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      A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel

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          Background and aims

          The aim of this study was to investigate the relationship between exercise addiction, abnormal eating attitudes, anxiety, and depression among competitive and amateur athletes.


          Participants were 100 athletes of mean age 28.3 years (18–62), of which there were 67 males and 35 females. The sample consisted of competitive and amateur athletes who participated in individual and group sports. They filled in the Exercise Addiction Inventory, Body Shape Questionnaire, a questionnaire assessing Eating Attitudes Test, Spielberger State-Trait Anxiety Inventory, and Beck Depression Inventory (BDI).


          Ratings of exercise addiction were positively correlated with BDI scores across the study sample. Exercise addiction ratings were associated with abnormal eating attitudes, but not with trait or state anxiety. Athletes engaging in individual sports scored marginally higher on depression scores than group athletes but there was no difference in depression scores between competitive and amateur athletes. Multiple regression analysis revealed that abnormal eating attitudes contributed significantly to ratings of exercise addiction and explained 7.7% of the variance. According to the Sobel test, the difference in the association between exercise addiction and eating disorder was significant. Therefore, body shape was a mediating factor between eating disorder and exercise addiction.

          Discussion and conclusions

          This study extends our preliminary findings of an association between exercise addiction and depression. Second, abnormal eating attitudes may explain most of the variance of exercise addiction. This is a further support for previous evidence of comorbidity between exercise addiction and eating disorders.

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          Most cited references 49

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          A ‘components’ model of addiction within a biopsychosocial framework

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            The development and validation of the body shape questionnaire

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              The runner's high: opioidergic mechanisms in the human brain.

              The runner's high describes a euphoric state resulting from long-distance running. The cerebral neurochemical correlates of exercise-induced mood changes have been barely investigated so far. We aimed to unravel the opioidergic mechanisms of the runner's high in the human brain and to identify the relationship to perceived euphoria. We performed a positron emission tomography "ligand activation" study with the nonselective opioidergic ligand 6-O-(2-[(18)F]fluoroethyl)-6-O-desmethyldiprenorphine ([(18)F]FDPN). Ten athletes were scanned at 2 separate occasions in random order, at rest and after 2 h of endurance running (21.5 +/- 4.7 km). Binding kinetics of [(18)F]FDPN were quantified by basis pursuit denoising (DEPICT software). Statistical parametric mapping (SPM2) was used for voxelwise analyses to determine relative changes in ligand binding after running and correlations of opioid binding with euphoria ratings. Reductions in opioid receptor availability were identified preferentially in prefrontal and limbic/paralimbic brain structures. The level of euphoria was significantly increased after running and was inversely correlated with opioid binding in prefrontal/orbitofrontal cortices, the anterior cingulate cortex, bilateral insula, parainsular cortex, and temporoparietal regions. These findings support the "opioid theory" of the runner's high and suggest region-specific effects in frontolimbic brain areas that are involved in the processing of affective states and mood.

                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                21 September 2018
                September 2018
                : 7
                : 3
                : 800-805
                [ 1 ]Department of Behavioral Sciences and Integrative Brain and Cognition Center, Ariel University , Ariel, Israel
                [ 2 ]Department of Research and Sports Medicine, The Wingate Institute , Netanya, Israel
                [ 3 ]School of Nutritional Sciences, Tel Hai Academic College , Tel-Hai, Israel
                Author notes
                [* ]Corresponding author: Aviv Weinstein; Department of Behavioral Sciences and Integrative Brain and Cognition Center, Ariel University, Ariel 40700, Israel; Phone: +972 3 907 6555; Fax: +972 3 906 6629; E-mails: avivwe@ ; avivweinstein@
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 47, Pages: 6
                Funding sources: The study was conducted as part of an academic course in behavioral addiction at the Ariel University, Ariel, Israel.
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