5 warning signs of exercise addiction

Exercise is a healthy habit that all health professionals unanimously advocate for. However, when someone develops an obsession with exercise and works out compulsively, it can have detrimental effects on their lives. Exercise addiction is difficult to spot, but there are various options for its treatment. Let’s take a look at 5 warning signs of exercise addiction and find out what makes it a unique behavioral disorder. 

What is exercise addiction?

Exercise addiction is a condition that involves excessive exercising and an unhealthy obsession with physical fitness. 

Just like other behavioral addictions, it has adverse effects on the addict’s social life, physical health, and psychological wellbeing. 

Exercise addiction often occurs alongside other issues, such as body dysmorphia and eating disorders – which may complicate assessment and treatment. It’s estimated that 39–48% of people with eating disorders also suffer from exercise addiction. (1)

In some cases, exercise addiction can accompany other addictions. Researchers have found that 15% of exercise addicts are addicted to nicotine, alcohol, or illicit drugs. (2) It may also be more common among individuals addicted to sex, work, or shopping. (3) (4) (5)

Exercise dependence is relatively uncommon. It’s estimated to affect around 3% of the population. (2) Next to eating disorder patients, those who are under pressure to maintain or improve their physique or fitness level – such as professional athletes or sports university students – are at higher risk than the general population. (6)

If you suspect that your exercise patterns may be unhealthy, take our exercise addiction quiz. 

Healthy exercise vs exercise dependence: where’s the line?

Not every avid gymgoer who calls themselves a “fitness junkie” is an exercise addict. Neither are most professional athletes who spend a large chunk of their time training for competitions. In fact, the quantity of exercise and individual engages in is not a good measure of whether they have a behavioral disorder. 

There are several methods to identify exercise addiction. The one proposed by Hausenblas and Downs (7) is based on the DSM-IV TR criteria for substance dependence:

• Tolerance: the addict becomes increasingly tolerant to the “high” that exercise produces and has to keep doing more and more exercise to keep experiencing it
• Withdrawal: when the addict doesn’t get to exercise, they experience negative effects such as anxiety, irritability, restlessness or sleeplessness
• Lack of control: the addict tries to reduce the amount of exercise they’re doing or to stop doing exercise for a while, but they fail
• Intention effects: the addict’s routine is disrupted because they keep spending more time doing exercise than they intend to
• Time: the addict spends a considerable amount of time preparing for, engaging in and recovering from exercise
• Reduction in other activities: as a result of doing too much exercise, other activities, such as social and recreational activities suffer 
• Continuance: the addict is aware of the negative consequences of their behavior and yet they continue to engage in it

Why do people get addicted to exercise?

It’s difficult to say what causes exercise addiction. In all likelihood, it’s at least partly caused by a dependence on the mood-improving benefits of exercise. 

Exercise releases endorphins, chemicals produced by the body that function similarly to opioid drugs, creating a sense of pleasure. If someone does intense aerobic exercise regularly, the brain may “notice” the increased endorphin production and eventually down-regulate it. To maintain the natural endorphin balance in the brain, the person may need to keep exercising.

Eating disorders such as bulimia or anorexia nervosa can also lead to exercise addiction, and so can body image disorders. Those who suffer from eating disorders may try to “out-exercise” their diet or compensate for a “cheat meal” to make sure they’re burning enough calories to lose weight. Individuals with body dysmorphic disorder who obsess over perceived flaws in their appearance may turn to excessive exercise to achieve a desired look. 

What are the signs of exercise addiction?

Exercise addiction can be difficult to diagnose. Most addicts don’t realize that their behaviors are abnormal, and self-reporting is rare. Diagnosis is further complicated by the fact that there are no standard assessment criteria for exercise addiction. However, there are certain signs to look out for.

The symptoms of exercise addiction include:

1. Experiencing uncontrollable urges to exercise

Exercise addicts are unable to control their desire to work out. Even if they try to stop themselves from going to the gym or going out for a run, they eventually give in. When they try to adopt a more normal exercise routine, they often relapse and revert to their previous patterns. 

2. Devoting time meant for other daily tasks to exercising

When someone spends so much time at the gym that their workouts start taking time away from other activities and tasks, it can be a sign of exercise addiction. 

3. Feeling the need to increase the frequency and intensity of workouts

For an exercise addict, no amount of exercise is enough. They constantly feel the need to amp up their workouts, even if their performance suffers. 

4. Becoming anxious, irritable or fatigued when not exercising

When someone who suffers from exercise dependency misses a workout or has to go a while without exercising, they often start experiencing withdrawal symptoms. These include anxiety, irritation, and fatigue. 

5. Exercising when sick, exhausted or injured

Working out is an exercise addict’s number one priority. They make sure to get their workout in even if they’re not in a fit state to exercise – such as when they’re sick, over-exhausted, or suffering from an (often exercise-related) injury. 

