Behavioral Addiction: Definition, Signs, Types, Causes, Effects, and Treatment

Behavioral addiction refers to compulsive conduct towards certain actions that are otherwise considered normal. Compulsive conduct urges individuals to crave or engage in actions without logical purpose.

According to Alimoradi, Z.’s 2022 study, ‘Estimation of Behavioral Addiction Prevalence During COVID-19 Pandemic: A Systematic Review and Meta-analysis.’, the prevalence rates of behavioral addictions during the COVID-19 pandemic were: smartphone addiction (30.7%), food addiction (21%), social media addiction (15.1%), internet addiction (10.6%), sex addiction (9.4%), gambling addiction (7.2%), shopping addiction (7.2%), exercise addiction (7%), and gaming addiction (5.3%). Food, gaming, and social media addictions were notably higher during lockdown periods.

The signs and symptoms of behavioral addiction include difficulty controlling impulses, feelings of guilt or shame after engaging in the behavior, and continued participation despite negative consequences. Individuals seek increasingly risky situations, develop tolerance, experience intense cravings, hide the problem, and use the behavior to cope with negative emotions.

The types of behavioral addictions include exercise addiction, food addiction, gambling addiction, internet addiction, porn addiction, sex addiction, shopping addiction, tattoo addiction, video game addiction, love addiction, and work addiction. Each of these addictions involves compulsive engagement in specific behaviors that negatively impact an individual’s life and well-being.

The causes of behavioral addiction include genetic predisposition, neurobiological factors, psychological vulnerabilities, and environmental influences. Altered brain chemistry and mental health disorders interact with personality traits like impulsivity, while social pressures and lack of support further increase susceptibility.

The effects of behavioral addiction include increased anxiety, depression, cognitive impairment, mood swings, social isolation, and diminished self-esteem, all of which significantly impact mental health and daily functioning. Physically, these addictions lead to neglected health routines, sleep disturbances, weight fluctuations, and higher risks of chronic diseases.

Behavioral addiction is treated with cognitive behavioral therapy (CBT), group therapy, medications, one-on-one or couples counseling, and self-help groups. CBT helps change negative thought patterns and effectively reduces symptoms of internet addiction. Group therapy offers support and reduces compulsive behaviors, while medications address underlying psychological disorders. Counseling identifies triggers, and self-help groups provide peer support and relapse prevention.

What Is Behavioral Addiction?

Behavioral addiction is a type of psychological dependency characterized by a compulsion to repeatedly engage in non-substance-related behaviors or activities despite negative consequences to one’s physical health, mental well-being, social relationships, or daily functioning. Unlike substance addictions, which involve chemical dependencies, behavioral addictions involve natural rewards and the neurological response to engaging in pleasurable activities, particularly those that activate the brain’s reward system by releasing dopamine. Common examples include gambling addiction, internet/gaming addiction, shopping addiction, sex addiction, exercise addiction, and work addiction. Behavioral addictions typically involve elements of compulsivity, loss of control, continued engagement despite negative consequences, development of tolerance (needing more of the behavior to achieve the same effect), withdrawal symptoms when unable to engage in the behavior, and preoccupation with the behavior.

What Is The Difference Between Behavioral Addiction And Physical Addiction?

The difference between behavioral addiction and physical addiction is that behavioral addiction is a compulsive engagement in behavior other than substance use, and physical addiction occurs in response to substance abuse.

According to the National Cancer Institute, physical addiction is characterized by unpleasant physical symptoms that occur if the substance is stopped or taken in small doses. On the other hand, behavioral addiction is compulsively taking part in an activity even after knowing its negative impact on an individual’s well-being. 

What Is The Difference Between Behavioral Addiction And Substance Addiction?

The difference between behavioral addiction and substance addiction is that behavioral addiction is a compulsive action or behavior, while substance addiction is simply the dependence on substances or drugs. 

Repetitive engagement in a compulsive behavior or action results in brief feelings of happiness due to the release of neurotransmitters like dopamine. Some common behavioral addictions are exercise, food, and internet addiction. Contrarily, substance addiction is a physical and psychological dependence on the ingestion of a substance or drug that leads to a temporary dopamine high, causing a sense of pleasure. 

