{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:22:14Z","timestamp":1778858534667,"version":"3.51.4"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Svenska spel AB","award":["non-specific"],"award-info":[{"award-number":["non-specific"]}]},{"name":"The Swedish Enforcement Authority","award":["non-specific"],"award-info":[{"award-number":["non-specific"]}]},{"name":"Svenska spel research council","award":["non-specific"],"award-info":[{"award-number":["non-specific"]}]},{"name":"Region Sk\u00e5ne - hospital research funding","award":["non-specific"],"award-info":[{"award-number":["non-specific"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The world of sports has a complex association to problem gambling, and the sparse research examining problem gambling in athletes has suggested an increased prevalence and particularly high male predominance. The present study aimed to study frequency and correlates of problem gambling in populations with moderate to high involvement in fitness or physical exercise. This is a self-selective online survey focusing on addictive behaviors in physical exercise distributed by \u2018fitness influencers\u2019 on social media and other online fitness forums to their followers. Respondents were included if they reported exercise at least thrice weekly, were above 15 years of age, and provided informed consent (N = 3088). Problem gambling, measured with the Lie\/Bet, was studied in association with demographic data, substance use, and mental health variables. The occurrence of lifetime problem gambling was 8 percent (12 percent in men, one percent in women). In logistic regression, problem gambling was associated with male gender, younger age, risky alcohol drinking, obsessive-compulsive disorder, and less frequent exercise habits. In conclusion, in this self-recruited population with moderate to high fitness involvement, problem gambling was moderately elevated. As shown previously in elite athletes, the male predominance was larger than in the general population. The findings strengthen the link between problem gambling and the world of sports.<\/jats:p>","DOI":"10.3390\/ijerph17041342","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T03:20:03Z","timestamp":1582168803000},"page":"1342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Problem Gambling in the Fitness World\u2014A General Population Web Survey"],"prefix":"10.3390","volume":"17","author":[{"given":"Anders","family":"H\u00e5kansson","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Dept of Clinical Health Sciences Malm\u00f6, Primary Care, Lund University, S-205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7418-8750","authenticated-orcid":false,"given":"Artin","family":"Entezarjou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dept of Clinical Health Sciences Malm\u00f6, Primary Care, Lund University, S-205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6ran","family":"Kentt\u00e4","sequence":"additional","affiliation":[{"name":"The Swedish School of Sport and Health Sciences, S-114 86 Stockholm, Sweden"},{"name":"School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada"},{"name":"Swedish Sport Federation, 100 61 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2968-9898","authenticated-orcid":false,"given":"Fernando","family":"Fern\u00e1ndez-Aranda","sequence":"additional","affiliation":[{"name":"Pathological Gambling Unit, Dept Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain"},{"name":"Ciber Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III, 28029 Barcelona, Spain"},{"name":"Dept Clin Sciences, Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3596-8033","authenticated-orcid":false,"given":"Susana","family":"Jim\u00e9nez-Murcia","sequence":"additional","affiliation":[{"name":"Pathological Gambling Unit, Dept Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain"},{"name":"Ciber Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III, 28029 Barcelona, Spain"},{"name":"Dept Clin Sciences, Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Gunnarsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dept of Clinical Health Sciences Malm\u00f6, Primary Care, Lund University, S-205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1556\/2006.5.2016.073","article-title":"Problem gambling worldwide: An update and systematic review of empirical research (2000\u20132015)","volume":"5","author":"Calado","year":"2016","journal-title":"J. Behav. Addict."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1007\/s10899-013-9396-3","article-title":"Gambling and problem gambling in Sweden: Changes between 1998 and 2009","volume":"30","author":"Abbott","year":"2014","journal-title":"J. Gambl. Stud."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1017\/S0033291706007410","article-title":"Sex differences in subclinical and DSM-IV pathological gambling: Results from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"36","author":"Blanco","year":"2006","journal-title":"Psychol. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.addbeh.2015.01.011","article-title":"Gender differences in the associations of gambling activities and suicidal behaviors with problem gambling in a nationally representative French sample","volume":"45","author":"Husky","year":"2015","journal-title":"Addict. Behav."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1080\/10550887.2016.1177807","article-title":"Gambling among European professional athletes. Prevalence and associated factors","volume":"35","author":"Caillon","year":"2016","journal-title":"J. Addict. Dis."