Impulsivity, compulsivity, and exercise dependence

Addictive behavior is often described as compulsive or impulsive. However, it’s important to note that exercise addiction is not a compulsive disorder or an impulse control disorder, as authors Marilyn Freimuth, Sandy Moniz, and Shari R. Kim point out in their paper Clarifying Exercise Addiction. (1)

Compulsive disorders consist of ritualized behaviors to reduce anxiety (like compulsively checking whether the lights are turned off) and focus on unrealistic outcomes (like the house burning down if the lights are left on). On the other hand, the outcomes that exercise addicts – and addicts in general – are concerned about are usually realistic. 

Besides reducing anxiety, exercise can also alleviate other negative emotions such as anger, depression, and boredom, and improve mood by making the exerciser feel more confident, or giving them a sense of accomplishment. This distinguishes exercise addiction from compulsive disorders, which build on negative reinforcement. 

Impulsivity doesn’t necessarily characterize exercise addiction, either. Unlike those who engage in impulsive behavior, exercise addicts often spend a significant amount of time thinking about and planning how they’re going to engage in their addiction. They often consider the negative consequences of their behavior and end up ignoring them, while those who suffer from impulse control disorders may not contemplate negative consequences at all.

What are the negative health effects of over-exercising?

Over-exercising can have a wide range of adverse health effects that make compulsive exercise extremely dangerous. Here are some of the most common ones: 

• Acute injuries
• Chronic musculoskeletal pain
• Compromised immune system
• Increased resting heart rate
• Restless legs
• Dehydration
• Decreased appetite
• Sleep disturbances
• Decreased energy
• Poor mental health
• Heightened stress levels
• Hormonal imbalances
• Amenorrhea
• Extreme weight loss

To avoid these issues, it’s vital to seek treatment if you recognize any signs of exercise addiction in yourself or someone around you. 

Treatment options for exercise addicts

So, how can fitness addicts be treated?

The goal of exercise addiction treatment isn’t to stop exercising altogether. When done in moderation, exercising is a healthy habit that can help prevent chronic diseases and increase one’s lifespan, among other benefits.

So, rather than quitting exercise, doctors may ask their patients to reduce the amount of exercise they’re doing or try a different form of exercise, for example, swimming instead of running. 

The ultimate goal is to help patients understand the difference between obsessive exercise and moderate, recreational exercise. Keeping a workout journal is a good way to keep track of exercise patterns.

Just like with other behavioral addictions, cognitive-behavioral therapy can also be useful in helping patients understand the negative consequences of their behavior. 

To achieve success in exercise addiction recovery, it’s crucial to take into account other disorders that commonly occur alongside it. In such cases, both disorders must be diagnosed and treated. If only the exercise addiction is treated, the patient may increase their bulimic or anorexic behavior to maintain their weight loss, and vice versa. 

If you ever feel like your desire to exercise may not be coming from a healthy place, talk to your doctor. 

Conclusion: exercise dependence

Exercise dependence is not a common addiction, but it affects eating disorder patients and professional athletes to a greater extent than the general population. Exercise addiction is difficult to diagnose because addicts don’t acknowledge their compulsive behavior and rarely self-report. 

To identify exercise addiction, doctors may look for signs that are similar to the symptoms of substance dependence. If someone experiences uncontrollable urges to exercise, devotes time meant for other activities to exercising, feels the need to keep increasing the duration and intensity of their workouts, becomes anxious or irritable when not exercising and continues to work out even when sick or injured, they may be suffering from exercise addiction.  

Since over-exercising can lead to serious health problems, it’s imperative that exercise addicts receive adequate treatment that takes into account potential co-occurring disorders. 

References

(1) Freimuth, M., Moniz, S., & Kim, S. R. (2011). Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. International journal of environmental research and public health, 8(10), 4069–4081. https://doi.org/10.3390/ijerph8104069

(2) Sussman, S., Lisha, N., & Griffiths, M. (2011). Prevalence of the addictions: a problem of the majority or the minority?. Evaluation & the health professions, 34(1), 3–56. https://doi.org/10.1177/0163278710380124

(3) Patrick J. Carnes, Robert E. Murray & Louis Charpentier (2005). Bargains With Chaos: Sex Addicts and Addiction Interaction Disorder. Sexual Addiction & Compulsivity, 12 (2-3), 79-120. https://doi.org/10.1080/10720160500201371

(4) MacLaren, V. V., & Best, L. A. (2010). Multiple addictive behaviors in young adults: student norms for the Shorter PROMIS Questionnaire. Addictive behaviors, 35(3), 252–255. https://doi.org/10.1016/j.addbeh.2009.09.023

(5) Haylett, S. A., Stephenson, G. M., & Lefever, R. M. (2004). Covariation in addictive behaviours: a study of addictive orientations using the Shorter PROMIS Questionnaire. Addictive behaviors, 29(1), 61–71. https://doi.org/10.1016/s0306-4603(03)00083-2

(6) Chen W. J. (2016). Frequent exercise: A healthy habit or a behavioral addiction?. Chronic diseases and translational medicine, 2(4), 235–240. https://doi.org/10.1016/j.cdtm.2016.11.014(7) Hausenblas, H. A., & Downs, D. S. (2002). How much is too much? The development and validation of the exercise dependence scale. Psychology and Health, 17(4), 387-404. https://doi.org/10.1080/0887044022000004894