A recent scientific review provides evidence that physical activity can sometimes turn into a harmful behavioral addiction, but researchers caution against pathologizing healthy approaches to sport and fitness. This analysis suggests that true addicts engage in compulsive training that has serious physical and emotional consequences, even though the condition is still not listed in official psychiatric diagnostic manuals. The results of this research have recently Behavioral Addiction Journal.
Regular physical activity is well proven to be beneficial for both body and mind. Reduce your risk of chronic disease, improve your mental health, and increase your overall quality of life. But exercise can sometimes turn from a healthy habit into an uncontrollable and destructive behavior.
A team of scientists reviewed existing literature to uncover the various definitions, symptoms, and treatment options surrounding this condition. The research team also included researcher Bavya Chhabra from Eötvös Lorand University. Zsolt Demetrović, Professor of Mental Health and Wellbeing at Flinders University. Attila Szabo, professor of psychology at István Széchenyi University and Eötvös Lorand University. Mark D. Griffiths, a researcher at Nottingham Trent University. The authors initiated this review because the scientific community currently struggles to agree on exactly how to define and measure problematic fitness habits.
Exercise addiction is classified as a behavioral addiction. Unlike substance addictions, such as drugs or alcohol, behavioral addictions involve a person becoming dependent on a particular behavior. In this case, individuals feel a strong urge to exercise and experience withdrawal symptoms such as psychological distress if they are unable to train.
Scientists explain that true addiction always includes two main components: dependence and compulsion. Dependency means that the body or mind depends on an activity to function properly. Compulsion refers to an overwhelming and irresistible urge to perform an action.
“The key difference is whether exercise is something you choose or something you feel forced to do,” Demetrovics says. He points out that while passion, discipline, and high training loads are generally positive traits, especially among athletes, these healthy habits can sometimes tip into harmful territory.
Addiction to physical activity can be classified as either primary or secondary. In primary exercise addiction, the workout itself is the primary source of addictive reward. In secondary exercise addiction, excessive activity is caused by another underlying condition, such as an eating disorder or poor body image.
“The underlying factors are often more complex than the training itself, with social pressures regarding body image and performance playing a key role, along with mental health issues such as anxiety and depression,” Demetrovics said. “Excessive exercise is often linked to deeper issues such as eating disorders or other compulsive behaviors.”
Despite more than 50 years of research, the condition is not officially recognized in major medical texts such as the Diagnostic and Statistical Manual of Mental Disorders. Researchers note that this exclusion is due to inconsistent screening methods and a lack of clinical studies. More than 30 different assessment tools are used in the academic literature to describe the problem, but there is no general agreement as to which one is best.
“That tends to inflate the estimates and make what is normally a healthy exercise pathological,” Demetrovics said. He explains that studies of how many people actually suffer from the condition yield highly inconsistent numbers, depending largely on the screening tools used.
“Widely cited figures suggest that up to 42% of some athletic populations may be at risk of being considered exercise addicts,” Demetrovics said. The authors note that these inflated numbers likely rely on basic self-reported surveys, and that it is often difficult to distinguish between a healthy passion for the sport and a true medical condition.
“While screening tools can indicate potential risks, they cannot diagnose exercise addiction, meaning the line between true harm and healthy approaches is often blurred,” Szabo said. Although questionnaires can measure a person’s dedication, they cannot replace a formal clinical diagnosis.
“As a result, highly motivated athletes and those who exercise regularly may be misclassified, but it is important to distinguish that being committed to fitness is not the same as an addiction,” Szabo said. These high scores often reflect deep passions rather than underlying mental health issues.
Scientists have also mapped out how this addiction tends to develop. They found that it often begins as a recreational activity aimed at promoting health. Over time, a person may begin to use the activity as a psychological escape to cope with stress and emotional difficulties. Ultimately, the action becomes an inflexible obligation that governs the person’s life.
These behaviors indicate a transition from healthy to harmful habits. “Exercising through pain or injury, feeling anxious or guilty when you miss a session, or consistently prioritizing training over rest, relationships, or responsibilities are signs that exercise may be moving from being enjoyable to compulsive,” Szabo says.