What are the Signs and Symptoms of Behavioral Addiction?

The signs and symptoms of behavioral addictions are difficulty controlling impulses, experiencing shame after engaging in the behavior, continuing despite negative consequences, seeking increasingly risky situations, developing tolerance to the activity, feeling intense urges, hiding or minimizing the problem, and using the behavior to cope with emotions.

Here are the key signs and symptoms of behavioral addiction:

• Difficulty Stopping or Controlling the Behavior: Persistent inability to cut back or stop the behavior, even when attempting to do so.
• Feelings of Guilt or Embarrassment: Experiencing negative emotions such as shame or regret after engaging in the behavior.
• Continued Engagement Despite Harm: Persisting with the behavior even when aware of its negative impact on physical, emotional, or social well-being.
• Escalation of Risks: Taking greater risks or engaging in more extreme actions to achieve the desired level of excitement or satisfaction.
• Tolerance Development: Needing to engage in the behavior more frequently or intensely to experience the same level of pleasure or relief.
• Intense Cravings: Feeling an overwhelming urge or desire to repeat the behavior.
• Denial or Concealment: Hiding the extent of the problem from others or downplaying its severity.
• Emotional Coping Mechanism: Using the behavior as a way to manage or escape negative emotions such as stress, sadness, or boredom.

What Are The Types Of Behavioral Addictions?

The types of behavioral addictions are the following.

1. Exercise addiction
2. Food addiction
3. Gambling addiction
4. Internet addiction
5. Porn addiction
6. Sex addiction
7. Shopping addiction
8. Tattoo addiction
9. Video game addiction
10. Love addiction
11. Work addiction

1. Exercise Addiction

Exercise addiction is an obsessive behavior characterized by exaggerated training, physical fitness, and bodily movement despite negative consequences. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also refers to unhealthy exercise obsession as an addiction.  

Exercise addiction occurs as a result of psychological disorders like OCD and megarexia, personality disorders, and other addictions or as a coping mechanism to life stresses. Obsessive exercise behavior is aggravated by the overstimulation of dopamine and endorphins released by regular exercise. 

Common symptoms of exercise addiction are exercising even with injury, anxiety, and irritability after missing a workout session. 

According to Trott, M.’s 2020 study, ‘Prevalence and Correlates of Exercise Addiction in the Presence vs. Absence of Indicated Eating Disorders.’, the overall prevalence of exercise addiction appears to be 3-14% of the exercising population, though this rate varies depending on the specific population studied and the measurement tools used. Studies by Di Lodovico et al. (2019), Marques et al. (2019), and Trott et al. (2020a) have documented these prevalence rates. 

Notably, individuals with indicated eating disorders have a 3.5 times higher risk of developing exercise addiction compared to those without eating disorders. Exercise addiction is treated with cognitive behavioral therapy (CBT) and psychiatric medication, according to Jeremy Adams, a Psychology professor at London Metropolitan University. 

2. Food Addiction

Food addiction is the inability to stop eating food due to the triggering of chemical reactions in the brain that induce pleasure and satisfaction despite its negative consequences. 

According to a study published in Psychiatria Polska in 2017, food addiction is caused by the release of high levels of dopamine and serotonin after eating palatable foods. Eventually, cravings start to have the same feeling of pleasure. 

Food addiction is caused by psychological reasons like sexual abuse, experiencing grief or loss, and social reasons like lack of social support and stressful life events. 

Common symptoms of food addiction are eating when not hungry or to the point of illness, feelings of worry, hiding food intake, and experiencing withdrawal symptoms like craving, headache, and restlessness. 

You treat or prevent food addiction by detoxifying from triggering foods and changing eating habits. 

3. Gambling Addiction

The American Psychiatric Association defines gambling addiction or disorder as a repeated and ongoing pattern of betting and wagering that continues despite multiple problems in different areas of an individual’s life. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies gambling as a behavioral addiction. 

The major causes of gambling addiction include diagnosed psychiatric disorders, increased release of dopaminergic and opioidergic signals, and genetic and environmental factors, as described by Prof. Dr. David C Hodgins in a study published in The Lancet. 

