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 Rácmolnár; Ilaria De Luca; Eduardo Cinosi; Rita Santacroce; Massimo Marini; David Wellsted; Keith Sullivan; Giuseppe Bersani; Giovanni Martinotti

doi:10.1371/journal.pone.0213060

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 Rácmolnár, Ilaria De Luca, Eduardo Cinosi, Rita Santacroce, Massimo Marini, David Wellsted, Keith Sullivan, Giuseppe Bersani, Giovanni Martinotti

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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 language	English
Article number	e0213060
Number of pages	17
Journal	PLoS ONE
Volume	14
Issue number	4
DOIs	https://doi.org/10.1371/journal.pone.0213060
Publication status	Published - 3 Apr 2019

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© 2019 Corazza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Corazza, O., Simonato, P., Demetrovics, Z., Mooney, R., van de Ven, K., Roman-Urrestarazu, A., Rácmolnár, L., De Luca, I., Cinosi, E., Santacroce, R., Marini, M., Wellsted, D., Sullivan, K., Bersani, G., & Martinotti, G. (2019). The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study. PLoS ONE, 14(4), Article e0213060. https://doi.org/10.1371/journal.pone.0213060

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

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.",

author = "Ornella Corazza and Pierluigi Simonato and Zsolt Demetrovics and Roisin Mooney and {van de Ven}, Katinka and Andres Roman-Urrestarazu and Lili R{\'a}cmoln{\'a}r and {De Luca}, Ilaria and Eduardo Cinosi and Rita Santacroce and Massimo Marini and David Wellsted and Keith Sullivan and Giuseppe Bersani and Giovanni Martinotti",

note = "{\textcopyright} 2019 Corazza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2019",

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doi = "10.1371/journal.pone.0213060",

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Corazza, O, Simonato, P, Demetrovics, Z, Mooney, R, van de Ven, K, Roman-Urrestarazu, A, Rácmolnár, L, De Luca, I, Cinosi, E, Santacroce, R, Marini, M, Wellsted, D , Sullivan, K, Bersani, G & Martinotti, G 2019, 'The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study', PLoS ONE, vol. 14, no. 4, e0213060. https://doi.org/10.1371/journal.pone.0213060

TY - JOUR

T1 - The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings

T2 - A cross sectional study

AU - Corazza, Ornella

AU - Simonato, Pierluigi

AU - Demetrovics, Zsolt

AU - Mooney, Roisin

AU - van de Ven, Katinka

AU - Roman-Urrestarazu, Andres

AU - Rácmolnár, Lili

AU - De Luca, Ilaria

AU - Cinosi, Eduardo

AU - Santacroce, Rita

AU - Marini, Massimo

AU - Wellsted, David

AU - Sullivan, Keith

AU - Bersani, Giuseppe

AU - Martinotti, Giovanni

N1 - © 2019 Corazza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2019/4/3

Y1 - 2019/4/3

N2 - 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.

AB - 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.

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U2 - 10.1371/journal.pone.0213060

DO - 10.1371/journal.pone.0213060

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SN - 1932-6203

VL - 14

JO - PLoS ONE

JF - PLoS ONE

IS - 4

M1 - e0213060

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

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