Psychologically, certain models suggest that addiction arises suddenly due to sudden and overwhelming life stressors. When people experience a traumatic event, such as a relationship breakup or job loss, they may retreat to physical training as their only coping mechanism. For some people, this means that addiction is triggered quickly in response to emotional distress.
Physiological models provide evidence that natural brain chemicals play a role in this addictive cycle. Engaging in physical activity releases endocannabinoids, natural compounds in the body that reduce pain and produce a feeling of euphoria. People who exercise excessively can become dependent on this chemical reaction and experience drug-like withdrawal symptoms when resting.
Another biological explanation focuses on resting energy levels. This idea suggests that regular physical activity lowers a person’s baseline nervous system activity. To eliminate daytime fatigue, a person may feel the need to increase the amount of training just to feel normal and alert.
The resulting negative effects extend to multiple areas of an individual’s life. Exercise addicts often work through severe physical injury knowing that their actions will cause further physical harm. They also tend to neglect family, friends, and work responsibilities, leading to social isolation and decreased quality of life.
Regarding treatment, the authors found that interventions used for other behavioral addictions showed promise. Cognitive behavioral therapy is widely recommended to help patients identify maladaptive thought patterns and establish balanced fitness habits. This form of therapy helps individuals change unhelpful thoughts and behaviors into healthier ones.
Acceptance and commitment therapy is also a recommended approach. This therapy encourages patients to carefully accept, rather than act on, the unpleasant urges they feel when they take a break from training. By increasing psychological flexibility, a person can slowly break the cycle of addiction and find alternative ways to cope with stress.
Cue exposure therapy is another method being discussed by scientists. In this approach, psychologists repeatedly expose patients to triggers that usually cause the urge to exercise. The patient is then induced to resist the behavior, and the mental connection between the trigger and the compulsion slowly weakens.
Alternative therapies also offer a practical path forward. This strategy encourages patients to find pleasure in alternative, low-impact activities. Hobbies such as meditation, yoga, and volunteering can replace problematic behaviors and provide another source of personal reward.
Psychotherapy is the first line of defense, but researchers note that drug therapy may also be considered in some cases. Medications that balance brain chemicals have also been shown to be effective for other behavioral addictions, such as gambling addiction and shopping addiction. Because there is no formal medical diagnosis for exercise addiction, doctors rarely prescribe medications specifically for this condition.
A major limitation of the current study is its heavy reliance on screening questionnaires rather than clinical interviews. High scores on these tests only indicate a risk of addiction, but are often mistaken for a definitive diagnosis. Some people may score high simply because they are passionate about sports, rather than actually suffering from a mental health disorder.
Future research will need to shift its focus from calculating risk scores to studying actually diagnosed cases of addiction. The authors recommend increasing collaboration between academic researchers and clinical psychologists. If researchers identify someone at risk, they should refer that person to a clinician who can determine whether true addiction is present.
There is also an urgent need for larger, long-term studies that follow individuals over time. Experimental research can help scientists better understand the root causes of this disorder. Establishing solid clinical evidence is a necessary step before exercise addiction is officially recognized in diagnostic manuals.
Even without a formal diagnosis, public health efforts can take steps to minimize damage. Promoting balanced fitness habits and educating sports organizations about the red flags of overtraining can help prevent healthy habits from turning into destructive impulses. Educational campaigns should focus on overall well-being rather than extreme performance or appearance goals.
The researchers hope their findings will encourage a more balanced approach to physical fitness. “Our message is not to exercise less, but to exercise smarter by building in rest and recovery days, focusing on overall health rather than appearance or performance, and seeking support early on when exercise starts to feel like an obligation rather than a choice,” Szabo said.
Recognizing personal limitations remains an important part of any training program. “In a culture that celebrates working harder, more is not always better, and staying healthy means knowing not only when to step forward, but also when to back off,” Demetrovics said.
This paper, “Exercise Addiction: A Review and Evaluation of Current Research and Theory,” was authored by Bhavya Chhabra, Zsolt Demetrovics, Mark D. Griffiths, and Attila Szabo.
