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Exploring the Relationship Between Body Mass Index, Obesity, and Gambling Level Across Different Gambling Types

Desmond Lam, Man Mok


Individuals’ body weight, measured in terms of body mass index (BMI), has been linked to various health issues in the literature. Recently, a positive relationship has been found between obesity and the level of problem gambling. In this exploratory study, we investigate the association between BMI, obesity, and gambling frequency across multiple types of leisure gambling. Data collected by the Pew Research Center among 1,473 gamblers was used to tests the links between BMI and gambling frequency for 16 types of leisure gambling activities. After we accounted for the effects of age, educational level, and family income and corrected for multiple comparisons, the results showed that obese participants (BMI ³ 30) conducted significantly more gambling activities in two types of gambling, namely, playing bingo for money and buying state lottery tickets. Moreover, among female gamblers only, BMI was positively associated with frequency of gambling related to casinos, college basketball, and video poker machines. The findings of this exploratory study allow a better understanding of the potential risk factors of obesity and may be of value to public policy makers.

Dans diverses études antérieures, le poids corporel des personnes, mesuré en termes d’indice de masse corporelle (IMC), a été lié à divers problèmes de santé. Récemment, un lien positif a été constaté entre l’obésité et le niveau de jeu compulsif. Dans cette étude exploratoire, nous examinons la relation entre l’indice de masse corporelle, l’obésité et la fréquence du jeu, en nous basant sur divers types de jeux de hasard récréatifs. À l’aide de données recueillies par Pew Research Center auprès de 1 473 joueurs, l’étude sonde les liens entre l’IMC et la fréquence du jeu dans le cas de seize types de jeux récréatifs. Les résultats montrent qu’après avoir tenu compte de l’effet de l’âge, du niveau d’instruction et du revenu familial, ainsi que de la correction de comparaisons multiples, les participants obèses (IMC ≧ 30) ont mené beaucoup plus d’activités de jeu dans deux types de jeux, à savoir le bingo lucratif et l’achat d’une loterie d’État. De plus, seulement chez les joueurs de sexe féminin, l’IMC est positivement associé à la fréquence du jeu dans les cas du casino, du basketball universitaire et de la machine de vidéo poker. Les résultats de cette étude exploratoire nous permettent de mieux comprendre les facteurs de risque éventuels de l’obésité et peuvent être utiles aux décideurs publics.  

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Abbott, D. A., & Cramer, S. L. (1993). Gambling attitudes and participation: A Midwestern survey. Journal of Gambling Studies, 9, 247–263.

Abdi, H. (2010). Holm’s sequential Bonferroni procedure. In Neil Salkind (Ed.), Encyclopedia of research design (pp. 1–8). Thousand Oaks, CA: Sage.

Adams, J., & Nettle, D. (2009). Time perspective, personality and smoking, body mass, and physical activity: An empirical study. British Journal of Health Psychology, 14, 83–105.

Algren, M. H., Ekholm, O., Davidsen, M., Larsen, C. V., & Juel, K. (2015). Health behaviour and body mass index among problem gamblers: Results from a nationwide survey. Journal of Gambling Studies, 31, 547–556.

Black, D. W., Shaw, M., McCormick, B., & Allen, J. (2013). Pathological gambling: Relationship to obesity, self-reported chronic medical conditions, poor lifestyle choices, and impaired quality of life. Comprehensive Psychiatry, 54, 97–104.

Blain, B., Gill, P. R., & Teese, R. (2015). Predicting problem gambling in Australian adults using a multifaceted model of impulsivity. International Gambling Studies, 15, 239¬–255.

Borghans, L., & Golsteyn, B. H. (2006). Time discounting and the body mass index: Evidence from the Netherlands. Economics and Human Biology, 4, 39–61.

Braet, C., Claus, L., Verbeken, S., & Van Vlierberghe, L. (2007). Impulsivity in overweight children. European Child and Adolescent Psychiatry, 16, 473–483.

