Exercise Dependence and Its Health Correlates: A Cross-Sectional Survey-Based Study of Impulsivity, Depression...

Exercise dependence is a potentially maladaptive pattern in which regular training becomes compulsive, poorly controlled, and associated with functional impairment. Given uncertainty about whether dependence-related symptoms are more closely associated with affective distress, impulsivity, or exercise exposure, the present study examined multidimensional impulsivity, depressive symptom severity, sociodemographic characteristics, and weekly exercise duration in relation to the 21-item Exercise Dependence Scale (EDS-21) risk classification among regular exercisers.

In the present cross-sectional study, 850 adults aged ≥18 years who regularly exercised at municipal centers, sports facilities, and healthy-living complexes in Türkiye completed the EDS-21, Short UPPS-P Impulsive Behavior Scale, Short Beck Depression Inventory, and questions on weekly exercise duration, sociodemographic information, and health-related variables. Analyses included descriptive statistics, Spearman correlations, Kruskal-Wallis tests, Firth-penalized binary logistic regression, and an exploratory multinomial logistic regression retaining all three EDS-21 categories.

Thirty-two participants met the EDS-21 dependence-risk classification (3.8%), while 443 were symptomatic (52.1%) and 375 were asymptomatic (44.1%). EDS-21 total score correlated with sensation seeking (r = 0.28, p < 0.001), total impulsivity (r = 0.23, p < 0.001), and depression symptom severity (r = 0.09, p = 0.01). In the Firth model, being single (OR = 5.77, 95% CI [1.23, 33.03], p = 0.02), higher total impulsivity (OR = 1.71 per 10-point increase, 95% CI [1.07, 2.75], p = 0.02), and longer weekly exercise duration (OR = 1.23 per additional 60 min/week, 95% CI [1.14, 1.33], p < 0.001) were associated with the dependence-risk classification. Depression symptom severity was not (p = 0.25).

EDS-21 dependence-risk classification was associated with impulsivity, single marital status, and weekly exercise duration in the present sample. The null depression finding should be interpreted cautiously because scores were low and showed limited between-group variability. These cross-sectional findings identify correlates rather than temporal or causal predictors.