Psychobiological mechanisms of exercise dependence.

Exercise dependence (ED) is characterised by an obsessive and unhealthy preoccupation with exercise. Previous research has focused largely on identifying behavioural aspects of ED, although the biological mechanisms remain unknown and are under researched. We review various ED hypotheses including affect regulation, anorexia analogue, sympathetic arousal and beta-endorphin. We also present a novel hypothesis pertaining to ED and interleukin (IL)-6, which combines previous hypotheses with literature from the field of psycho-neuroimmunology. We explore the notion that IL-6 provides a link from the periphery to the brain, which may mediate the underlying features of ED. We propose a conceptual model indicating that, in individuals prone to ED, exercise results in a transient reduction in negative affect, but concurrently results in excessive production of IL-6 and the activation of neuroendocrine pathways, which are associated with behavioural and psychological disturbances of exercise withdrawal. Our intention is for this model to serve as a basis for further research in the area of ED, which may eventually lead to the development of successful treatment strategies. Recent developments in methods to reliably assess these biological markers from blood and saliva samples should encourage such research to be undertaken in exercise settings.