The symptoms of gambling addiction are gambling despite knowing the negative consequences, hiding gambling, chasing losses, stealing money to gamble, and lying. These symptoms of gambling addiction are treated by psychological and pharmacological intervention. 

According to Gabellini, E.’s 2023 study, ‘Prevalence of Problem Gambling: A Meta-analysis of Recent Empirical Research (2016-2022).’, problem gambling affects approximately 1.29% of the general adult population, while moderate risk or at-risk gambling behaviors were found in 2.43% of adults. This comprehensive review examined 23 studies published between 2016 and early 2022, providing the most current estimates of gambling addiction prevalence.

4. Internet Addiction

Internet addiction is characterized by preoccupations, urges, or behaviors leading to excessive Internet use. Internet use triggers the ‘dopamine’ reward system in the brain that leads to its addiction. High stress levels, psychological disorders, genetics, loneliness, and environmental factors also pose a risk to internet addiction.

According to Hassan, T.’s 2020 study, ‘Prevalence and associated factors of internet addiction among young adults in Bangladesh.’, internet addiction prevalence in the USA ranged from 7.9% to 25.2% among adolescents based on 2012 data. This rate is lower than that found in some Asian countries, where prevalence reached up to 50.9%, but it is comparable to rates in the Middle East and Africa (17.3% to 23.6%). The variation in these statistics is attributed to differences in diagnostic criteria, assessment methods, and cultural factors across different regions.

The signs and symptoms of internet addiction are headache, insomnia, poor nutrition, loss of interest in leisure activities, internet usage in social gatherings, anxiety, isolation, and feelings of guilt. 

Both psychological and pharmacological interventions are effective in treating Internet addiction and associated symptoms of anxiety and depression. 

5. Porn Addiction

Porn addiction is a compulsive behavior where an individual cannot stop watching porn even if they want to, which results in negative consequences to mental, physical, and social health. 

According to Kumar, P.’s 2021 study, ‘Prevalence of problematic pornography use and attitude toward pornography among undergraduate medical students.’, on problematic pornography use in the USA, approximately 4.5% to 9.8% of Americans experience pornography addiction. Studies show that 58% of American men view pornography weekly, while 87% report viewing it at least monthly. US college students demonstrate significant gender differences in consumption patterns, with male students consistently showing higher rates of problematic use compared to their female counterparts. This gender disparity has been explored through both evolutionary perspectives and neuroimaging studies, which suggest differences in how male and female brains respond to visual erotic stimuli. Researchers note that excessive pornography consumption leads to brain changes similar to those observed in substance addictions, potentially affecting sexual satisfaction, relationships, and overall mental health.

Porn addiction occur due to hormone imbalance, substance addiction, relationship difficulties, escape from stress, and medical conditions like epilepsy and dementia.

According to a study published in the Journal of Clinical Medicine, porn addicts depict cravings for watching porn, engage in constant masturbation, show risky behaviors like viewing porn in the office, are unsatisfied in their sex life with their partner and have anxiety due to the inability to stop porn. The long-term consequences of porn addiction include social withdrawal, body weakness, and depression. 

Like other behavioral addictions, porn addiction be treated using cognitive behavioral therapy, individual counseling, and medications. 

6. Sex Addiction

Sex addiction or hypersexuality is a loss of control over sexual desires or impulsive engagement in sexual activities despite negative life consequences, as described by a study in Psychiatry (Edgmont) by Dr. Timothy Fong, a Psychiatry Professor.  

The causes of sex addiction include neurotransmitter imbalance, epilepsy, dementia, bipolar disease, substance abuse, stress, or childhood trauma. 

The signs and symptoms of sex addiction include fantasizing about sex, masturbating, viewing pornography, constantly planning sexual activity, and engaging in dangerous and immoral sexual activities. The negative long-term consequences include lack of a healthy relationship, sexually transmitted diseases, and depression and anxiety. 