},{"key":"ref_6","first-page":"79","article-title":"Problem gambling and gaming in elite athletes","volume":"8","year":"2018","journal-title":"Addict. Behav. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"81","DOI":"10.2190\/DE.43.1.f","article-title":"Can personality account for differences in drinking between college athletes and non-athletes? Explaining the role of sensation seeking, risk-taking, and impulsivity","volume":"43","author":"Mastroleo","year":"2013","journal-title":"J. Drug Educ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s10899-013-9431-4","article-title":"Competitiveness facets and sensation seeking as predictors of problem gambling among a sample of university student gamblers","volume":"31","author":"Harris","year":"2015","journal-title":"J. Gambl. Stud."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10899-006-9043-3","article-title":"Gambling behavior of student-athletes and a student cohort: What are the odds?","volume":"23","author":"Weinstock","year":"2007","journal-title":"J. Gambl Stud."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.jadohealth.2006.11.146","article-title":"Gambling and health risk behaviors among US college student-athletes: Findings from a national study","volume":"40","author":"Huang","year":"2007","journal-title":"J. Adolesc Health."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s10899-012-9355-4","article-title":"Predicting gambling problems from gambling outcome expectancies in college student-athletes","volume":"30","author":"Temcheff","year":"2014","journal-title":"J. Gambl. Stud."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Maher, A., Wilson, N., Signal, L., and Thomson, G. (2006). Patterns of sports sponsorship by gambling, alcohol and food companies: An Internet survey. BMC Publ. Health, 6.","DOI":"10.1186\/1471-2458-6-95"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1136\/bjsports-2019-100668","article-title":"Problem gambling and associated mental health concerns in elite athletes: A narrative review","volume":"53","author":"Derevensky","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s10899-018-9765-z","article-title":"Gambling risk groups are not all the same: Risk factors amongst sports bettors","volume":"35","author":"Russell","year":"2018","journal-title":"J. Gambl. Stud."},{"key":"ref_15","first-page":"571","article-title":"Can positive social perception and reduced stigma be a problem in sports betting? A qualitative focus group study with Spanish sports bettors undergoing treatment for gambling disorder","volume":"35","author":"Griffiths","year":"2018","journal-title":"J. Gambl. Stud."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1556\/2006.6.2017.067","article-title":"How do online sports gambling disorder patients compare with land-based patients?","volume":"6","author":"Granero","year":"2017","journal-title":"J. Behav. Addict."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3389\/fpsyt.2017.00255","article-title":"Who seeks treatment when medicine opens the door to gambling disorder patients \u2013 psychiatric co-morbidity and heavy predominance of online gambling","volume":"8","author":"Zaar","year":"2017","journal-title":"Front. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"961","DOI":"10.2165\/11536580-000000000-00000","article-title":"A systematic review of diagnosis and medical treatment of mental illness in athletes","volume":"40","author":"Reardon","year":"2010","journal-title":"Sports Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s40279-012-0013-x","article-title":"Exercise addiction","volume":"43","author":"Landolfi","year":"2013","journal-title":"Sports Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/s10899-013-9437-y","article-title":"Health behaviour and body mass index among problem gamblers: Results from a nationwide survey","volume":"31","author":"Algren","year":"2015","journal-title":"J. Gambl. Stud."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.2466\/pr0.1998.83.3f.1219","article-title":"The Lie\/Bet questionnaire for screening pathological gamblers: A follow-up study","volume":"83","author":"Johnson","year":"1998","journal-title":"Psychol. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2466\/pr0.1997.80.1.83","article-title":"The Lie\/Bet questionnaire for screening pathological gamblers","volume":"80","author":"Johnson","year":"1997","journal-title":"Psychol. Rep."},{"key":"ref_23","first-page":"1009v1013","article-title":"Validation of the lie\/bet screen for pathological gambling on two normal population data sets","volume":"95","author":"Johansson","year":"2004","journal-title":"Psychol. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/add.14150","article-title":"Screening for problem gambling within mental health services: A comparison of the classification accuracy of brief instruments","volume":"113","author":"Dowling","year":"2018","journal-title":"Addiction"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1001\/archinte.158.16.1789","article-title":"The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking","volume":"158","author":"Bush","year":"1998","journal-title":"Arch. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1159\/000496741","article-title":"Psychometric properties of the AUDIT, AUDIT-C, CRAFFT and ASSIST-Y among Swedish adolescents","volume":"25","author":"Berman","year":"2019","journal-title":"Eur. Addict. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.drugalcdep.2019.01.030","article-title":"Alcohol screening and assessment measures for young people: A systematic reviews and meta-analysis of validation studies","volume":"202","author":"Toner","year":"2019","journal-title":"Drug Alcohol Depend."