Exercise Addiction: Pushing the Limits of Healthy Behavior

My article appeared originally on Recovery Brands' Pro Corner site.

The statistics are staggering; millions of Americans don’t get enough exercise. In the early part of my career, as a certified personal trainer and group fitness instructor, I focused on this end of the spectrum – helping people to incorporate exercise into their lives and adhere to regular exercise programs. But, as I trained to be a clinical psychologist, I saw more and more of other end of the exercise spectrum. On this other side sit those who have a compulsive relationship to exercise; that exercise despite pain or illness; that feel anxious, angry, or depressed if they miss an exercise session; that unhealthily use exercise to influence their weight or shape; and that engage in rigid exercise behavior, despite little enjoyment from the activity.

Females who under-eat and over-exercise are at risk for the Female Athlete Triad, comprised of disordered eating, amenorrhea, and osteoporosis.-STACEY ROSENFELDWhile not a standalone DSM-5 disorder, exercise dependence is associated with other disorders. Many individuals who struggle with eating disorders engage in compulsive exercise. Those who use exercise as a way to compensate for binge eating (with a diagnosis of bulimia nervosa), will tack on extra activity to compensate for binge eating. Those with restrictive eating disorders might also use exercise in a compulsive way – spending excessive time at the gym and pushing their bodies to the extreme, as an additional way to control their weight.

Medical complications from exercise dependence can include cardiovascular concerns, amenorrhea, stress fractures, and other overuse injuries. Females who under-eat and over-exercise are at risk for the Female Athlete Triad, comprised of disordered eating, amenorrhea, and osteoporosis.

Some who don’t suffer from clinical eating disorders might also engage in compulsive exercise. They might spend excessive time engaged in physical activity in the name of health, or to ward off uncomfortable feelings. Typically, these individuals feel guilty when they miss a workout and can experience signs of withdrawal, such as irritability, anxiety, or depression when their exercise schedules are compromised.

Robert “Raven” Kraft is an iconic example of exercise addiction. Kraft has been running the same eight-mile stretch on Miami Beach, daily, for almost forty years. He’s run during hurricanes; while sick with pneumonia and food poisoning; and despite chronic, crippling pain. When an angiogram brought him to the hospital, he clocked his eight miles by pacing the hospital halls.

Kraft, who suffers from anxiety-driven behavior, admits: “I’m a prisoner of routine, but I’ve become comfortable with it.” He reports: “It’s like, as soon as I get out there, I’m suddenly a different person. My personality changes. I almost seem taller, stronger, bigger. It’s my comfort zone, where I feel right. And once I start going, I feel good.”

While Kraft certainly pushes exercise to the extreme, there’s a fine line between healthy and disordered. Is a regular gym-goer addicted to exercise? Are marathon runners compulsive? Several measures have been developed to assess one’s relationship to exercise, including the Exercise Dependence Scale-21, theCompulsive Exercise Test, and the brief Exercise Addiction Inventory.

Does missing a scheduled workout land you in a sea of negative emotions? Do you refuse to take days off from exercise, even when injured…?-STACEY ROSENFELD

One of the most important criteria in teasing out whether or not a behavior is addictive is how it impacts your life as a whole. Do you prioritize exercise above professional, educational, familial, or social events? Does missing a scheduled workout land you in a sea of negative emotions? Do you refuse to take days off from exercise, even when injured or ill? Do your workouts persist beyond your intentions, with you regularly tacking on unscheduled activity time? Is exercise no longer enjoyable for you, now just a burdensome chore? These are clear warning signs that compulsive exercise might be at play.

If you are concerned about your relationship to exercise, then consider these tips:

• Schedule regular days off. Your body needs time to repair and relax following demanding workouts. This can help ward off overuse injuries and illness.
• Take some time away from exercise. Return gradually and monitor for signs of dependence.
• Engage in physical activity with others, rather than alone. This can help make exercise less compulsive and more enjoyable.
• Focus on the physical and mental health benefits of exercise, placing less emphasis on weight control.
• If you are unable to develop a healthier relationship to exercise, try a course of therapy to help you manage the behavior and provide you with other coping resources. Therapy can help you learn to tolerate difficult emotions without turning to excessive exercise for relief.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com.