Burns, A. C., Gillet, P. G., Rubinstein, M., & Gentry, J. W. (1990). An exploratory study of lottery playing, gambling addiction and links to compulsive consumption. Advances in Consumer Research, 17, 298–305.

Carr, D., & Friedman, M. A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46, 244–259.

Cole, T. J., Bellizzi, M. C., Flegal, K. M., & Dietz, W. H. (2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal, 320, 1240–1243.

Crabtree, N. J., Kibirige, M. S., Fordham, J. N., Banks, L. M., Muntoni, F., Chinn, D., . . . Shaw, N. J. (2004). The relationship between lean body mass and bone mineral content in paediatric health and disease. Bone, 35, 965–972.

Crandall, C. S. (1994). Prejudice against fat people: Ideology and self-interest. Journal of Personality and Social Psychology, 66, 882–894.

Currie, S. R., Hodgins, D. C., Wang, J., El‐Guebaly, N., Wynne, H., & Chen, S. (2006). Risk of harm among gamblers in the general population as a function of level of participation in gambling activities. Addiction, 101, 570–580.

De Laet, C., Kanis, J. A., Odén, A., Johanson, H., Johnell, O., Delmas, P., . . . Tenenhouse, A. (2005). Body mass index as a predictor of fracture risk: A meta-analysis. Osteoporosis International, 16, 1330–1338.

Delgado-Rico, E., Río-Valle, J. S., González-Jiménez, E., Campoy, C., & Verdejo-García, A. (2012). BMI predicts emotion-driven impulsivity and cognitive inflexibility in adolescents with excess weight. Obesity, 20, 1604–1610.

Dunstan, D. W., Zimmet, P. Z., Welborn, T. A., De Courten, M. P., Cameron, A. J., Sicree, R. A., . . . Shaw, J. E. (2002). The rising prevalence of diabetes and impaired glucose tolerance: The Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care, 25, 829–834.

Elgar, F. J., Roberts, C., Tudor-Smith, C., & Moore, L. (2005). Validity of self-reported height and weight and predictors of bias in adolescents. Journal of Adolescent Health, 37, 371-375.

Fisher, S. (1993). The pull of the fruit machine: A sociological typology of young players. The Sociological Review, 41, 446–474.

Flegal, K. M., Carroll, M. D., Ogden, C. L., & Johnson, C. L. (2002). Prevalence and trends in obesity among US adults, 1999–2000. JAMA, 288, 1723–1727.

Flintoff, A., & Scraton, S. (2001). Stepping into active leisure? Young women's perceptions of active lifestyles and their experiences of school physical education. Sport, Education and Society, 6, 5–21.

Forbes, G. B., & Reina, J. C. (1970). Adult lean body mass declines with age: Some longitudinal observations. Metabolism, 19, 653–663.

Ford, E. S., Maynard, L. M., & Li, C. (2014). Trends in mean waist circumference and abdominal obesity among US adults, 1999–2012. JAMA, 312, 1151–1153.

Franklin, J., Denyer, G., Steinbeck, K. S., Caterson, I. D., & Hill, A. J. (2006). Obesity and risk of low self-esteem: A statewide survey of Australian children. Pediatrics, 118, 2481–2487.

Gaetano, J. (2013). Holm-Bonferroni sequential correction: An EXCEL calculator (1.1) [Microsoft Excel workbook]. Retrieved from

Grant, J. E., Derbyshire, K., Leppink, E., & Chamberlain, S. R. (2015). Obesity and gambling: Neurocognitive and clinical associations. Acta Psychiatrica Scandinavica, 131, 379–386.

Herring, M., & Bledsoe, T. (1994). A model of lottery participation: Demographics, context, and attitudes. Policy Studies Journal, 22, 245–257.

Janssen, I., Katzmarzyk, P. T., & Ross, R. (2004). Waist circumference and not body mass index explains obesity-related health risk. The American Journal of Clinical Nutrition, 79, 379–384.