According to Sahithya, B. R.’s 2022 study, ‘Sexual addiction disorder—A review with recent updates.’, sexual addiction disorder prevalence rates vary considerably in the United States. Earlier studies on hypersexuality estimated prevalence at approximately 2% to 6% of the general population. However, more recent epidemiological studies in the US have found higher rates, with compulsive sexual behavior affecting approximately 8.6% of the population.

The effective treatment for sex addiction is cognitive behavioral therapy, individual counseling, and pharmacotherapy, as found in a meta-analysis in the Journal of Behavioral Addictions.

7. Shopping Addiction

Shopping addiction or compulsive shopping is a behavioral addiction defined as excessive buying as a way to feel pleasure and avoid negative emotions, according to Lorrin Koran, a Psychiatrist at Stanford University. 

According to Black, D. W.’s 2022 study, ‘Compulsive shopping: A review and update.’, compulsive shopping (CS) has an estimated prevalence of 5% in the United States general population, with onset typically occurring in the late teens or early twenties. The article references earlier research showing varying prevalence estimates, including work by Faber and O’Guinn that placed the rate between 1.8% and 8.1% of the U.S. general adult population, and a study by Koran et al. that estimated the point prevalence at 5.8% of respondents (calculated using compulsive buying scale scores two standard deviations above the mean). The disorder is characterized by excessive shopping and spending that leads to subjective distress and impaired functioning.

The causes of shopping addiction are boredom or high excitement levels, instant gratification, low self-esteem, or stress. It is also comorbid with anxiety disorders, impulsive behaviors, and substance abuse.

The signs and symptoms of shopping addiction are always thinking or talking about buying stuff, regularly surfing online stores, feeling euphoria or regret after buying, buying things one doesn’t need, and lying about purchases. A study published in The American Journal of Drug and Alcohol Abuse on compulsive buying states that the long-term consequences of compulsive shopping are debt, depression, frustration, shame, and relationship breakdown. 

The treatment approaches for shopping addicts include pharmacological intervention, counseling, and cognitive behavioral therapy. 

8. Tattoo Addiction

Tattoo addiction is yet to be recognized as a separate disorder. It is more of a compulsive need to get tattoos where you spend considerable time and money. 

Nearly 46% of Americans have a tattoo, 30% of 46% have 2-3 tattoos, and 19% have 4-5 tattoos, as per a report by Statista in 2019. These stats show that a considerable amount of people are hooked on tattooing. 

The dangers of tattoo addiction are increased risk of infection, skin allergies, scarring, bloodborne diseases, and cancer. 

Since tattoo addiction is not an official disorder, there is no established treatment protocol for it. However, cognitive behavioral therapy and counseling are helpful in this behavioral addiction. 

9. Video Game Addiction

Video game addiction is a behavioral addiction defined by the 11th Revision of the International Classification of Diseases (ICD-11) as a lack of control over gaming, giving priority to gaming over daily activities and other interests despite consequences.

According to Limone, P.’s 2023 study, ‘The epidemiology and effects of video game addiction: A systematic review and meta-analysis.’, the global pooled prevalence of video game addiction is 5.0% (95% CI, 2.1–8.8%). In the United States, people under 34 years constitute 58% of all gamers. The global average gaming time is 8.45 hours weekly, with most players spending between two to five hours daily. The meta-analysis revealed that male gamers are significantly more likely to develop gaming addiction, with studies reporting rates of 78.4% and 73.8% male prevalence among those diagnosed with gaming addiction. Online gamers demonstrated higher addiction rates than offline gamers, with 71.4% reporting irritability and anger compared to 50.4% among offline gamers.

The etiological factors of video game addiction are constant pleasure-seeking, impulsiveness, depression, escape from real-life problems, and instant gratification. These causative factors make video game addicts suffer from sleep disturbances, higher school absenteeism, and lower grades, as concluded by a study in Psychology Research and Behavior Management. Other symptoms include fatigue, restlessness, hunger, anger, giving up old hobbies, lying to play games, decline in personal hygiene, and social withdrawal. 

Video game addiction is treated by cognitive behavioral therapy, PIPATIC, self-help groups, and medications, as indicated by a study published in the Journal Cureus.

