The research, led by Chiara Lombardi and Maria Anna Donati of the University of Florence, together with colleagues including Giulia Fioravanti and Sara Bocci Benucci, set out to integrate two research traditions that have largely run in parallel. On one side sits the addiction literature, which has long identified impulsivity—a multidimensional trait encompassing tendencies toward rash action, lack of planning, and difficulty inhibiting responses—as a transdiagnostic vulnerability factor across substance and behavioral addictions. On the other side sits the body image literature, which links body dissatisfaction, the drive for thinness or muscularity, and diminished body appreciation to disordered eating and compulsive exercise. Until now, few studies had modeled how these two sets of variables operate together in predicting exercise addiction risk within a single statistical framework.

Exercise addiction itself remains a contested and under-studied phenomenon. It is not formally listed as a standalone diagnosis in the DSM-5-TR or the ICD-11, although compulsive exercise is recognized as a frequent feature of eating disorders and body dysmorphic disorder. Researchers typically define it through core addiction components: salience, in which exercise becomes the most important activity in a person’s life; mood modification, using workouts to alter emotional states; tolerance, requiring ever-greater doses of activity to achieve the same effect; withdrawal symptoms such as irritability and anxiety when exercise is missed; conflict, with exercise interfering with work, relationships, and other pursuits; and relapse, the rapid return to excessive patterns after attempts to cut back. Prevalence estimates vary widely by population and instrument, but risk appears elevated among endurance athletes, fitness-center clients, and individuals with eating disorder pathology.

To probe the pathways into this risk, the Italian team recruited 418 adults, 54 percent of whom were female, with a mean age of 30.76 years and a standard deviation of 13.08, yielding a broad sample spanning late adolescence through middle age. Participants completed a battery of validated self-report instruments measuring exercise addiction symptoms, multidimensional impulsivity, and a set of body image–related variables, including dysmorphic body image concerns, drive for muscularity, and body appreciation—the capacity to hold favorable opinions of one’s body regardless of perceived imperfections. The researchers then employed path analysis, a form of structural equation modeling that estimates direct and indirect pathways among variables simultaneously, while statistically controlling for gender and age.

The methodological rigor of the analysis deserves emphasis. Path analysis allowed the team to test whether impulsivity and body image variables each contributed uniquely to exercise addiction risk, and whether their effects were better understood as independent channels or as interconnected routes—for example, whether impulsive individuals who also harbor body image concerns face compounded vulnerability. Fit indices such as the comparative fit index, the Tucker-Lewis index, and the root mean square error of approximation were used to evaluate how well the hypothesized model reproduced the observed covariance structure, following conventional thresholds established in the structural equation modeling literature. Bootstrapping procedures provided confidence intervals for indirect effects, a technique recommended for mediation testing because it avoids relying on assumptions of normality in the sampling distribution of product terms.

The central finding was clear: both impulsivity and body image–related variables were significantly associated with exercise addiction risk. In other words, the psychological machinery of addiction—the tendency to act without adequate forethought and to experience difficulty stopping a rewarding behavior—contributes to vulnerability, but so does the motivational engine rooted in how people perceive and feel about their own bodies. Individuals with heightened dysmorphic concern, a stronger drive for muscularity, and lower body appreciation reported more exercise addiction symptoms, consistent with the idea that for many people, exercise functions as a body-shaping or anxiety-regulating behavior rather than purely a health behavior. The coexistence of these two pathways suggests that exercise addiction may arise through multiple etiological routes, mirroring what has been observed in eating disorders, where both trait impulsivity and sociocultural body ideals play documented roles.

Because men and women often differ in both impulsivity profiles and body image concerns—women historically reporting more drive for thinness and body dissatisfaction, men more drive for muscularity and muscle dysmorphia symptoms—the researchers went a step further and tested whether their model held equally across genders. Using multi-group path analysis, they examined structural invariance, asking whether the same pathways operated with the same strength for men and women. This is a critical but frequently skipped step in behavioral research; models estimated on mixed samples can mask meaningful gender differences or, conversely, overstate them. The invariance testing in this study provides a more nuanced picture of how risk unfolds differently, or similarly, across genders, and the authors report that gender differences were present in the data, prompting the formal comparison of group-specific models.

The findings carry practical implications for screening and prevention. Fitness professionals, sports coaches, and clinicians are increasingly encouraged to view excessive exercise not as admirable discipline but as a potential red flag when accompanied by distress, rigidity, and life interference. If impulsivity marks one vulnerability channel, brief screening tools derived from the UPPS-P impulsive behavior tradition could help identify at-risk exercisers in gyms and athletic settings. If body image concerns mark another, interventions that cultivate body appreciation and challenge internalized appearance ideals—approaches already validated in the body image field—may reduce the motivational fuel for compulsive training. Integrated prevention programs that address both trait-level self-regulation and appearance-related cognition could plausibly outperform approaches targeting either factor alone.

The study also contributes to an ongoing conceptual debate. Some researchers argue that exercise addiction is best understood through interactional models that emphasize the paradox of exercise: a behavior that is beneficial in moderation becomes pathological only in specific psychological and social contexts. Others caution that measurement limitations, reliance on self-report, and the absence of longitudinal designs have hampered the field. The present study acknowledges these constraints; its cross-sectional design cannot establish causal direction, and self-report measures are susceptible to social desirability bias, particularly in domains like exercise where excessive behavior may be culturally rewarded. Still, by modeling pathways rather than simple correlations, and by testing invariance across genders, the work moves the field toward the kind of mechanistic understanding needed to design effective interventions.

Ultimately, the message for the public is nuanced. Exercise remains one of the most powerful tools available for preventing chronic disease and supporting mental health, and the overwhelming majority of people who train regularly benefit enormously. But the Florence study is a reminder that the same behavior can serve very different psychological masters. For individuals high in impulsivity, exercise may become another arena for dysregulated reward seeking; for those struggling with body dissatisfaction or a relentless drive for muscularity, the treadmill and the weight rack can become instruments of appearance anxiety. Recognizing these dual pathways is a step toward ensuring that the pursuit of fitness stays, for everyone, genuinely health-promoting rather than quietly addictive.

Subject of Research: Psychological risk factors for exercise addiction, focusing on impulsivity and body image–related variables

Article Title: Exploring the Pathways to Exercise Addiction Risk: The Role of Impulsivity and Body Image–Related Variables

Article References: Lombardi, C., Fioravanti, G., Bocci Benucci, S., & Donati, M. A. (2026). Exploring the Pathways to Exercise Addiction Risk: The Role of Impulsivity and Body Image–Related Variables. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-026-01721-4

Image Credits: AI Generated

DOI: 10.1007/s11469-026-01721-4

Keywords: exercise addiction, impulsivity, body image, drive for muscularity, body appreciation, behavioral addiction, path analysis, eating disorders, mental health, physical exercise, gender differences, University of Florence