Workaholism as a neglected risk factor for unhealthy aging: implications for the Semmelweis–EUniWell Workplace Health Promotion Program

Abstract

Workaholism, also referred to as problematic overworking, has received increasing attention due to its adverse consequences for individuals, families, and organizations. This perspective paper argues that workaholism represents a largely neglected risk factor for unhealthy aging, as sustained exposure to excessive and compulsive work might be associated with an increased risk of cardiometabolic conditions, including hypertension and cardiovascular disease. We further highlight that, despite the high prevalence of work-related stressors in academia, empirical research on workaholism in university settings remains limited, underscoring the need for targeted prevention and intervention strategies. Addressing workaholism through approaches that reduce problematic overworking, promote adaptive work engagement, and support a healthier balance between professional and personal life may contribute to improved long-term health trajectories among academic staff. Finally, we propose the integration of workaholism-focused assessment and intervention components into the Semmelweis–EUniWell Workplace Health Promotion Program as a scalable framework for fostering healthy aging in academic workplaces.

Introduction

In the literature, the construct of workaholism was introduced more than fifty years ago by Oates [1]. Since then, a growing body of research has examined this potential clinical condition associated with problematic overworking, employing different conceptual frameworks. These theorizations primarily diverge in whether they conceptualize workaholism as a “pure” behavioral addiction or as a condition characterized by both addictive and obsessive-compulsive symptoms, while also underlining the importance of distinguishing between engaged and disengaged workaholics [2]. Moreover, Loscalzo and Giannini [2] emphasized the importance of avoiding the over-pathologizing of a common behavior such as working. They pointed out that among heavy work investors (i.e., individuals who devote substantial time and energy to their work), there may also be engaged workers, who are characterized by high levels of work engagement and low levels of workaholism. Consequently, these individuals exhibit a positive and healthy attitude toward their job. Additionally, based on their comprehensive review of the literature on antecedents of workaholism, they also emphasized that workaholism should not be understood solely from an individual-level perspective. In addition to individual antecedents (such as personality traits, perfectionism, or cognitive biases), they highlighted the importance of situational antecedents, with particular reference to the critical role that an overwork climate may play when it is present both within the family and the organizational context.

Recent bibliometric analyses (regardless of the specific conceptualization) showed that a notable surge in workaholism publications occurred in 2014, likely reflecting increased societal interest in mental health within the workplace [3, 4]. Though, it also coincided with the 2013 peak in publications on new potential behavioral addictions [5], following the inclusion of Gambling Disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [6]. This might have encouraged researchers to adopt, often a priori, a behavioral-addiction perspective across a wide range of everyday activities, a trend that subsequently drew criticism for contributing to the over-pathologization of common behaviors (e.g., dancing or tanning) and for overlooking the unique features of specific excessive behaviors [5, 7, 8]. Nevertheless, Trasca found that the peak in publications specifically addressing workaholism was reached in 2023, a drift she linked to the post-pandemic context [3]. Changes in work arrangements – such as the expansion of remote work – introduced new sources of stress for employees, who simultaneously experienced increasing challenges in maintaining work-life balance. Indeed, recent studies have investigated the relationship between technostress and workaholism (e.g., [9–11]). Additionally, Andersen et al. [12] highlighted the importance of preventing workaholism by showing that its prevalence across 23 countries was 15.2%.

In this context, given the growing interest in workaholism literature across diverse occupational groups and its adverse outcomes [2, 13, 14], it is surprising that scholars have devoted relatively little attention to their own profession. Therefore, in this perspective paper, we aim to briefly review the negative outcomes associated with workaholism – particularly its physical impact on individuals and, consequently, on healthy aging. Then, we will synthesize the limited literature on workaholism among academics, with the goal of prompting preventive interventions for this population.

Workaholism: a risk factor for unhealthy aging

The detrimental effects of workaholism on individuals, their families and organizations are well documented, as evidenced by reviews published over the past decade [2, 13, 15]. Focusing on individual outcomes, the meta-analytic review by Morkevičiūtė [14] highlighted that workaholism is associated with impairments across several domains: overall health, psychological and psychophysical health, and physical health. More specifically, workaholism predicts poorer global health and higher levels of general health complaints and physical complaints. With regard to the psychological and psychophysical outcomes, evidence indicates that workaholism predicts lower life satisfaction and happiness, as well as higher overall levels of psychological disorders and burnout, general anxiety and stress, depression, distress, somatic symptoms, and sleep problems [14].