10. Love Addiction

Love addiction, as defined by Marsal Sanches and John Vineeth P. in The European Journal of Psychiatry, is a maladaptive, pervasive, and excessive affection towards one or more romantic partners, which results in negative consequences like lack of control and reduced interest in other behaviors.

According to Giacobbe, C.’s 2024 study, ‘Psychological and cognitive complaints in individuals with love addiction.’, The prevalence of love addiction is estimated to be around 3–6% in the general adult population, but it grow up to 25% if evaluated within specific populations such as young college students.

Love addiction or pathological love occurs due to cultural influences, childhood trauma, low self-esteem, past break-ups, fear of abandonment, and sex or porn addiction. 

The symptoms of love addiction are feeling lost without a partner, constantly seeking relationships, prioritizing partner over family, and obsessively thinking about a partner. Extreme emotional dependence and idealization are also present in love addicts, also found.

11. Work Addiction

Work addiction is defined as a compulsive behavior to work and preoccupation with work activities in personal time, leading to significant functional harm and distress to the individual and/or friends and family. 

The causes of work addiction include competitive work culture, high expectations, genetic predisposition, and psychological disorders like OCD, bipolar disorder, and perfectionism.  

According to a Polish researcher, Paweł A. Atroszko, the signs and symptoms of work addiction are working more than planned, irritability, worrying about work-related success, and sleep disturbances. Other symptoms include fear of failure at work, working to avoid negative feelings like guilt or financial problems, and defending an obsessive work attitude in front of others. 

The treatment options include counseling, cognitive behavioral therapy, and medications for comorbid psychological disorders. 

What Are The Causes Of Behavioral Addiction?

The causes of behavioral addiction include genetic predisposition, neurobiological factors, psychological vulnerabilities, environmental influences, and early developmental experiences. Biological factors like altered brain chemistry and mental health disorders combine with personality traits such as impulsivity and risk-taking tendencies to increase susceptibility.

Here are the common causes of behavioral addiction in detail below:

Biological Factors

• Genetic Predisposition: A family history of addiction increases susceptibility due to shared genetic traits that influence brain chemistry and reward systems.
• Neurobiology: Dysfunctions in neurotransmitter systems, especially dopamine and serotonin, drive compulsive behaviors by reinforcing reward-seeking patterns. Alterations in brain regions like the frontal lobe and nucleus accumbens contribute to impulsivity and reduced self-control.
• Mental Health Disorders: Conditions such as anxiety, depression, or bipolar disorder co-occur with behavioral addictions, as individuals use addictive behaviors to cope with emotional distress.

Psychological Factors

• Trauma and Stress: Early childhood trauma, abuse, or neglect increases vulnerability by impairing coping mechanisms and altering stress responses.
• Personality Traits: Impulsivity, risk-taking tendencies, and difficulty delaying gratification are associated with higher risks of behavioral addiction.

Environmental Factors

• Social Influences: Peer pressure, cultural norms, and exposure to addictive behaviors in one’s environment normalize such activities, especially during adolescence.
• Lack of Support Systems: Weak family bonds or inadequate social support lead to reliance on addictive behaviors as a coping mechanism.

Behavioral and Developmental Factors

• Early Exposure: Engaging in addictive behaviors at a young age increases the likelihood of long-term addiction due to heightened plasticity in the developing brain.
• Reward Mechanisms: Repetitive engagement in pleasurable activities reinforces neural pathways that make the behavior habitual, even when it becomes harmful.

What Are The Effects Of Behavioral Addiction?

The effects of behavioral addiction include increased anxiety, depression, cognitive impairment, mood swings, social isolation, and diminished self-esteem, significantly impacting mental health and daily functioning. Physically, behavioral addictions lead to neglected health routines, sleep disturbances, weight fluctuations, and elevated chronic disease risks.

Here are the common effects of behavioral addiction:

How Behavioral Addiction Affects Your Mental Health?

The behavioral addiction affects mental health by creating a cycle of increased anxiety, depression, and cognitive impairment. Individuals struggling with behavioral addictions experience heightened anxiety levels due to the compulsive need to engage in the behavior, which exacerbates existing mental health disorders.

