J Health Behav Med Hist 2025-6.
Commentary (2) on: “Exercise Snacks and Physical Fitness in Sedentary Populations” – Wang et al., Sports Med Health Sci 2024.
Robert C. van de Graaf, MD, director
MEDTCC Institute for Health, Behaviour, Medicine and its History, The Netherlands.
The recent review by Wang and colleagues offers a timely and pragmatic contribution to the challenge of physical inactivity. Their advocacy for “exercise snacks”—short bouts of physical activity interspersed throughout the day—presents a low-barrier, scalable approach to disrupting prolonged sitting patterns in sedentary populations. The physiological benefits and implementation strategies they outline are clear and actionable. However, I believe an additional perspective may help to explain why sedentary behavior is so persistent and difficult to change: the emerging concept of Chair Use Disorder (CUD) [van de Graaf, 2022].
CUD reframes excessive sitting not merely as a behavioral risk but as a form of psychological and physiological dependence on comfortable seating. It aligns closely with addiction models traditionally applied to substances like tobacco, alcohol, and ultra-processed foods. Comfortable chairs are, in essence, consumer products designed to offer immediate gratification and prolonged passivity—serving short-term needs at the expense of long-term health.
From an addiction medicine perspective, we have observed striking parallels between Chair Use Disorder and substance use disorders. These include compulsive use despite known harms, repeated failed attempts to reduce use, environmental cue-triggered behavior, and withdrawal symptoms such as discomfort, irritability, and lethargy upon attempting to sit less. CUD may also involve tolerance—the need for increasingly prolonged or more cushioned sitting to achieve the same level of perceived comfort.
Viewing sedentary behavior through the lens of addiction offers important clinical and societal advantages. It enables the use of established treatment approaches such as self-monitoring, cognitive-behavioral therapy, environmental restructuring, and peer support networks. It also highlights the systemic dimension of the problem: our environments are saturated with soft seating and social norms that implicitly promote passive behavior. In this context, public health promotion alone—without addressing the addictive nature of the product—may prove insufficient.
In practice, reframing sedentary behavior as a form of behavioral addiction has proven motivational for patients. It invites critical reflection on one’s surroundings, empowers behavior change, and encourages the creation of social support systems—just as we have seen in the context of tobacco control and other addictive behaviors.
Future research on “exercise snacks” and sedentary lifestyle interventions may benefit from integrating addiction-based frameworks. Understanding why individuals remain seated—often against their own intentions—may be just as critical as understanding how to prompt them to move.
References
Wang T, Laher I, Li S. Exercise snacks and physical fitness in sedentary populations. Sports Med Health Sci. 2024;7(1):1–7. doi:10.1016/j.smhs.2024.02.006. Link
Van de Graaf RC, Hofstra L, Scherder EJA. Chair use disorder: we should treat excessive chair use as an addiction. J Phys Act Health. 2022;19(7):473. doi:10.1123/jpah.2022-0330.