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Scoping review of five studies on interventions for secondary exercise addiction and eating disordersTherapy Helps People Heal Exercise Addiction Linked to Eating

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Key Takeaway
Interpret findings cautiously as improvements in compulsivity did not always imply a reduction in exercise amount.

This publication is a scoping review examining psychotherapeutic interventions for adult individuals with secondary exercise addiction and eating disorders. The authors identified five studies included in the analysis, comprising four randomized controlled trials and one quasi-experimental study. Settings ranged from one inpatient and four outpatient treatments. Interventions included cognitive-behavioral models and those integrating physical or nutritional components.

Regarding outcomes, four out of five included studies reported improvements in variables related to compulsivity. Longer interventions showed more consistent effects compared to shorter durations. In non-clinical populations, brief treatments generated positive changes. However, improvements in compulsivity did not always imply a reduction in the amount of exercise. The primary outcome was not reported in the source data.

The authors note a significant gap in studies addressing interventions for those with secondary exercise addiction. There is a stated need for randomized controlled trials with proper randomization methods to strengthen the evidence base. Safety data regarding adverse events, serious adverse events, and discontinuations were not reported. Clinicians should interpret these findings cautiously given the limited sample size and observational nature of some included studies. Practice relevance was not reported, and funding or conflicts were not reported.

Imagine waking up and feeling guilty if you skip a workout. For some people, this feeling is not just about fitness. It is a sign of a deeper struggle. Many individuals push their bodies hard every single day. This drive often comes from a place of fear. It is not about getting stronger or healthier.

Exercise addiction often hides behind healthy habits. It frequently appears alongside eating disorders. This combination can damage both body and mind. People may think they are doing good for their health. In reality, the behavior is causing harm. Daily life becomes difficult to manage. This condition affects many adults who need help.

Doctors used to focus on stopping the movement. They told patients to simply run less. Now, they look at the thoughts behind the movement. The goal is healing, not just counting steps. This shift changes how treatment works completely. It addresses the root cause of the behavior.

Think of the brain like a locked door. The key is how you view food and exercise. Therapy helps turn that key gently. It changes the relationship between body and mind. You learn to see exercise as a choice. You learn to see food as fuel. This approach reduces the pressure to perform.

Therapy Changes Mindset Over Movement

Experts reviewed five studies from recent years. They looked at adults with eating disorders and exercise addiction. Some treatments happened in clinics, others at home. The programs used different methods to help patients. Most focused on changing thoughts and feelings. These methods aim to improve overall well-being.

Four out of five studies showed real progress. People felt less driven to exercise compulsively. The amount of exercise did not always drop. This finding is important for understanding recovery. It means the behavior itself is not the only problem. The mental drive behind the behavior is the main target. Patients felt better even if they kept moving.

Quality Matters More Than Quantity

But there is a catch. Longer treatments worked better than short ones. We need more data to know the best path. Brief treatments helped people in non-clinical groups. However, those with serious disorders needed more time. Consistency is key for lasting change. Time allows the brain to rewire its habits.

Experts say this review highlights a gap in care. There are not enough high-quality trials yet. More research is required to confirm these results. The field needs randomized controlled trials with proper methods. This ensures the findings apply to everyone. Current evidence is promising but incomplete. We must wait for more solid proof.

What This Means for Recovery

If you struggle with this, talk to a doctor. These therapies are not ready for everyone yet. Professional guidance is essential for safety. You need a team to support your journey. They can help you find the right balance. Recovery is a process that takes patience.

This does not mean you should stop exercising on your own.

The studies were small and varied in design. Some used older methods that might not fit today. Results might change with larger groups. We must be careful not to overstate the results. The sample sizes were limited in scope. Future work will clarify these details.

Future trials will test these methods more closely. Approval takes time to ensure safety for patients. Hope remains for better treatment options soon. Doctors will learn more about what works best. Patients will have more choices in the future. This research paves the way for new hope.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
Secondary exercise addiction shows high comorbidity with eating and body image disorders. Despite its substantial impact on physical and mental health and daily functioning, evidence on effective therapeutic interventions remains limited. The aim of this scoping review was to identify and describe therapeutic interventions applied to adult individuals with secondary exercise addiction. This review followed the PRISMA Sc-R guidelines and covered the years 2002–2024. Ultimately, five studies were included (four randomized controlled trials and one quasi-experimental study). Three studies applied psychotherapeutic interventions based on cognitive-behavioral models (Cognitive Behavioral Therapy, Lifestyle, Exercise, Attitudes, and Relationships Program, Physical Exercise and Dietary Therapy), while two integrated physical or nutritional components. A secondary analysis published in 2024 based on the LEAP trial dataset was identified but not treated as an independent study to avoid duplication. EBSCOhost, Web of Science, PubMed, and Google Scholar were searched from January to May 2025 using terms related to exercise addiction, exercise abuse, psychotherapy, intervention, and treatment. English-language studies were eligible if they described an intervention with at least one treated group with pre- and post-test measures; the participants of the study were adult patients suffering from eating disorders and exercise addiction (the therapy programs involved one inpatient and four outpatient treatments) and therapeutic intervention was carried out with outcomes based on exercise addiction level data. Four out of five included studies reported improvements in variables related to compulsivity, although these did not always imply a reduction in the amount of exercise, indicating that qualitative changes may be more relevant. Longer interventions showed more consistent effects, but even brief treatments generated positive changes in non-clinical populations. The examination of the research revealed a gap in studies addressing interventions for those with secondary exercise addiction, especially highlighting the need for randomized controlled trials (RCTs) with proper randomization methods.
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