Here are the key effects of behavioral addiction on the mind:

• Increased Anxiety: Behavioral addictions lead to heightened levels of anxiety. The constant need to engage in the addictive behavior creates a cycle of stress and worry, particularly when the individual cannot participate in the behavior. This exacerbates existing anxiety disorders or leads to the development of new ones. According to Starcevic, V.’s 2017, ‘Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?.’, in pathological gambling, any anxiety disorder occurs in 37.4% and any mood disorder in 37.9% of individuals; in Problematic Internet Use (PIU), depression affects up to 77.8% and anxiety disorders up to 50%; in problematic online gaming, increased levels of depression, anxiety, and social anxiety are commonly reported; in Compulsive Sexual Behavior Disorder (CSBD), anxiety disorders occur in up to 96% and mood disorders up to 71%; in compulsive buying, anxiety disorders affect up to 80% and mood disorders up to 95%; and in exercise addiction, symptoms of anxiety and depression are also linked, with exercise potentially being driven by a need to alleviate these symptoms.
• Depression: A strong link exists between behavioral addiction and depression. The compulsive nature of the addiction leads to feelings of hopelessness and despair, especially when the behavior results in negative consequences such as financial loss or damaged relationships. This deepens depressive symptoms or triggers depression in individuals who were previously unaffected.
• Impaired Cognitive Function: Addictions affect cognitive functions such as memory, attention, and decision-making. The preoccupation with the addictive behavior leads to neglect of other important tasks, resulting in a decline in cognitive performance. This has long-term effects on an individual’s ability to function effectively in daily life. According to Ngetich, R. K.’s 2024 study, ‘Learning and memory processes in behavioural addiction: A systematic review.’, behavioral addictions such as gambling and gaming are associated with significant cognitive impairments. Individuals with behavioral addictions exhibit altered executive function-dependent learning processes, excessively enhanced habit learning, and disrupted long-term memory functioning. The researchers found neurophysiological evidence of maladaptive modulation in key brain areas and functional networks critical for cognitive processes. These neural alterations mirror those seen in substance use disorders, suggesting that compromised learning and memory systems are fundamental to both the development and persistence of addictive behaviors, regardless of whether they involve substances or specific activities.
• Mood Swings: Behavioral addiction causes significant mood swings. The highs associated with engaging in the behavior are followed by lows when the individual cannot continue, leading to emotional instability. This is particularly challenging for individuals with pre-existing mood disorders.
• Social Isolation: As individuals become more engrossed in their addictive behavior, they withdraw from social interactions. This isolation exacerbates feelings of loneliness and contributes to the development or worsening of mental health issues such as depression and anxiety.
• Co-occurring Disorders: Behavioral addictions co-occur with other mental health disorders, such as Axis I disorders, which are clinical mental health conditions that include a range of diagnoses such as mood disorders, anxiety disorders, and substance use disorders.. For instance, individuals with gambling addiction struggle with bipolar disorder or obsessive-compulsive disorder (OCD). The presence of one condition exacerbates the other, creating a complex web of mental health challenges. According to Starcevic, V.’s 2017, ‘Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?.’, co-occurring psychiatric disorders are extremely common across all behavioral addictions: pathological gambling shows rates of 74.8% for any current “Axis I” disorder and 75.5% for any lifetime “Axis I” disorder, with nicotine dependence (56.4%) and substance use disorders (47.0% lifetime) being most frequent; Problematic Internet Use (PIU) shows strongest associations with depression, Attention-Deficit/Hyperactivity Disorder (ADHD), substance use disorders, and anxiety; problematic online gaming demonstrates significant comorbidity with Attention-Deficit/Hyperactivity Disorder (ADHD) (39.1% in one study); Compulsive Sexual Behavior Disorder (CSBD) reports lifetime rates of any “Axis I” disorder between 83% and 100%; compulsive buying shows a lifetime rate of any co-occurring “Axis I” disorder of 89.5%; and exercise addiction primarily co-occurs with eating disorders, particularly bulimia nervosa, along with obsessive-compulsive traits.
• Impact on Self-Esteem: Engaging in addictive behaviors leads to feelings of guilt, shame, and low self-worth, particularly when the behavior results in negative outcomes. This significantly impacts an individual’s self-esteem and overall mental well-being.