Johnson‐Taylor, W. L., & Everhart, J. E. (2006). Modifiable environmental and behavioral determinants of overweight among children and adolescents: Report of a workshop. Obesity, 14, 929–966.

Khullar, K., Agarwal, A., & du Plessis, S. S. (2014). BMI and obesity. In S. S. du Plessis, A. Agarwal, & E. S. Sabanegh Jr. (Eds.), Male infertility: A complete guide to lifestyle and environmental factors (pp. 31–45). New York, NY: Springer.

Ko, G. T., Tang, J., Chan, J. C., Sung, R., Wu, M. M., Wai, H. P., & Chen, R. (2001). Lower BMI cut-off value to define obesity in Hong Kong Chinese: An analysis based on body fat assessment by bioelectrical impedance. British Journal of Nutrition, 85, 239–242.

Kuczmarski, R. J., Carroll, M. D., Flegal, K. M., & Troiano, R. P. (1997). Varying body mass index cutoff points to describe overweight prevalence among US adults: NHANES III (1988 to 1994). Obesity Research, 5, 542–548.

Lam, D. (2007). An exploratory study of gambling motivations and their impact on the purchase frequencies of various gambling products. Psychology & Marketing, 24, 815–827.

Larsson, I., Lissner, L., Näslund, I., & Lindroos, A. K. (2008). Leisure and occupational physical activity in relation to body mass index in men and women. Food and Nutrition Research, 48, 165–172.

Lønbro, S., Dalgas, U., Primdahl, H., Johansen, J., Nielsen, J. L., Overgaard, J., & Overgaard, K. (2013). Lean body mass and muscle function in head and neck cancer patients and healthy individuals—Results from the DAHANCA 25 study. Acta Oncologica, 52, 1543–1551.

Loroz, P. S. (2004). Golden‐age gambling: Psychological benefits and self‐concept dynamics in aging consumers' consumption experiences. Psychology & Marketing, 21, 323–349.

Luppino, F. S., de Wit, L. M., Bouvy, P. F., Stijnen, T., Cuijpers, P., Penninx, B. W., & Zitman, F. G. (2010). Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry, 67, 220–229.

Mukamal, K. J., & Miller, M. (2009). BMI and risk factors for suicide: Why is BMI inversely related to suicide? Obesity, 17, 532–538.

Nower, L., & Blaszczynski, A. (2006). Impulsivity and pathological gambling: A descriptive model. International Gambling Studies, 6, 61–75.

O’brien, R. M. (2007). A caution regarding rules of thumb for variance inflation factors. Quality and Quantity, 41, 673–690.

O'dea, J. A. (2006). Self-concept, self-esteem and body weight in adolescent females: A three-year longitudinal study. Journal of Health Psychology, 11, 599–611.

Ozier, A. D., Kendrick, O. W., Leeper, J. D., Knol, L. L., Perko, M., & Burnham, J. (2008). Overweight and obesity are associated with emotion- and stress-related eating as measured by the Eating and Appraisal Due to Emotions and Stress Questionnaire. Journal of the American Dietetic Association, 108, 49–56.

Pagoto, S. L., Spring, B., Cook, J. W., McChargue, D., & Schneider, K. (2006). High BMI and reduced engagement and enjoyment of pleasant events. Personality and Individual Differences, 40, 1421–1431.

Palmisano, G. L., Innamorati, M., & Vanderlinden, J. (2016). Life adverse experiences in relation with obesity and binge eating disorder: A systematic review. Journal of Behavioral Addictions, 5, 11–31.

Puhl, R., & Brownell K. D. (2001). Bias, discrimination and obesity. Obesity Research, 9, 788–805.

Ramachandran, A., & Snehalatha, C. (2010). Rising burden of obesity in Asia. Journal of Obesity, 2010, 1–8.

