Mediating Roles of Psychological Distress, Insomnia, and Body Image Concerns in the Association Between Exercise Addiction and Eating Disorders

Daniel Kwasi Ahorsu; Vida Imani; Marc N Potenza; Hsin-Pao Chen; Chung-Ying Lin; Amir H Pakpour

doi:10.2147/PRBM.S414543

Mediating Roles of Psychological Distress, Insomnia, and Body Image Concerns in the Association Between Exercise Addiction and Eating Disorders

Psychol Res Behav Manag. 2023 Jul 5:16:2533-2542. doi: 10.2147/PRBM.S414543. eCollection 2023.

Authors

Daniel Kwasi Ahorsu¹, Vida Imani², Marc N Potenza³, Hsin-Pao Chen^{4

5}, Chung-Ying Lin⁶, Amir H Pakpour^{7

8}

Affiliations

¹ Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
² Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, 5166/15731, Iran.
³ Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
⁴ Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, School of Medicine, Kaohsiung, Taiwan.
⁵ College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan.
⁶ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁷ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
⁸ Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.

Abstract

Purpose: Exercising can promote good health. However, excessive exercising may have downsides. This study examined the association between exercise addiction and eating disorders and whether the identified association was mediated by psychological distress, insomnia (including sleep quality), and body image concern.

Methods: A total of 2088 adolescents (mean age of 15.3 years) participated in this cross-sectional study by questions assessing exercise addiction, eating disorders, psychological distress, insomnia, sleep quality, and body image concern.

Results: There were significantly positive relationships between the variables (r=0.12-0.54, p<0.01) with effect sizes from small to large. The four potential mediators (ie, insomnia, sleep quality, psychological distress, and body image concern), individually and in total, significantly mediated the association between exercise addiction and eating disorders.

Conclusion: The findings suggest that exercise addiction in adolescents may influence eating disorders through multiple pathways, such as insomnia, psychological distress, and body image concerns. Future research should examine these relationships longitudinally and use gathered information to inform intervention development. Clinicians and healthcare workers are encouraged to assess exercise addiction when treating individuals with eating disorders.

Keywords: addictive behaviour; adolescent; compulsive behaviour; eating disorder; exercise; insomnia; stress.

Grants and funding

This study was funded by the Qazvin University of Medical Sciences (1401). Hsin-Pao Chen is financially supported by the funding of the E-Da Hospital (EDAPH111043 & EDACHT111007).