Although studies on the physical correlates of workaholism are fewer than those conducted in other domains, the literature synthesized by Hu [16] suggests that workaholism may have a negative impact on physiological health because overworking behaviors prevent the body and brain from resting and recovering, while also increasing sympathetic nervous system activity. In line with this, the high levels of anxiety that characterize workaholics may lead to increased heart rate and systolic blood pressure. Therefore, workaholism has been proposed as a risk factor for stress-related diseases, cardiovascular disease and hypertension [16]. There is also evidence of an association between workaholism and metabolic syndromes [17]. More specifically, Aziz and Covington [18] – based on their review of recent findings concerning the impact of workaholism on health outcomes, such as impaired sleep and higher stress and burnout – concluded that workaholism may be linked not only with various risk factors for cardiovascular diseases (the leading cause of death globally [19]) but also with other issues due to metabolic abnormalities, such as type 2 diabetes.

Sleep disturbance might represent a key mechanistic pathway linking workaholism to unhealthy aging. Workaholics might experience shortened sleep duration, increased sleep latency, and impaired sleep quality, partly due to cognitive preoccupation with work and blurred work-life boundaries. Chronic sleep disruption is a well-established contributor to cardiometabolic dysfunction, autonomic imbalance, accelerated biological aging and premature mortality [20]. Thus, sleep impairment may function as a central mediator through which sustained overworking translates into long-term cardiovascular and metabolic risk [21]. From a geroscience perspective, these mechanisms may converge to promote accelerated biological aging, defined as a divergence between biological and chronological age [22]. Chronic overwork, through sustained stress exposure, autonomic imbalance, and impaired recovery, may contribute to cumulative physiological dysregulation across multiple systems [23, 24]. Such processes are increasingly recognized as measurable through integrative biomarkers of aging, including composite physiological indices and emerging molecular markers (e.g., epigenetic clocks) [25–28]. In this context, workaholism may represent a behavioral driver of accelerated aging, linking occupational exposures to long-term health trajectories [18, 29–32]. Figure 1 graphically illustrates how workaholism may function as a risk factor for unhealthy aging by negatively affecting sleep quality and triggering stress-related physiological activation. Additionally, it also shows how fostering work engagement, on the other hand, might promote healthy aging.

Fig. 1.

Workers’ attitudes as risk factors for unhealthy aging. Note. Image created by the authors with Canva

Taken together, this evidence indicates that, in the long run, workaholism might be a substantial risk factor for unhealthy aging, underscoring the importance of preventing this detrimental work attitude (and promoting work engagement) within organizations – including universities – where this phenomenon has been largely understudied.

Workaholism in the university setting

Academia is characterized by a culture that fosters increased working time, workload intensity, productivity and performance. As a result, working on weekends and, more generally, at home outside regular working hours is common among professors [33–37]. In parallel, academic staff are increasingly burdened with administrative responsibilities, often without corresponding recognition or compensation [38], a factor that Tight [39] previously identified as contributing to perceptions of rising academic workload. Together, these features place university staff at heightened risk of developing workaholism. Despite this, research focusing specifically on the university setting remains scarce. For example, among the 53 studies included in the meta-analysis by Andersen et al. [12], only three focused on university staff [40–42].

Allam et al. [40] investigated academics across different career stages and disciplines and reported that workaholism prevalence did not differ between faculties, but increased following the COVID-19 pandemic. They also showed that workaholism among academics negatively affects sleep, thereby impacting their overall health. Similarly, Galdino et al. [41], focusing on graduate-level (permanent) nursing professors, reported that about one in three participants experienced high levels of burnout and workaholism, and that workaholism was associated with burnout, negatively influencing professors’ biopsychosocial health. Finally, Hogan et al. [42], whose sample included both senior and junior academics, found that half of their participants reported workaholic tendencies and that those without concurrent work enjoyment were particularly likely to exhibit poorer functioning (e.g., lower general well-being and higher work-family conflict). Other studies on workaholism among academics converge in showing that this phenomenon is present among professors and negatively affects their functioning and health, including higher levels of depression, work-family conflict, and psychological distress [38, 43, 44].

Notably, a recent study by Almeida et al. [45] involving Brazilian graduate nursing professors highlighted several factors associated with workaholism, including having received a research productivity grant, feeling pressure to publish, working on more than 11 articles simultaneously, providing more than 21 peer reviews in the previous year, and working 11 hours per week beyond the required schedule. Moreover, 7.2% of participants were unable to disengage from work upon retirement, continuing to work as a senior professor (even without pay). Thus, although the literature on workaholism in academia remains limited, existing evidence underscores the importance of addressing this issue to improve professors’ well-being and to promote healthy aging, both physically (e.g., reducing adverse outcomes such as increased cardiovascular risk) and psychologically (e.g., supporting a positive transition into retirement).

