Today’s summary is on “Exercise addiction: A study of eating disorder symptoms, quality of life, personality traits, and attachment styles” by Lichetenstein et al (Psychiatry Research, 2013). I chose this article because I never would have considered myself an over-exerciser before I received the diagnosis of anorexia. When I was in high school, I was on a swim team where the minimum time commitment was 20 hours a week of swimming so exercising for 15+ hours a week when I later developed my eating disorder seemed like nothing. The problem with my exercise habits was that I did not eat enough to compensate for my high activity levels, but there is more to it than that…
Introduction: Exercise addiction was once embraced for its euphoria and relaxation effects, until studies found that excessive exercise can cause health problems and decrease quality of life. Half a percent of people in the general population have exercise addiction, according to the Exercise Addiction Inventory (EAI), while 6.9% of sport science students in one study had exercise addiction. There is some controversy over whether exercise addiction is a primary condition or is always secondary to an eating disorder. The following personality traits are associate with exercise addiction: perfectionism, anxiety, obsessive compulsiveness, and narcissism. Attachment patterns can also influence excessive exercise tendencies, wherein people with more insecure attachment styles are more likely to have eating disorder symptoms. The authors compared an exercise addiction group with a non-addicted exercise group, hypothesizing that the groups would have few eating disorder symptoms and that exercise addiction would be associated with health problems and related to personality type and attachment type.
Methods: The authors used an online survey to gather information about participant demographics; the EAI score for defining exercise addiction; health-related quality of life; personality types; and attachment style. There were a total of 121 participants (79 men, 42 women) who exercised from 2 – 18 hours a week (mean of 8.4). High EAI scores (24 – 30) were found in 41 participants and lower scores (6 – 23) were found in 80 participants.
Results: Compared to the control group, the exercise addiction group was younger, exercised 2x more, had more overload injuries (including that impaired work performance), and had more eating disorder symptoms (higher drive for thinness, perfectionism, internal awareness, asceticism, and impulse regulation), though the body mass index did not differ between the two groups. The quality of life scores were not significantly different fro the two groups, except that the exercise addiction scored worse on bodily pain. The exercise addiction group was more likely to be extroverted, hostile, and achievement oriented as well as less likely to be agreeable, straightforwards, altruistic, compliant, or modest. There were no differences in the attachment styles.
Discussion: The exercise addiction group had higher scores on the eating disorder symptom scale components (though their BMIs were normal), especially the drive for thinness and perfectionism; as a result, this study was unable to distinguish between primary and secondary causes of exercise addiction. The exercise addiction group experienced more physical discomfort that interfered with normal activities, which may be due to injuries, though their overall scores were not lower. There is some complicated description of personality traits in exercise addiction that does not add more than what was stated in the results. The study limitations include: self-reported data (could be biased or inaccurate), cross-sectional design (gives snapshot in time, but not changes over time), lack of clinical interviews to assess eating disorder diagnoses (would help distinguish between primary and secondary causes of exercise addiction), and some others.
Conclusion: Exercise addiction is associated with weight concerns and perfectionism. There is no evidence for decreased quality of life in people with exercise addictions, except for the worse bodily pain scores. People with exercise addiction are more likely to seek excitement and work for high goals and standards, while they are less likely to be straightforward, altruistic, modest, and compliant, which is consistent with narcissistic personality traits. Exercise addiction was not related to attachment style.