Renehan, A. G., Tyson, M., Egger, M., Heller, R. F., & Zwahlen, M. (2008). Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies. The Lancet, 371, 569–578.

Rexrode, K. M., Hennekens, C. H., Willett, W. C., Colditz, G. A., Stampfer, M. J., Rich-Edwards, J. W., . . . Manson, J. E. (1997). A prospective study of body mass index, weight change, and risk of stroke in women. JAMA, 277, 1539–1545.

Rogers, P. (1998). The cognitive psychology of lottery gambling: A theoretical review. Journal of Gambling Studies, 14, 111–134.

Ruxton, G. D. (2006). The unequal variance t-test is an underused alternative to Student's t-test and the Mann–Whitney U test. Behavioral Ecology, 17, 688–690.

Schwartz, M. B., Chambliss, H. O. N., Brownell, K. D., Blair, S. N., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11, 1033–1039.

Scott, K. M., McGee, M. A., Wells, J. E., & Oakley Browne, M. A. (2008). Obesity and mental disorders in the adult general population. Journal of Psychosomatic Research, 64, 97–105.

Seidell, J. C. (2000). Obesity, insulin resistance and diabetes—A worldwide epidemic. British Journal of Nutrition, 83, S5–S8.

Simon, G. E., Von Korff, M., Saunders, K., Miglioretti, D. L., Crane, P. K., van Belle, G., & Kessler, R. C. (2006). Association between obesity and psychiatric disorders in the US adult population. Archives of General Psychiatry, 63, 824–830.

Steel, Z., & Blaszczynski, A. (1998). Impulsivity, personality disorders and pathological gambling severity. Addiction, 93, 895–905.

Tang, C. S. K., & Wu, A. M. (2012). Impulsivity as a moderator and mediator between life stress and pathological gambling among Chinese treatment-seeking gamblers. International Journal of Mental Health and Addiction, 10, 573–584.

Taylor, P., Funk, C., & Craighill, P. (2006). Gambling: As the take rises, so does public concern. Retrieved from the Pew Research Center website:

Titz, K., Andrus, D., & Miller, J. (2012). Hedonistic differences between mechanical game players and table game players: an exploratory investigation on the road to a comprehensive theory for gambling. UNLV Gaming Research & Review Journal, 6, 23–32.

Troiano, R. P., Frongillo, E. A., Jr., Sobal, J., & Levitsky, D. A. (1996). The relationship between body weight and mortality: A quantitative analysis of combined information from existing studies. International Journal of Obesity and Related Metabolic Disorders, 20, 63–75.

Vitaro, F., Arseneault, L., & Tremblay, R. E. (1999). Impulsivity predicts problem gambling in low SES adolescent males. Addiction, 94, 565–575.

Weinsier, R. L., Hunter, G. R., Heini, A. F., Goran, M. I., & Sell, S. M. (1998). The etiology of obesity: Relative contribution of metabolic factors, diet, and physical activity. The American Journal of Medicine, 105, 145–150.

Weller, R. E., Cook, E. W., III, Avsar, K. B., & Cox, J. E. (2008). Obese women show greater delay discounting than healthy-weight women. Appetite, 51, 563–569.

Wood, R. T., & Griffiths, M. D. (2007). A qualitative investigation of problem gambling as an escape‐based coping strategy. Psychology and Psychotherapy: Theory, Research and Practice, 80, 107–125.

World Health Organization. (2014a). BMI classification. Retrieved from

World Health Organization. (2014b). Obesity and overweight. Retrieved from

Young, M., & Stevens, M. (2009). Player preferences and social harm: An analysis of the relationships between player characteristics, gambling modes, and problem gambling. International Journal of Mental Health and Addiction, 7, 262–279.

Zhao, G., Ford, E. S., Dhingra, S., Li, C., Strine, T. W., & Mokdad, A. H. (2009). Depression and anxiety among US adults: Associations with body mass index. International Journal of Obesity, 33, 257–266.


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