Effects of exercise on alcohol use disorders

Background: Alcohol use disorders are common, yet highly undertreated. Major barriers for not seeking treatment are stigma, lack of problem awareness, and the desire to self-manage the problem. In addition to health consequences resulting from harmful alcohol consumption, there are reports that individuals with alcohol use disorders are physically inactive. Exercise is a non-stigmatizing treatment option associated with positive health outcomes, both in terms of physical health and mental health. The aim of this thesis is to evaluate if exercise can help reduce alcohol consumption in non-treatment seeking adults with alcohol use disorders.

Method: Study I was a randomized controlled trial (n=140) evaluating the change in weekly alcohol consumption at the end of a 12-week intervention, comparing aerobic exercise, yoga, and treatment as usual (phone counselling). In Study II, the aim was to narratively describe the experiences of yoga and aerobic exercise among non-treatment seeking adults with alcohol use disorder. Data was collected through individual semi-structured interviews with twelve participants from Study I.

Results: In Study I, the within-group reductions in weekly consumption were statistically significant in all three groups, but no group differences were found at follow-up. Compared to treatment as usual the per-protocol analyses favored yoga compared to aerobic exercise. Study II identified one main category; Motivating and maintaining a lifestyle change including four generic categories: (a) Initiating factors for lifestyle change, (b) Influencing lifestyle change, (c) Influencing physical and mental health and (d) Influencing alcohol consumption.

Conclusion: Exercise is an attractive treatment option for non-treatment seeking individuals with alcohol use disorders. Changing alcohol habits may be easier to accomplish when presented as part of a larger lifestyle change, with focus on increased exercise. A 12-week exercise program has effects on alcohol consumption comparable to usual care, and yoga- based exercise tends to reduce consumption more than aerobic exercise. Self-selected exercise may increase compliance, strengthen the mood-enhancing effects of exercise, and as a result reduce alcohol cravings and the need to drink. The success of changing exercise habits may reinforce the individual’s self-esteem and self-efficacy and consequently increase the individual’s motivation to change the drinking habits.

List of scientific papers

I. Gunillasdotter V, Andréasson S, Jirwe M, Ekblom Ö, Hallgren M. Effects of exercise in non-treatment seeking adults with alcohol use disorder: a three-armed randomized controlled trial (FitForChange). Drug and Alcohol Dependence. 2022:109266.
https://doi.org/10.1016/j.drugalcdep.2022.109266

II. Gunillasdotter V, Andréasson S, Hallgren M, Jirwe M. Exercise as treatment for alcohol use disorder: a qualitative study. Drug and Alcohol Review. [Accepted]
https://doi.org/10.1111/dar.13527