Gender-related differences in self-reported problematic exercise symptoms: A systematic review and meta-analysis

To provide quantitative summarized evidence on gender-related differences in self-reported problematic exercise (PE) symptoms. Eligible studies were searched up to December 31, 2021 in the databases MEDLINE, Current Contents Connect, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global. Studies were considered eligible if they included information that allowed the calculation of the differences of interest as expressed by either the aggregate or subscales scores of the main self-reported instruments of PE identified by previous research (i.e., Commitment to Exercise Scale, Compulsive Exercise Test, Exercise Addiction Inventory, Exercise Dependence Questionnaire, Exercise Dependence Scale-Revised, and Obligatory Exercise Questionnaire). Data were analysed using three-level meta-analytic models. Potential moderator variables were examined using meta-regressions. A total of 168 effect-sizes from 117 studies ( N  = 65,718) were retrieved. Results showed (i) small overall differences favouring males for the aggregate scores of the instruments ( g  = 0.105), (ii) small-to-moderate differences favouring females for symptoms involving withdrawal ( g  = 0.169 and 0.118), lack of exercise enjoyment ( g  = 0.226), and the employment of exercise as a means to ends such as health improvement ( g  = 0.222), mood management ( g  = 0.158 and 0.226), and body weight control ( g  = 0.453 and 0.465); and (iii) small differences favouring males for symptoms involving spending considerable amount of time in the activity ( g  = 0.250), exercising with greater volume/intensity than planned ( g  = 0.254), a need for increased amounts of exercise to achieve the desired effect ( g  = 0.291), loss of control over the behaviour ( g  = 0.101), reduction or cessation of other activities because of exercise ( g  = 0.323), and continue to exercise despite physical and/or psychological issues being caused or exacerbated by this behaviour ( g  = 0.243). Adopting a gender-informed perspective may be needed both in the professional praxis of exercise and health practitioners prescribing and guiding exercise practice and in the design of prevention and treatment efforts aimed at avoiding the occurrence of PE.