A Disorder or Just a Symptom?
Exercise is a generally a healthy behavior that promotes wellness. However, some individuals become addicted to physical activity and engage in compulsive, excessive exercise that is extreme in frequency and both psychologically and psychosocially impairing. Exercise becomes the most important priority in the excessive exerciser's life. All other obligations and responsibilities such as families, careers, and social engagements suffer. This addiction is referred to by a variety of names such as exercise dependence, exercise addiction, obligatory exercise, compulsive athleticism, compulsive exercising, and exercise abuse.
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Common Symptoms
People who are addicted to exercise may have various motivations for their behavior, including a desire to control their body weight or shape, a feeling of inexplicable dread is exercise is not performed, or to achieve an exercise-induced "high."
Exercise addicts may have a very rigid fitness schedule to which they always adhere. They may compulsively exercise alone to avoid attracting the attention of others, including trainers and gym staff.
Addicts will exercise even though they are sick or injured, in the end causing more physical problems for themselves. They may miss work, school, or other social obligations to exercise.
Related Disorders
Currently, exercise dependence is not recognized by the American Psychiatric Association as a primary disorder. Excessive exercise is known to be a symptom of bulimia nervosa. The Diagnostic Manual, the DSM-IV-TR, defines excessive exercise as exercise that "significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications." In this case, individuals with bulimia will exercise excessively as a way to control their body weight or to compensate for a binge eating episode, as opposed to or in addition to purging.
Individuals suffering from anorexia nervosa may also engage in excessive exercise in order to achieve weight loss.
Exercise addiction might also be a symptom of obsessive-compulsive disorder, if the exercise is intended to relieve feeling of anxiety about some feared consequence other than weight gain.
"I do still get the same feelings of distress if I can't go because exercise is such a major part of my life... I get very very depressed — depression to the point where I can weep and berate myself for not going."
Clearly, there is a link between excessive exercise and exercise dependence. In fact, many researchers have concluded that exercise dependence occurs only in the presence of an eating disorder. However, multiple studies have found the existence of exercise dependence in individuals who did not suffer from poor body image or disordered eating habits. Therefore, they concluded that it is a primary disorder that results in exercising for the sake of exercising in itself.
No Scientific Consensus
You are probably wondering is why are there conflicting ideas about the cause of exercise dependence? This is because so little is actually known about this possible primary disorder. There is not a formal definition or universally recognized set of symptoms. Therefore, researchers are using different testing parameters to classify possibly dependent individuals. The same individual could be considered exercise dependent in one study and non-dependent in the next study. Without a formal definition and testing measure, future studies will continue to produce conflicting results.
Seven Warning Signs of Exercise Addiction
- Always working out alone, isolated from others.
- Always following the same rigid exercise pattern.
- Exercising for more than two hours daily, repeatedly.
- Fixation on weight loss or calories burned.
- Exercising when sick or injured.
- Exercising to the point of pain and beyond.
- Skipping work, class, or social plans for workouts.
Many Suffer
What is known is that there are many individuals who suffer from an addiction to exercise. Often they will continue to workout even through the pain of an injury or against the advice of their physician. The psychological torment of not exercising is greater than the negative consequences that affect their physical and social well-being. Often when exercise is withheld, these individuals will experience irritability and depression. These symptoms are relieved by exercising, and thus the cycle is continued. Regardless of the reason behind the excessive exercise, whether or not it is caused by an eating disorder, the effects are harmful to the individuals on psychological, physiological, and psychosocial levels.
While there is an important debate about exercise dependence and eating disorders, it is also important to realize that this is a real addiction that affects real people and real families. Regardless of the cause, more research needs to be done on effectively treating this behavior. Ultimately, the goal is help these individuals overcome this harmful dependence.
Go to Eating Disorder and Body Image Resources
Disclaimer: This information should not be considered medical advice and should not substitute the judgment of a competent psychiatrist.
Credits: Credits: Article written by Hollyann E. Jenkins and M. Williams, Ph.D., Clinical Psychologist.
Source: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
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