The association between exercise addiction and mental health problems: A systematic review and meta-analysis

This study examined the relationship between exercise addiction (EA) and various mental health problems, including eating disorders, body image disturbance, obsessive-compulsive tendencies, anxiety, depression, stress, and emotional dysregulation.

A systematic search was conducted across the PubMed, SCOPUS, SPORTDiscus, Web of Science, PsycINFO, and Embase databases. Random-effects models were employed using the R program, with effect sizes expressed as correlation coefficients (r).

A total of 79 studies involving 40,329 participants were included. EA showed moderate significant associations with eating disorders (r = 0.33, I² = 94.4 %), obsessive-compulsive symptoms (r = 0.30, I² = 97.4 %), depression (r = 0.30, I² = 95.1 %), and stress (r = 0.36, I² = 94.4 %). Smaller but significant associations were found for body image disturbance (r = 0.27, I² = 94.3 %), anxiety (r = 0.27, I² = 94.1 %), and emotional dysregulation (r = 0.25, I² = 89.9 %). Moderator analyses showed stronger associations between EA and eating disorders in Western countries, while the link between EA and depression was more pronounced in Eastern countries. Gender differences indicated that higher proportions of female participants weakened the association between EA and obsessive-compulsive symptoms. Higher exercise levels amplified the associations between EA and anxiety, depression, and obsessive-compulsive symptoms.

The findings provide significant evidence of the associations between EA and various mental health issues, highlighting the moderating roles of cultural context, gender, and exercise levels. These insights provide directions for future research into the mechanisms linking exercise addiction with mental health challenges.