Exercise dependence framework in exercise addiction research: pathological or protective dependence?

The terms ‘exercise dependence’ and ‘exercise addiction’ are used interchangeably in the exercise science and sport psychology literature. However, considering them as equivalent is a fundamental mistake with theoretical, methodological, and clinical consequences. Drawing on the dual-component model of addiction and on nosological, psychometric, and neurocognitive evidence, I argue that addiction comprises two distinct yet essential components. One is dependence, and the other is compulsion. However, dependence is not a unitary phenomenon in the context of exercise. On the one hand, there is addiction-associated pathological dependence, a maladaptive aspect of exercise behavior characterized by tolerance, withdrawal, and rigid continuation through illness, injury, or medical advice. On the other hand, there is also protective dependence, reflecting a health-preserving reliance on regular exercise that is medically adaptive and/or functionally necessary, such as in cardiac rehabilitation, diabetes management, or weight control, and that remains flexible and volitionally controlled. Consequently, only pathological dependence could be associated with exercise addiction. Protective dependence, by contrast, represents an adaptive health behavior that current instruments cannot unambiguously distinguish from its pathological counterparts. Compulsion, marked by loss of voluntary control, is equally critical yet measured mainly within the eating-disorders tradition and poorly integrated with exercise addiction instruments. Based on the arguments presented in this paper, I propose a tripartite framework that differentiates protective dependence, pathological dependence, and compulsion as continuous dimensions, each with three measurable indicators, a decision rule, and falsification conditions, to be tested before adoption in future empirical work, research assessment, and clinical practice.