Clinical Cases of Exercise Addiction: A Systematic Literature Review

Purpose of Review Exercise addiction (EA) is characterized by a loss of control over exercise, resulting in physical, social, or psychological harm. More than 1,000 published papers on EA rely on questionnaire data that lack clinical relevance. In response to recent calls for greater emphasis on individual clinical cases, we compiled the first systematic review of individuals with EA published in scholarly outlets. Recent Findings Following PRISMA guidelines, we systematically searched three electronic databases (Web of Science, Scopus, and PubMed) and Google Scholar. We assessed study quality with the Mixed Methods Appraisal Tool (MMAT). Eight studies met the inclusion criteria, yielding 17 clinical cases of EA. Of these cases, seven individuals had psychological comorbidities, including stress, anxiety, depression, and dysthymia. The findings indicate that excessive exercise often served as a coping mechanism for stress and negative emotional states. Summary The findings support the interactional model of addiction, suggesting that EA may develop when individuals rely excessively on exercise to regulate stress, manage negative emotions, and maintain subjective well-being. In some cases, EA may constitute a manifestation of a psychiatric morbidity. These results underscore the importance of addressing underlying psychological triggers in treatment, rather than focusing solely on reducing exercise volume.