When exercise becomes dangerous

Exercise can be too much of a good thing.

Posted Jun 22, 2011

The health benefits of exercise are well known: it helps you sleep better, improves mood and anxiety, it helps with your metabolism, and (my favorite benefit) it can be really fun. 

I started exercising regularly when I entered college. My initial goal was fitness and stress relief--nothing to do with weight loss.  As the stresses of college began to pile up, exercise provided one of my only ways to relieve the pressure.  I didn't cross the line into exercise addiction until the onset of my eating disorder. Ironically, the less I ate, the more I felt I had to exercise.  And if I ended up eating "extra," well, I also felt compelled to exercise to relieve the anxiety I had over those few extra calories.

Exercise addiction (also referred to as exercise dependence or excessive/compulsive/obligatory exercise) is common in people with eating disorders. Although many patients cite "burning calories" as a motivation for exercise, this is far from the only (or even most important) motivator. Many people with eating disorders find their exercise helps them control negative emotions like depression and anxiety, that they feel guilty or anxious if they don't exercise, and that they experience withdrawls if they don't exercise.

Although people with eating disorders are generally thought to exercise more than the average person, it isn't duration of exercise that provides researchers with a definition of exercise dependence. After all, plenty of athletes exercise long and hard without any signs of eating disorders. Instead, it is your attitude towards exercise and how you behave when you can't exercise that is the most telling. What researchers have found by interviewing people with eating disorders who report being dependant on exercise is that the two most important factors are impairment in normal functioning and withdrawl symptoms. Later studies also noted the importance of using exercise as a way to improve or alter your mood was also a marker for exercise addiction.

It's hard to know when your exercise habits are negatively impacting your life, especially since exercise addiction is much less likely to draw cultural criticism than other kinds of addictions. So how can you tell if you're addicted to exercise?

1. You avoid other, important activities to workout. This isn't just making room in your schedule for a trip to the gym.  It's skipping work, school, and spending time with friends in order to exercise.  Instead of being at a lecture, you're at the gym. If a friend visits from out of town and this interferes with your workout? You don't see your friend.

2. Exercise is the most important thing in your life. You plan your day around your exercise routine. If something comes up, you might shift other things in your schedule, but not your exercise. And when you're not exercising, you're thinking about exercise: when you will work out next, how many miles you ran last time, what other people must be exercising.

3. You use exercise to alter your mood. Many people report that exercise makes them feel better, mentally and physically. But if you rely on exercise to give you a euphoric high or more of a numb, tranquilized feeling, that's different--and much more problematic.

4. Your exercise habits create conflict in your life. Maybe your loved ones express concern for how much you're at the gym.  Or that you can never seem to take a day off. That, perhaps, your workouts might be a bit excessive. You probably brush them off, because how the hell can there be something as too much exercise? So you begin avoiding the people who love you to stave off the conflict, or you lie about your workouts. As much as you might justify your behavior by saying that it's their comments that are the problem, it might be worth looking at your exercise as the real culprit.

5. You've tried to cut back on exercise, but it doesn't last. Whether not exercising makes you feel too guilty, too anxious, or simply an emotional mess, these feelings are much stronger than your desire to exercise less.

6. You experience withdrawal symptoms when you delay or stop exercising. Exercise works in the brain much like opiates (researchers theorize this is how exercise becomes addicting), and withdrawal symptoms are similar: shaking, depression, and fatigue. It's not bad to be disappointed if your normal workout is interrupted or canceled, but this shouldn't evoke strong physical symptoms.

7. You base your food intake around your workout (or vice versa). Plenty of people say that a decadent dessert necessitates some extra time on the treadmill. It might be normalized, but this thinking is neither healthy nor accurate.  Still, if you find yourself doing mental gymnastics to balance your food intake and your exercise output (or, like me, stick to rigid schedules for both to prevent the need for said mental gymnastics), then this could be signs of a serious problem.

8. You "make up" for missed exercise sessions. Whether it's the day before or the day after, scheduling in additional workouts to make up for a missed session is the sign of a problem.

9. You find you need more and more exercise to get the same benefits. Maybe when you first started working out, a simple 15 minute daily walk was enough.  But soon, you began with a 30-minute daily run, and then you added in some weights, then some more cardio, then a few calisthenics.  And on and on it goes.  Ultimately your new "maximum" amount becomes your daily minimum. No amount of exercise ever seems to be enough.

10. You lie about how much you exercise. 'Nuff said.

If you do recognize these signs in yourself or a loved one, you need to seek out aggressive, evidence-based care for an eating disorder. It can be the difference (literally) between recovery and a life spent tethered to the treadmill.

About the Author

Carrie Arnold is in recovery from a decade-plus battle with anorexia and is working on her third book, Decoding Anorexia: How Science Offers Hope for Eating Disorders.

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