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1521-0391.2011.00118.x","article-title":"A quick and simple screening method for pathological and problem gamblers in addiction programs and practices","volume":"20","author":"Volberg","year":"2011","journal-title":"Am. J. Addict."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1177\/0706743715625950","article-title":"A longitudinal study of the temporal relation between problem gambling and mental and substance use disorders among young adults","volume":"61","author":"Afifi","year":"2016","journal-title":"Can. J. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1177\/0004867415575774","article-title":"Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis","volume":"49","author":"Dowling","year":"2015","journal-title":"Austr. N. Z. J. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1002\/erv.2561","article-title":"Detecting Eating Psychopathology in Female Athletes by Asking About Exercise: Use of the Compulsive Exercise Test","volume":"25","author":"Plateau","year":"2017","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/j.1360-0443.2010.03300.x","article-title":"Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys","volume":"106","author":"Lorains","year":"2011","journal-title":"Addiction"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.drugalcdep.2013.05.002","article-title":"Gender differences in the relationship between gambling problems and the incidence of substance-use disorders in a nationally representative population sample","volume":"133","author":"Pilver","year":"2013","journal-title":"Drug Alcohol Depend."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.euroneuro.2015.12.003","article-title":"Compulsivity in obsessive-compulsive disorder and addictions","volume":"26","author":"Figee","year":"2016","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1001\/jamapsychiatry.2014.2497","article-title":"Associations between obsessive-compulsive classes and pathological gambling in a national cohort of male twins","volume":"72","author":"Scherrer","year":"2015","journal-title":"JAMA Psychiatry."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"426","DOI":"10.3389\/fpsyt.2018.00426","article-title":"Primary and secondary diagnoses of gambling disorder and psychiatric comorbidity in the Swedish health care system\u2014A nationwide register study","volume":"9","author":"Karlsson","year":"2018","journal-title":"Front. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1023\/A:1016620513381","article-title":"Gender differences in gambling progression","volume":"17","author":"Tavares","year":"2001","journal-title":"J. Gambl. Stud."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4088\/JCP.v64n0311","article-title":"Gender differences in pathological gambling","volume":"64","author":"Blanco","year":"2003","journal-title":"J. Clin. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1097\/NMD.0b013e3182718a4d","article-title":"Telescoping phenomenon in pathological gambling: Association with gender and comorbidities","volume":"200","author":"Grant","year":"2012","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1037\/1064-1297.10.3.302","article-title":"Gender differences among pathological gamblers seeking treatment","volume":"10","author":"Ladd","year":"2002","journal-title":"Exp. Clin. Psychopharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1053\/comp.2002.29857","article-title":"Gender differences in pathological gamblers seeking medication treatment","volume":"43","author":"Grant","year":"2002","journal-title":"Compr. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1007\/s10899-016-9594-x","article-title":"Gambling problems among community cocaine users","volume":"32","author":"Dufour","year":"2016","journal-title":"J. Gambl. Stud."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1007\/s10899-018-9785-8","article-title":"Gambling disorder in male violent offenders in the prison system: Psychiatric and substance-related comorbidity","volume":"35","author":"Widinghoff","year":"2019","journal-title":"J. Gambl. Stud."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/ADM.0000000000000448","article-title":"Nonmedical use of stimulants is associated with riskier sexual practices and other forms of impulsivity","volume":"12","author":"Grant","year":"2018","journal-title":"J. Addict. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.jadohealth.2016.10.021","article-title":"Independent versus co-occurring substance use in relation to gambling outcomes in older adolescents and young adults","volume":"60","author":"Cronce","year":"2017","journal-title":"J. Adol. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s40279-016-0492-2","article-title":"The mental health of elite athletes: A narrative systematic review","volume":"46","author":"Rice","year":"2016","journal-title":"Sports Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s40519-017-0364-2","article-title":"Instagram use is linked to increased symptoms of orthorexia nervosa","volume":"22","author":"Turner","year":"2017","journal-title":"Eat. Weight Dis."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/4\/1342\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:59:08Z","timestamp":1760173148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/4\/1342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,19]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["ijerph17041342"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17041342","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,19]]}}}