Compulsive exercise among college students: 5-year time trends in prevalence and demographic, substance use, and mental health correlates

Purpose: To provide 5-year time trends in prevalence and demographic, substance use, and mental health correlates of compulsive exercise among a national sample of college men and women. Methods: We analyzed 4 academic survey years (2016–2020; N = 8251) of the national (USA) Healthy Minds Study. Compulsive exercise was measured by self-report of any occurrence of “compulsive” exercise in the past 4 weeks. Unadjusted prevalence of compulsive exercise in the past 4 weeks was estimated across the 4 survey years by sex. Multiple logistic regression analyses were conducted among the pooled sample and stratified by sex to estimate the associations between compulsive exercise in the past 4 weeks and demographic, substance use, and mental health correlates. Results: Among the pooled sample, 11% (95% confidence interval [CI] 9.60–12.42%) of men and 17% (95% CI 15.86–18.24%) of women reported compulsive exercise in the past 4 weeks. Prevalence across the 4 survey years remained stable among men and women. Higher body mass index was associated with greater odds of any compulsive exercise in the past 4 weeks among men, while any sports participation was associated with greater odds of any compulsive exercise in the past 4 weeks among women. Compulsive exercise in the past 4 weeks was associated with greater odds of all mental health symptoms and illicit drug use among men and women, and higher odds of alcohol use among women. Conclusion: Compulsive exercise is relatively common among college men and women and is associated with substance use behaviors and poor mental health symptoms. Level of Evidence: V, cross-sectional descriptive study