Exercise Addiction: Causes, Signs & Treatment Options

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What is Exercise Addiction?

An individual with exercise addiction demonstrates an unhealthy preoccupation with fitness goals and working out. It can be difficult to believe someone who is obsessed with fitness could be addicted, but individuals with exercise addiction share behavioral and psychological traits with those who are addicted to substances such as alcohol. These include continuing the destructive behavior despite severe consequences, hiding or lying about exercise, and feeling unable to control how much or when exercise occurs.

Many individuals who exercise obsessively report feeling high and powerful. This happens because exercise releases endorphins and dopamine that lead to feeling happy and relaxed — feelings that dissipate when exercise stops. Unless the individual trains again, the same intensity of those feelings will not return. Although in most cases this is a desirable response to working out, individuals with exercise addiction continue to train even when injuries, relationship problems and dangerous weather dictate slowing down is the appropriate response. Exercise addiction can also occur alongside eating disorders such as anorexia nervosa.

The effects of exercise addiction can be deadly, especially if exercise addiction occurs alongside an eating disorder. A nutrient-poor diet, too-rapid weight loss and deteriorating mental health can lead to life-threatening problems such as heart failure, organ failure or suicide. Although exercise addiction may begin with innocent intentions, it can result in deadly effects — but help is available.1-exercise-addiction

The Relationship Between Exercise Addiction and Substance Abuse

Exercise addiction symptoms resemble the side effects felt by an individual with a substance abuse problem. Feeling high after working out is an extremely common side effect, and some scientists theorize the euphoria caused by exercise is similar to the rush felt by opiate addicts. Suffering from depression or anxiety if too much time passes without a workout is also extremely common. An exercise addict might train for far longer than the current 30-minute daily recommendation — instead, intense workouts lasting 2 or 3 hours might be the norm. This significant time commitment may lead to problems in other areas of the individual’s life.

If someone you care about is addicted to exercise, you have already noticed a failure to meet certain commitments or obligations. In the exercise addict’s life, working out is the most important thing. Unlike healthy individuals, who work exercise into their daily routine, an individual with exercise addiction plans working out first and adapts everything else to meet that schedule — including work, spending time with family and friends, and other personal obligations. Workout intensity might mean your loved one also has to spend a lot of time preparing for and recovering from exercise, which leaves little time for other activities. Attempts to cut back don’t work, because the desire to exercise is too strong.

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Who Is at Risk for Exercise Addiction?

Anyone can develop an addiction to exercise, but certain groups may be more likely to develop a problem. An individual with an eating disorder such as anorexia nervosa may be likely to obsessively exercise to support caloric restriction goals. Also, those who have extreme weight loss goals — particularly those who suffer from obesity — are at risk. Individuals who were once teased for weight or appearance are at risk, as are those who were once addicted to alcohol or drugs. Using exercise as a “healthy” substitute for using sometimes backfires.

Orthorexia is also common in individuals with exercise addiction. Orthorexia is an unhealthy obsession with nutrition and exercise, and it frequently results in injuries, exhaustion, anxiety, isolation, depression and changes in menstruation. An individual with orthorexia grows obsessed with healthy eating habits and may refuse to eat entire food groups, or foods that contain additives. These individuals go to extremes to assure certain foods are never consumed, and they may feel superior to those who opt for less-rigid dietary choices.

“Type A” or perfectionistic individuals are also at risk of developing an exercise addiction.

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Exercise Addiction Symptoms and Signs

At first, an individual with exercise addiction might appear to be the picture of health. Lean limbs and strong muscles, regular participation in endurance races and other popular fitness events, and an unrelenting commitment to working out are fitness goals many healthy individuals aspire to. Individuals with exercise addiction take their goals too far, however — and like a person with a substance abuse problem, continue to engage in unhealthy activities even when the signs to stop are clear.

An individual with exercise addiction might:

  • Get hooked on the number of compliments received as well as the endorphin rush felt while working out. The only way for the exercise addict to feel good is to work out, and regaining that rush must happen no matter what.
  • Participate in multiple fitness classes or workouts per day. The intoxicating effects of working out encourage the individual to exercise for hours a day.
  • Work out even after sustaining an injury. Overtraining is a serious problem for all athletes, but especially for those with exercise addiction. When a healthy person who exercises regularly injures a muscle or a bone, he will stop working out until he has healed. When an individual with exercise addiction sustains an injury, he continues to exercise anyway — thus worsening the problem.
  • Exercise even when working out takes too much time away from important obligations. When exercise interferes with personal and professional obligations — and despite warnings to cut back, continues anyway — exercise addiction could be a problem.
  • Feel exhausted instead of strong after working out, and depressed or anxious when working out isn’t possible. Individuals who work out obsessively frequently feel exhaustion because their muscles have not been allowed to recover. Skipping a workout for a day or two is normal, and it can even help the body, because muscles gain strength while at rest. When irritability and depressive symptoms occur after a short time that could be a sign of exercise addiction.
  • Be obsessed with perceived perfection. An individual who uses exercise to cope with an obsession with appearance and perfection needs treatment. Although exercise is a proven mood booster, those who use it to battle low self-esteem are at risk of becoming dependent.
  • Ignore friends and favorite activities to focus on working out. Individuals with exercise addiction dislike skipping working out and prefer to train alone. They express frustration or guilt when their routines are altered or skipped. They may also express dissatisfaction with their workouts, even if their workouts are already intense.
  • Suffer obvious physical problems. Exercise addicts are at high risk of overtraining, which reduces the ability to perform. In addition to fatigue, an individual with exercise addiction will be sore and stiff nearly constantly. An inability to concentrate — especially if combined with an eating disorder — is also common. Muscle wasting and adrenal exhaustion are serious consequences of exercise addiction.