Importantly, several factors linked to workaholism among academics reflect structural and institutional pressures rather than individual vulnerability alone. Competitive grant funding systems, performance metrics emphasizing publication volume, and expectations of constant availability may normalize excessive work investment and indirectly reinforce workaholic patterns. In this sense, workaholism in academia should be understood not only as an individual behavioral risk factor, but also as a byproduct of organizational cultures that prioritize productivity over recovery and long-term health.

From a life-course perspective, workaholism might emerge during early- and mid-career stages, whereas its adverse health consequences may become apparent only decades later. Prolonged exposure to excessive work demands, chronic stress, and impaired recovery across the working lifespan may cumulatively increase cardiometabolic risk and erode physical and psychological resilience in later life. The inability to disengage from work after retirement may represent the culmination of this long-term exposure, reflecting impaired psychological aging characterized by reduced capacity for recovery, boundary-setting, and role transition. Because retirement represents a critical window for physiological and psychological restoration, failure to capitalize on this transition may prolong stress-related biological activation and limit opportunities for recovery. Accordingly, addressing workaholism early in academic careers represents a critical opportunity to preserve long-term health, support sustainable productivity, and facilitate healthier transitions into retirement.

Implications for the Semmelweis–EUniWell Workplace Health Promotion Program

The European University for Well-Being (EUniWell) is a multinational alliance of European universities committed to promoting well-being, health, and social responsibility within higher education. The alliance brings together diverse institutions across Europe that share a common interest in prevention-oriented, evidence-based approaches to improving the mental, physical, and social well-being of students and staff. By encouraging the use of shared conceptual frameworks and harmonized assessment strategies, EUniWell provides a unique platform for cross-country comparisons of workplace health risks and protective factors, while also facilitating the translation of research findings into institutional practices and policy-relevant recommendations. In this way, EUniWell functions not merely as a network, but as a strategic European framework for advancing healthy aging and sustainable work environments in academia.

Within this alliance, Semmelweis University has developed and implemented the Semmelweis Study, a large-scale longitudinal occupational cohort designed to identify determinants of healthy and unhealthy aging among university employees [46]. Initiated within the framework of the Semmelweis-EUniWell Workplace Health Promotion Program [47, 48], the Semmelweis Study integrates comprehensive survey-based assessments of psychosocial stressors, work-related factors, sleep, lifestyle behaviors, and socioeconomic conditions with objective clinical and biological measurements, including blood pressure, anthropometry, and laboratory parameters. This integrative design allows for the simultaneous examination of multiple, interacting risk factors, thereby avoiding siloed interpretations of workplace health and providing a robust evidence base for targeted prevention. Importantly, the methodological structure of the Semmelweis Study is inherently scalable and transferable, making it a suitable template for adaptation across EUniWell partner institutions.

Given the growing evidence linking workaholism to adverse physical and psychological outcomes in academia, incorporating workaholism-related assessment into this framework represents a logical next step. The Work-Related Inventory (WI-10 [49]) offers a validated instrument for identifying both engaged and disengaged workaholics, two profiles that are associated with distinct but clinically relevant risks. Although engaged workaholics – who also exhibit high work engagement – are generally less negatively impacted than disengaged workaholics [50, 51], both types warrant attention. Embedding the WI-10 within the Semmelweis Study and, by extension, within harmonized EUniWell data collection efforts, would enable the systematic assessment of workaholism prevalence across universities, while also allowing the examination of its associations with sleep disturbance, cardiometabolic risk factors, burnout, and other aging-related outcomes in an integrated manner. Given the multinational EUniWell framework – comprising countries with diverse work norms and culture background that might shape employees’ attitudes – it is important to note that the cut-off scores for workaholism (and work engagement) on the WI-10 are determined using the 40th and 60th T-scores derived from each country’s working population. This approach allows for the establishment of culture-sensitive cut-off scores. In this vein, it would be advisable to conduct WI-10 validation studies in the EUniWell countries where they are not yet available, as well as to perform measurement variance analyses.

A parallel approach may be applied to students through the Studyholism Inventory (SI-10 [52, 53]), which captures excessive and problematic study behaviors. As noted by Loscalzo and Giannini [54], workaholism may also be present among students, since studying constitutes the primary “work” activity for students. Research on studyholism (or obsession with studying) increasingly supports its conceptualization as a construct distinct from workaholism, specifically as an Obsessive–Compulsive related Disorder [55]. Nonetheless, both workaholism and studyholism are characterized by excessive investment in working or studying, which is associated with adverse outcomes. From a life-course perspective, studyholism may serve as a precursor to later workaholism, particularly in students who pursue academic careers (e.g., PhD students, lecturers, professors). Assessing both phenomena within a shared institutional framework would therefore support early identification and prevention across career stages, from students to senior faculty. More specifically, it would be both important and feasible – given the relatively small number of Ph.D. students and post-doctoral researchers compared to the broader student population – to screen early-career university employees for workaholic tendencies. Doing so could enable early intervention, before excessive work investment becomes entrenched and more difficult to change.