How Does Behavioral Addiction Affect Your Physical Health?

The behavioral addiction affects physical health by leading to neglect of essential self-care practices, resulting in poor diet, lack of exercise, and inadequate sleep. This neglect increases the risk of chronic diseases, such as cardiovascular conditions and obesity, while also causing weight fluctuations and sleep disturbances.

Here are the common effects of behavioral addiction on physical health:

• Neglect of Physical Health: Individuals with behavioral addictions neglect their physical health. This manifests as poor diet, lack of exercise, and inadequate sleep, leading to a decline in overall physical well-being. 

According to Pilver, C. E.’s 2013 study, ‘Increased incidence of cardiovascular conditions among older adults with pathological gambling features in a prospective study.’, individuals with at-risk/problem/pathological gambling (ARPG) demonstrated significantly higher rates of developing arteriosclerosis and other heart conditions compared to non-gamblers or recreational gamblers. This prospective study followed 10,231 adults aged 55 and older over three years, finding that the association between gambling problems and cardiovascular conditions remained significant even after controlling for demographic factors, psychiatric comorbidities, substance use, and body mass index.

• Weight Fluctuations: Certain behavioral addictions, such as food addiction or exercise addiction, lead to significant weight fluctuations. Food addiction results in obesity, while excessive exercise leads to weight loss or even eating disorders. According to Pedram, P.’s 2013 study, ‘Food addiction: its prevalence and significant association with obesity in the general population.’, 88.6% of those classified as food addicted are overweight or obese. People with food addiction tend to be heavier, averaging 11.7 kg more, with a BMI that is 4.6 units higher, 8.2% more body fat, and 8.5% more trunk fat than those without food addiction.
• Sleep Disturbances: Behavioral addictions disrupt normal sleep patterns. The preoccupation with the addictive behavior leads to insomnia or irregular sleep schedules, which have long-term effects on physical health.
• Increased Risk of Chronic Diseases: The lifestyle changes associated with behavioral addiction, such as poor diet and lack of exercise, increase the risk of chronic diseases like heart disease, diabetes, and hypertension. According to Booth, F. W.’s 2012 study, ‘Lack of exercise is a major cause of chronic diseases.’, reducing daily steps from 10,501 to 1,344 for just 2 weeks decreased cardiorespiratory fitness (VO₂max) by 7%, highlighting how quickly inactivity impacts health markers associated with chronic disease risk.
• Physical Symptoms of Stress: The stress and anxiety associated with behavioral addiction manifest physically, leading to symptoms such as headaches, muscle tension, and gastrointestinal issues.
• Impact on Immune System: Chronic stress from behavioral addiction weakens the immune system, making individuals more susceptible to illnesses and infections.
• Physical Consequences of Specific Addictions: Certain behavioral addictions have specific physical consequences. For example, gambling addiction leads to financial ruin, which results in poor living conditions and inadequate nutrition. Similarly, internet addiction leads to a sedentary lifestyle, contributing to physical health issues.

How Does Behavioral Addiction Affect The Brain?

Behavioral addiction affects the brain through significant functional and structural changes. Key brain structures involved in behavioral addictions include the ventral tegmental area (VTA), nucleus accumbens, dorsolateral prefrontal cortex, amygdala, anterior cingulate cortex (ACC), and parahippocampus. When the VTA and nucleus accumbens are activated, they release dopamine, creating a reward response that reinforces addictive behaviors.

What Are The Risk Factors For Behavioral Addiction?

The risk factors for behavioral addiction are family history, comorbid psychological disorders, peer pressure, stress, and consuming addictive drugs. 