If you are concerned you or someone you love is addicted to exercise, you may be able to further identify the problem by keeping a journal. Write it down every time exercise occurs, including the type and length of exercise. If you observe possible eating disorder symptoms, record that also. These may include skipped meals, dietary supplements, obsessive recording of caloric intake, spending a lot of time in the bathroom, oral health problems and extreme weight loss.

The Relationship Between Exercise Addiction and Eating Disorders

There is a strong relationship between exercise addiction and eating disorders. An individual who has an eating disorder demonstrates unhealthy attitudes about food and weight, has unrealistic standards and is extremely self-critical. Food, weight and caloric intake consume other thoughts. This unhealthy focus disrupts normal bodily functions and habits, and in serious cases can end in death. According to Anorexia Nervosa and Associated Disorders, eating disorders cause more fatalities than every other type of mental health condition. An individual with an eating disorder may adopt an obsessive exercise routine to support extreme weight loss goals.

Although women are more likely than men to develop an eating disorder, men are less likely to get help. The number of men with eating disorders is also rising. Adolescents are extremely susceptible to eating disorders, but it may develop in men and women of all ages.

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There are several types of eating disorders that may occur alongside exercise addiction. They include:

  • Anorexia nervosa. An individual with anorexia may starve himself by strictly limiting caloric intake because of a distorted body image. Vomiting, also called purging, may accompany eating. The anorectic may try to lose weight in a short period of time with diet pills, stimulants or fad diets. Individuals with anorexia often use intense exercise as a way to control weight and reduce the caloric effects of eating.
  • Bulimia. Bulimia is a disorder typified by consuming large amounts of food at one time. Individuals with bulimia often vomit or purge after eating to reduce caloric intake. In addition to purging, other methods of calorie restriction include the use of diuretics or water pills, fasting and excessive exercise. If vomiting is the method of choice, a trip to the dentist may alert a concerned parent that bulimia is possible. That’s because vomit wears away at tooth enamel and can cause gum disease.
  • Binge eating disorder. A diagnosis of binge eating disorder means uncontrolled eating not followed by purging. Strong feelings of shame accompany binge eating disorder, and a struggling person may alternate binges with fasting or fad dieting.
  • Orthorexia. An individual with this avoidant disorder refuses to eat certain foods, food groups or additives. For example, an individual with orthorexia might refuse to eat carbohydrates. This obsession with healthy eating is closely linked with exercise addiction. Because orthorexia leads to bone density loss and heart problems, a coexisting exercise addiction can cause serious injury at best and death at worst.

Common Causes of Exercise Addiction and Eating Disorders

Exercise addiction and eating disorders are complex diseases that cause a variety of serious physical and psychological health problems. The roots of these disorders live far deeper than concerns over appearance. The causes for each disorder remain unclear, but researchers agree a variety of factors contribute to exercise addiction and eating disorders. These factors include physical, psychological, social and cultural problems.

Each individual has their own reasons why exercise addiction and/or an eating disorder became a problem. Common causes of exercise addiction and eating disorders include:

  • Low self-esteem. Individuals with exercise addiction enjoy observing measurable progress in terms of size, strength or speed. These feelings are reinforced when others make positive comments on changes in appearance.
  • Body image disorder. What begins as a healthy desire to achieve clear fitness goals may lead to exercise addiction if symptoms of body image disorder exist. When an individual believes he is fat when weight is not a problem, he may suffer from a distorted self image.
  • A craving for endorphins. During intense exercise, the body releases endorphins. Endorphins cause euphoric feelings during exercise, excitement and sexual activity. This euphoric feeling is similar to what opiate drug users experience when high, according to ProjectKnow.com. Also like substance abuse, getting that euphoric feeling back requires exercising longer and harder.
  • Depression and anxiety. Exercise is a proven mood booster and an individual with exercise addiction may work out obsessively to self-treat uncomfortable symptoms. When working out isn’t possible, feelings of anxiety, sadness and guilt become overwhelming.

The Physical and Psychological Effects of Exercise Addiction

The physical and psychological effects of exercise addiction can be profound. They may include:

  • Eating disorders.
  • Damage to joints and muscles that limit the capacity for movement.
  • Stress fractures and severe bone loss. Bone loss can be a serious problem, particularly for older women, but it can also increase the risk of injuries.
  • Scarring of the heart muscle. Scarring can cause abnormal function and heart failure. Endurance athletes are more likely to suffer heart muscle scarring.
  • Problems with menstruation.
  • Cognitive distortion. Cognitive distortion helps an individual addicted to exercise justify his workout routine. Habits may include superstitious thinking, discounting, black and white thinking, over-generalization, and associating extreme exercise habits with long-term happiness.

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Treating Exercise Addiction

The answer to exercise addiction is more complex than cutting back on working out. To achieve a better balance while retaining a healthy commitment to fitness, a multidisciplinary approach is necessary.

Programs that address the physical damage caused by overtraining and the psychological impact of addiction are a good place to start. In these programs, the struggling individual will take time off from exercise to allow injuries to heal. He will also practice sound dietary habits. Through psychotherapies such as cognitive behavioral therapy, he will identify the root causes of the addiction, and learn to cope. He will also identify triggers that precede exercise, and figure out how to manage those frustrations and impulses with life-affirming practices. If a mental health disorder such as depression or anxiety exists, he or she will receive treatment for that as well. This treatment may include psychotherapy, a pharmacological remedy or both.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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