Moreover, it would be valuable to integrate WI-10 (and SI-10) assessments – particularly for individuals with high scores – with objective physiological indicators of distress and biomarkers of biological aging collected via the Ecological Momentary Assessment (EMA) approach, which consists of repeated and frequent assessments in daily life [56]. More specifically, we propose the development of a mobile phone-based application that would enable workers (and students) to monitor physiological indicators of distress and physical strain (e.g., blood pressure or heart rate) in an objective manner, while simultaneously providing brief mindfulness-based techniques to support the regulation of emotional and physiological activation.

Importantly, effective prevention of workaholism in academic settings cannot rely solely on individual-level interventions. Organizational factors – including leadership norms, performance evaluation systems, and the distribution of grant-related workloads – play a critical role in shaping work cultures that either promote sustainable engagement or normalize chronic overwork. Institutional signals that value recovery, psychological detachment from work, and healthy boundary-setting may be particularly important in mitigating workaholic tendencies. From this perspective, workplace health promotion initiatives should aim not only to identify at-risk individuals, but also to support organizational practices that foster long-term well-being and sustainable productivity across the academic life course.

The Semmelweis–EUniWell Workplace Health Promotion Program is envisaged as a dynamic collection of best practices derived from participating universities, encompassing individual-, organizational-, and policy-level interventions. Within this framework, workaholism could be targeted through a combination of screening, awareness-raising, and organizational reflection, informed by institution-specific data. Importantly, such efforts need not focus solely on individual behavior change, but may also encourage universities to attend to the structural factors outlined above (e.g., the distribution of grant-related workloads and the valuing of recovery and healthy boundary-setting). From this perspective, we suggest that the most feasible institutional-level interventions to be implemented first are those focused on leadership training, as organizational culture is unlikely to change without a corresponding shift in leaders’ attitudes. For example, Loscalzo et al. [57] recommend implementing soft-skills training designed to make leaders aware of the different types of heavy-work investor, thereby enabling them to identify those with an underlying workaholic tendency. Moreover, it is important to address potential workaholic tendencies among leaders themselves to prevent them from fostering similar attitudes in their employees, while also enabling them to act as role models – for example, by demonstrating how to set boundaries and engaging in recovery activities. Finally, organizations should provide workers with access to free psychological counseling services within the workplace.

In conclusion, the current literature on workaholism in academia remains limited, particularly regarding its negative impact on biopsychosocial health and, consequently, on healthy aging. We therefore recommend that future research address this gap, especially through longitudinal designs. Such approaches would help clarify whether workaholism predicts unhealthy aging beyond the well-established psychological and physical stressors associated with it, thereby providing a stronger evidence base for preventive interventions. However, based on the preliminary evidence available and reviewed in this paper, we suggest that embedding workaholism and studyholism assessment within the Semmelweis Study framework and extending this approach across EUniWell partner institutions would enable coordinated, evidence-based prevention strategies. By leveraging harmonized data collection and shared best practices, the Semmelweis–EUniWell Workplace Health Promotion Program has the potential to address problematic overworking (and overstudying) as a modifiable risk factor for unhealthy aging, thereby promoting healthier aging trajectories, sustainable productivity, and long-term well-being among both academic staff and students across Europe.

Funding

This study was supported by project no. TKP2021-NKTA-47, implemented with support from the Ministry of Innovation and Technology of Hungary through the National Research, Development and Innovation Fund, under the TKP2021-NKTA funding scheme; the 2015–1.2.1.-HU-RIZONT-2–25-00016 (INNOBRAIN), the National Cardiovascular Laboratory Program (RRF-2.3.1–21–2022–00003) and the Mission-driven National Cardiovascular Laboratory Program (2026), supported by the National Research, Development and Innovation Office of Hungary. Project no. 135784 implemented with the support provided from the National Research, Development and Innovation Fund of Hungary, financed under the K20 funding scheme and the European University for Well-Being (EUniWell) program (grant agreement number: 101004093/EUniWell/EAC-A02-2019/EAC-A02-2019–1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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Competing interests

Dr. Zoltan Ungvari serves as Editor-in-Chief for GeroScience. The authors declare no competing financial interests.