Here are the common risk factors for behavioral addiction in detail below:

• Family History: Family history plays a significant role as a risk factor for behavioral addiction. Individuals with a first-degree family member suffering from a substance use disorder (SUD) are more likely to experience higher rates of substance use and mental health disorders. According to Morales, A. M.’s 2020 study, ‘Identifying Early Risk Factors for Addiction Later in Life: A Review of Prospective Longitudinal Studies.’, Genetic factors account for 40–60% of the variability in developing substance use disorders, while environmental influences also contribute significantly.
• Comorbid Psychological Disorders: Comorbid psychological disorders are frequently observed in individuals with behavioral addictions, such as gambling, internet use, or compulsive shopping. These co-occurring conditions include depression, anxiety, and substance use disorders (SUDs), reflecting overlapping etiological and neurobiological mechanisms. According to Petry, N. M.’s 2018 study, ‘Behavioral Addictions as Mental Disorders: To Be or Not To Be?’, 76.3% of individuals with gambling disorder also have a SUD, a rate 5.5 times higher than those without gambling disorder5. Similarly, mood disorders and anxiety affect 37.9% and 37.4% of individuals with gambling disorder, respectively.
• Peer Pressure: Peer pressure significantly contributes to behavioral addiction by influencing individuals to conform to group norms. This pressure leads to the adoption of addictive behaviors such as substance use, excessive internet use, or mobile social media addiction. Peer influence is particularly strong during adolescence, a period marked by increased susceptibility to peer pressure and decreased parental supervision. According to Karakos H.’s 2014 study, ‘Positive Peer Support or Negative Peer Influence? The Role of Peers among Adolescents in Recovery High Schools. Approximately 70% of adolescents report trying alcohol or other drugs due to peer influence.
• Stress: Chronic stress drives individuals to seek relief through addictive behaviors, creating a cycle of reliance on substances or activities for emotional escape.
• Consuming addictive drugs: Using addictive drugs alters brain chemistry and reinforces the desire for continued use, leading to dependency and compulsive consumption despite negative consequences.

How Is Behavioral Addiction Treated?

Behavioral addiction is treated by cognitive behavioral therapy, group therapy, medications, one-on-one or couples counseling, and self-help groups. 

Here are the key treatment options for behavioral addiction:

Cognitive behavioral therapy

Cognitive behavioral therapy, a talking therapy aimed at changing the way one thinks about negative life consequences, plays a fundamental role in treating behavioral addictions. In his study published in the Lancet, Jeremy Adams, a Psychology Professor, states that therapists help individuals undergoing CBT by identifying and correcting irrational thoughts and maladaptive behavior. 

A study in the BioMed Research International monitored the effects of Cognitive behavioral therapy (CBT) on internet addiction. The results showed that 70% of the patients had decreased psychopathological symptoms and psychosocial problems.   

Group therapy

Group therapy, a therapy of one or more psychologists leading a group of 10-15 people, is effective in reducing behavioral addiction symptoms. Cognitive behavioral group therapy is a type of group therapy commonly implemented in behavioral addicts. Group therapy reduces compulsive behavior and interpersonal and health issues while improving tolerance and time management. 

Medications

Medications treat behavioral addictions by treating causative agents like psychological disorders, personality disorders, and neurotransmitter imbalances. According to Chadha, Y.’s 2024 study, ‘Internet Addiction Management: A Comprehensive Review of Clinical Interventions and Modalities.’, 

there are currently no FDA-approved medications specifically for treating behavioral addictions like internet addiction. However, naltrexone, commonly used for substance use disorders, shows potential in reducing cravings associated with compulsive internet use, though more research is needed to establish its efficacy and safety. Treatment involves prescribing medications for co-occurring conditions such as depression, anxiety, or ADHD, with antidepressants and anxiolytics being common choices to address underlying issues that contribute to addictive online behaviors. The pharmacological approach to behavioral addictions remains an evolving area of study that offers additional treatment options in the future.

One-on-one or couples counseling

One-on-one or couples counseling controls behavioral addictions by helping you identify triggers and ways to prevent them. Controlling triggers impair impulsive and compulsive behavior, reducing non-stop engagement in harmful behaviors. 

Self-help groups

Self-help groups are informal groups where individuals support and help each other to recover from different behavioral addictions. Self-help groups foster a sense of understanding and purpose among addicts and serve as an adjunct treatment. Famous behavioral addiction self-help groups include Sex Anonymous, Love Anonymous,  and Gamblers Anonymous. Another benefit of self-help groups is relapse prevention.