiction. Sports Med 2013; 43 (2):111–119.
Griffiths M. Exercise addiction: a case study. Addict Res 1997; 5 (2):161–168.
Leuenberger A. Endorphins, exercise, and addictions: a review of exercise dependence. Prem J Undergrad Publ Neurosci 2006; 3:1–9.
Adams J. Understanding exercise dependence. J Contemp Psychother 2009; 39 (4):231–240.
Szabo A, Griffiths MD, de La Vega Marcos R, Mervó B, Demetrovics Z. Methodological and conceptual limitations in exercise addiction research. Yale J Biol Med 2015; 88 (3):303–308.
Berczik K, Szabó A, Griffiths MD, et al. Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Subst Use Misuse 2012; 47 (4):403–417.
de Coverley Veale DM, Veale DMWD. Exercise dependence. Br J Addict 1987; 82 (7):735–740.
Veale D. Does Primary Exercise Dependence Really Exist? In: Annett J, Cripps B, Steinberg H, eds. Exercise Addiction: Motivation for Participation in Sport and Exercise. Leicester: British Psychological Society; 1995:1–5.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Washington DC: American Psychiatric Pub; 2013.
World Health Organization. International classification of diseases for mortality and morbidity statistics (11th Revision). 2018. https://icd.who.int/browse11/l-m/en. Accessed January 1, 2020.
Terry A, Szabo A, Griffiths M. The exercise addiction inventory: a new brief screening tool. Addict Res Theory 2004; 12 (5):489–499.
Brown RIF. Eadington W, Cornelius J. Some contributions of the study of gambling to the study of other addictions. Gambling Behavior and Problem Gambling. Nevada: Commercial Gaming, University of Nevada; 1993. 241–272.
Hausenblas HA, Downs DS. How much is too much? The development and validation of the exercise dependence scale. Psychol Health 2002; 17 (4):387–404.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders IV. 4th ed.Washington, DC: American Psychiatric Association; 2000.
Pasman L, Thompson JK. Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. Int J Eat Disord 1988; 7 (6):759–769.
Blumenthal JA, O’Toole LC, Chang JL. Is running an analogue of anorexia nervosa?: An empirical study of obligatory running and anorexia nervosa. JAMA 1984; 252 (4):520–523.
Ogden J, Veale D, Summers Z. The development and validation of the Exercise Dependence Questionnaire. Addict Res 1997; 5 (4):343–355.
Lease HJ, Bond MJ. Correspondence between alternate measures of maladaptive exercise, and their associations with disordered eating symptomatology. J Behav Addict 2013; 2 (3):153–159.
Cunningham HE, Pearman 3rd S, Brewerton TD. Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise. Int J Eat Disord 2016; 49 (8):778–792.
Di Lodovico L, Poulnais S, Gorwood P. Which sports are more at risk of physical exercise addiction: a systematic review. Addict Behav 2019; 93:257–262.
Bratland-Sanda S, Sundgot-Borgen J, Rø Ø, Rosenvinge JH, Hoffart A, Martinsen EW. Physical activity and exercise dependence during inpatient treatment of longstanding eating disorders: an exploratory study of excessive and non-excessive exercisers. Int J Eat Disord 2010; 43 (3):266–273.
Dalle Grave R, Calugi S, Marchesini G. Compulsive exercise to control shape or weight in eating disorders: prevalence, associated features, and treatment outcome. Compr Psychiatry 2008; 49 (4):346–352.
Bamber DJ, Cockerill IM, Rodgers S, Carroll D. Diagnostic criteria for exercise dependence in women. Br J Sports Med 2003; 37 (5):393–400.
Lichtenstein MB, Hinze CJ, Emborg B, Thomsen F, Hemmingsen SD. Compulsive exercise: links, risks and challenges faced. Psychol Res Behav Manag 2017; 10:85–95.
Phillips KA. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. USA: Oxford University Press; 2005.
Cassin SE, von Ranson KM. Personality and eating disorders: a decade in review. Clin Psychol Rev 2005; 25 (7):895–916.
Pallister E, Waller G. Anxiety in the eating disorders: understanding the overlap. Clin Psychol Rev 2008; 28 (3):366–386.
Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med 2007; 4 (10):e296–e1296.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009; 6 (7):e1000100–e11000100.
Wells GA, Shea B, O’connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. 2009; Ottawa (ON): Ottawa Hospital Research Institute, 2009.
Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive Meta Analysis. Englewood, NJ: Biostat; 2013.
Cochran WG. The combination of estimates from different experiments. Biometrics 1954; 10 (1):101–129.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21 (11):1539–1558.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327 (7414):557–560.
Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50 (4):1088–1101.
Egger M, Smith GD, Schneider M, Minder C. Bias in meta - analysis detected by a simple, graphical test. BMJ 1997; 315 (7109):629–634.
Fu R, Gartlehner G, Grant M, et al. Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011; 64 (11):1187–1197.
Sterne JA, Egger M, Moher D. Addressing Reporting Biases. In: Higgins JP, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions (Vol. 4). Chichester: John Wiley & Sons; 2008:297–333.
Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000; 56:455–463.
Bamber D, Cockerill IM, Carroll D. The pathological status of exercise dependence. Br J Sports Med 2000; 34 (2):125–132.
Blaydon MJ, Lindner KJ. Eating disorders and exercise dependence in triathletes. Eat Disord 2002; 10 (1):49–60.
Blaydon MJ, Linder KJ, Kerr JH. Metamotivational characteristics of exercise dependence and eating disorders in highly active amateur sport participants. Personal Individ Differ 2004; 36 (6):1419–1432.
De Young KP, Anderson DA. The importance of the function of exercise in the relationship between obligatory exercise and eating and body image concerns. Eat Behav 2010; 11 (1):62–64.
Di Lodovico L, Dubertret C, Ameller A. Vulnerability to exercise addiction, socio-demographic, behavioral and psychological characteristics of runners at risk for eating disorders. Compr Psychiatry 2018; 81:48–52.
Gapin J, Etnier JL, Tucker D. The relationship between frontal brain asymmetry and exercise addiction. J Psychophysiol 2009; 23 (3):135–142.
Grandi S, Clementi C, Guidi J, Benassi M, Tossani E. Personality characteristics and psychological distress associated with primary exercise dependence: an exploratory study. Psychiatry Res 2011; 189 (2):270–275.
Menczel Z, Griffiths MD, Vingender I, et al. Exercise dependence in amateur competitors and non-competitor recreational exercisers. Int J Ment Health Addict 2017; 15 (3):580–587.
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):4895–4905.
Serier KN, Smith JE, Lash DN, et al. Obligatory exercise and coping in treatment-seeking women with poor body image. Eat Weight Disord EWD 2018; 23 (3):331–338.
Müller A, Claes L, Wos K, et al. Temperament and risk for exercise dependence: results of a pilot study in female patients with eating disorders compared to elite athletes. Psychopathology 2015; 48 (4):264–269.
Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med 1982; 12 (4):871–878.
Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med 1979; 9 (2):273–279.
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 1994; 16 (4):363–370.
Garner DM. Eating Disorder Inventory-2 professional manual. Odessa, FL: Psychological Assessment Resources; 1991.
Mintz LB, O’Halloran MS, Mulholland AM, Schneider PA. Questionnaire for eating disorder diagnoses: reliability and validity of operationalizing DSM-IV criteria into a self-report format. J Couns Psychol 1997; 44 (1):63–79.
Morgan JF, Reid F, Lacey JH. The SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ 1999; 319 (7223):1467–1468.
Susánszky É, Konkolÿ Thege B, Stauder A, Kopp M. A WHO Jól-lét Kérdőív rövidített (WBI-5) magyar változatának validálása a Hungarostudy 2002 országos lakossági egészségfelmérés alapján. Mentálhig És Pszichoszomatika 2006; 7 (3):247–255.
Rosenberg M. Society and the Adolescent Self-Image. New Jersey: Princeton University Press; 2015.
Warner R, Griffiths MD. A qualitative thematic analysis of exercise addiction: an exploratory study. Int J Ment Health Addict 2006; 4 (1):13–26.
Bamber D, Cockerill I, Rodgers S, Carroll D. “It's exercise or nothing”: a qualitative analysis of exercise dependence. Br J Sports Med 2000; 34 (6):423–430.
Petruzzello SJ, Landers DM, Hatfield BD, Kubitz KA, Salazar W. A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Sports Med 1991; 11 (3):143–182.
De Moor MHM, Beem AL, Stubbe JH, Boomsma DI, De Geus EJC. Regular exercise, anxiety, depression and personality: a population-based study. Prev Med 2006; 42 (4):273–279.
McNally GP, Akil H. Role of corticotropin-releasing hormone in the amygdala and bed nucleus of the stria terminalis in the behavioral, pain modulatory, and endocrine consequences of opiate withdrawal. Neuroscience 2002; 112 (3):605–617.
Trott M, Jackson SE, Firth J, et al. A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders. Eat Weight Disord - Stud Anorex Bulim Obes 2020. 1–10.
Sundgot-Borgen J, Torstveit MK. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med 2004; 14 (1):25–32.