The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study

Ornella Corazza*, Pierluigi Simonato, Zsolt Demetrovics, Roisin Mooney, Katinka van de Ven, Andres Roman-Urrestarazu, Lili Racmolnar, Ilaria De Luca, Eduardo Cinosi, Rita Santacroce, Massimo Marini, David Wellsted, Keith Sullivan, Giuseppe Bersani, Giovanni Martinotti

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

41 Citations (Web of Science)

Abstract

Introduction

In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements.

Methods

A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements.

Results

Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08).

Conclusions

This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.

Original languageEnglish
Article number0213060
Number of pages17
JournalPLOS ONE
Volume14
Issue number4
DOIs
Publication statusPublished - 3 Apr 2019

Keywords

  • PERFORMANCE-ENHANCING DRUGS
  • ANDROGENIC STEROID USE
  • MEDITERRANEAN DIET
  • EXCESSIVE EXERCISE
  • MUSCLE DYSMORPHIA
  • PSYCHOACTIVE SUBSTANCES
  • APPEARANCE ANXIETY
  • EATING-DISORDER
  • CONSTRUCTION
  • PARTICIPANTS

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