If you’ve tuned into a sporting event recently, you’ve likely noticed how much sports gambling has changed. Whether you’ve placed a bet or not, the shift in the gambling landscape is undeniable.
From casino floors to your couch
Dr. Timothy Fong, a professor of psychiatry at the University of California, Los Angeles (UCLA), describes the evolution as transformative. “It’s not even the same world,” says Fong, co-director of the UCLA Gambling Studies Program. Twenty years ago, if you wanted to legally place a sports bet, you had to travel to a casino in Las Vegas or Atlantic City. Now, thanks to legal changes and the rise of mobile technology, sports betting is accessible from the comfort of your couch.
This new convenience, bolstered by millions spent on advertising by gambling companies, has made betting mainstream. But what many people might not realize is how this accessibility can be linked to their health.
Gambling and health
According to Fong, the connection between gambling and health is often overlooked. “We just think, ‘Oh, it’s completely separate.’ It’s not separate. It’s completely intertwined with our physical health states,” he said.
The research connecting sports betting and health outcomes is still developing. As Dr. Marc Potenza, a professor of psychiatry at Yale University School of Medicine, points out, the majority of people gamble without issue. However, it’s important not to stigmatize those who enjoy gambling responsibly. Nonetheless, the massive rise in sports betting, which exploded after the 2018 Supreme Court ruling that legalized it in many states, raises concerns.
A new era of sports betting: more access, more risk?
In 2023 alone, a record $119.8 billion was legally wagered on sports, according to the American Gaming Association. Fong notes that betting options today extend far beyond traditional outcomes. For example, instead of betting on whether a team wins or loses, bettors can place wagers on micro-events like whether a pitch is a ball or a strike, or even whether a ball lands on the grass between innings. This variety makes sports betting accessible at any time, on any sport—even Polish table tennis or Japanese badminton.
The increase in accessibility and betting options has been a boon for the gambling industry, which earned $10.9 billion in revenue in 2023. However, this also raises red flags for public health experts. Potenza, who directs Yale’s Center of Excellence in Gambling Research, highlights a concerning statistic from Connecticut: requests to the state’s gambling helpline increased by 91% after sports betting was legalized in 2021, with most of these calls coming from college-age men.
The health impacts of problem gambling
Problem gambling can have serious health implications. About 1% of U.S. adults meet the criteria for severe gambling issues, with an additional 2-3% having mild or moderate problems, according to the National Council on Problem Gambling.
Fong points out that people with gambling disorders often have other medical issues. These individuals may experience sleep deprivation, visit emergency rooms more often, and struggle with other unhealthy behaviors like smoking or excessive alcohol consumption. A 2013 study co-authored by Potenza found that older adults with gambling problems were more than twice as likely to develop arteriosclerosis, a condition where plaque builds up in the arteries. Problem gamblers also had a 53% higher risk of developing any type of heart condition.
Is sports betting more addictive?
While much of the research on gambling predates the sports betting boom, there are signs that sports gambling might present its own unique risks. A 2023 study in Sweden found that problem gamblers had higher rates of cardiovascular, respiratory, and metabolic conditions, including diabetes. Another study published in JAMA Network Open earlier this year found that sports bettors were more likely to binge drink compared to non-gamblers.
Fong explains that while researchers haven’t yet studied sports betting in isolation, gambling’s core processes—risk and reward—remain the same. The excitement of gambling triggers the release of brain chemicals that can resemble those seen in individuals addicted to alcohol or drugs. “Weighing risks is a basic human activity,” Fong said, but when it comes to gambling, the stakes can get high, both financially and mentally.
The stress of sports betting
Gambling is inherently stressful. This stress can manifest in various health problems, even for those who don’t step foot inside a casino. Fong likens sports betting to playing slot machines: people can sit still for hours, mentally anticipating the next bet, which can affect both physical and mental health.
Studies have shown higher levels of stress-related chemicals in the blood of people who gamble, particularly those who do so problematically. As Potenza points out, how a person responds to the stress of gambling often delineates a casual gambler from someone with a problem.
Entertainment or addiction?
For most people, gambling is a form of entertainment. Some even use it as a way to socialize. But Fong cautions that there’s a line between entertainment and addiction. He likens it to riding a roller coaster: doing it once in a while is fine, but if you spend all day on the ride despite feeling sick, “that’s not entertainment anymore. That’s a harmful compulsion.”
Fong has encountered extreme cases in his practice, where patients’ gambling disorders have led to crises, including suicide. Data from California’s Gambling Education and Treatment Services showed that about 19% of people entering outpatient care for gambling had suicidal thoughts—ten times higher than the general population.
Staying in control
Gambling can be safe when it’s well-regulated. Potenza advises treating it like any form of entertainment: setting limits on time and money. However, signs of trouble include secrecy, lying about gambling habits, and spending more than intended. Early intervention is key, and seeking help at the first signs of a problem can prevent severe consequences.
Fong and Potenza agree that more research is needed to fully understand how modern sports betting impacts health. “We’ve learned a lot in the past few years,” Fong said, “but there’s still much more to uncover.”
