At face value, over-exercising doesn’t seem like a big deal. Yet, there are those who hit the gym with a compulsion approaching self-harm. Writer Katherine Schreiber and co-author Heather Hausenblas, Ph.D., have put together a well-researched resource on this very topic; their book The Truth About Exercise Addiction: Understanding the Dark Side of Thinsperation is on shelves this week. And Schreiber, having first-hand knowledge of the compulsion, has written honestly about it. Here are some of her thoughts on the topic:
With obesity a huge concern, do people see this issue as a non-issue?
The biggest problem is that, given society's insistence on being active atop of our cultural hysteria to lose weight, be thin, and look fit, the signs and symptoms of exercise addiction often get misinterpreted as evidence of an over-exerciser's healthy commitment.
Obesity is definitely a huge concern. (No pun intended.) The CDC estimates that 34.9 percent of Americans qualify as such. When you compare this to the 3 percent of Americans estimated to meet the criteria for exercise addiction, the latter seems relatively less important. But the comparison isn't exactly logical. Obesity and exercise addiction are two vastly different disorders, each of which take their own physical and mental tolls.
What's more, just because the general population isn't suffering as "epidemically" from exercise addiction as they are from obesity, it doesn't mean the severity of suffering experienced by those who are hooked on physical activity is any less. No mental health professional would say that because only 4 percent of Americans are thought to engage in self-harm, people who cut themselves aren't as important as, say, the 9.3 percent of Americans who suffer from substance abuse. So why should we similarly discount exercise addiction?
That said, if higher numbers speak louder, skeptics may want to take a closer look at specific populations. For instance, nearly half of all individuals struggling with an eating disorder display symptoms of exercise addiction, up to 52 percent of all triathletes display signs, and 25 percent of runners qualify as addicted to their sport of choice.
It's critical that we do not let competing issues eclipse the serious consequences wrought by exercise addiction. Physically speaking, overexercise results in injuries like herniated discs, stress fractures, broken bones, and even head traumas. And new research is underscoring the role of overexercise in heart scarring, increased risk of arrhythmias, and even the buildup of arterial plaque that may lead to cardiac arrest.
Where is the line between healthy and harmful?
It boils down to the degree of conflict, misery, and loss of control exercise introduces into your life. You can go to the gym daily, even for hours on end without qualifying as addicted to exercise provided you're still able to dial back when injured or ill, you're able to make time for other hobbies and social activities, your work doesn't suffer, and you don't have a panic attack on days when you have to reschedule a workout. It's fine to be passionate about exercise. But is the drive to hit the gym more about offsetting the anxiety, guilt, and depression you feel on your off-days? And is your motivation derived more from a rigid sense of compulsion than a sense of anticipated enjoyment? If so, then you may need to re-evaluate your intentions. If you are repeatedly getting injured by your exercise habits, if your gym time is interfering with relationships and work, and if you're regularly made anxious by your routines, then you've clearly moved into the harmful zone.
Tell us the five top signs.
- Continuance: You persist in exercising despite illness or injury, or even in opposition to medical advice to dial back.
- Loss of Control + "Intention Effect”: You feel that you cannot control your urges to exercise, nor can you taper down on the amount of time you spend engaging in physical activity. Repeatedly canceling social plans, losing sleep, cutting out of meetings or work and missing deadlines because you had to get your workout in are examples of this. So is not being able to enjoy yourself until you've gotten to the gym.
- Tolerance: You need more and more of the original activity that granted you your first exercise high to feel relief. This is an example of tolerance. Whereas a two-mile run may have done the trick when you initially began exercising, you've watched your workout schedule bloom to marathon-length sessions, hours of lifting, or multiple sessions per day.
- Withdrawal: In the event you cannot get to the gym as planned (say, you're traveling or a loved one needs your help) you're gripped with an anxiety that may border on panic. You may even feel depressed, achy, or excessively fatigued.
- Loss of Interest in Other Activities: Exercise becomes paramount, overshadowing the appeal of pretty much anything you used to find fun. Social gatherings, non-exercise-related endeavors—even, perhaps, sitting for too long at work or at home—are considered impediments to your obsessive need to remain in motion or constantly work toward some ever-elusive fitness goal.
Was it hard to write this honestly?
Surprisingly, no. I tend toward being more open about my struggles than I probably should be. A lot of this comes from being fed up with people misinterpreting my behavior as healthy. I tried hard to convince fellow gym goers, personal trainers, and even friends that my compulsion was making me insane—that I was miserable and felt trapped in this awful cycle that kept leading to injury and vastly impaired my ability to function flexibly in the world. But everyone seemed to keep saying: “You look amazing! I wish I had your drive!" My honesty in sharing my story comes from a frustrated need to clarify that exercise addiction is by no means "the best addiction to have." No addiction is good—the very term addiction implies a level of behavioral dysfunction that impairs one from experiencing a healthy, happy life. I also hope that sharing my story will enable others who are suffering to feel less alone.
Did you have any obstacles, any fears during this project?
My biggest fear was that people wouldn't take me seriously. Both because I don't have a Ph.D. after my name and because of the pervasive skepticism surrounding behavioral addictions in the lay and professional communities alike. That said, I'm pleased with this book's outcome. It's a resource that needed to be out there for sufferers, their families and friends, as well as mental health professionals. The book has received positive endorsements from exercise addiction and eating disorder experts—a good sign of its anticipated impact. I want to help raise awareness of this addiction in addition to underscoring the importance of continuing to research its risk factors and develop treatments to help people manage their symptoms.
What did you discover about yourself along the way?
Researching and writing about this topic clarified a lot: Why was I driven to excessive levels of physical activity in the first place? Hearing others' stories and interviewing experts about what treatment options are available also gave me hope that I could unhinge myself from my entrenched habits and made me feel less isolated, less alone. Finding purpose (namely: sitting down long enough to parse studies, write and edit each chapter, and compile resources) helped loosen my dependence on my addiction. Having written this book gave me an identity that wasn't contingent on how many calories I'd burned, how many reps I'd done, or how long I was able to stay on the Stairmaster. The process convinced me that I could believe in myself and that there was a lot more to me than body fat percentages and the capacity to do handstands. What's more, by not always being able to get to the gym due to the workload of this project, I was forced to realize the world wouldn't end if I didn't adhere to a hyper-rigid schedule.
If you had one piece of advice, what would it be and for whom?
People who feel like they're struggling with this addiction are certainly not alone, that there is hope, but that recovery takes a hell of a long time. It took me about a year of putting other things before the gym (grad school, writing, my fiancé, all included) to get comfortable in my skin. Therapy helped, especially CBT. And having a prescription for anti-anxiety medication was also a plus.
I don't, however, want people to think that recovery from exercise addiction has to entail quitting exercise altogether. I certainly haven't, and I don't plan to. Recovery from exercise addiction is complicated by the fact that abstinence from physical activity simply isn't an option. So anyone who wants to be "healthier" needs to master the arduous art of moderation. This is not easy, especially when we're bombarded by thinspiration and fitspiration slogans atop images of idealistic muscular bodies simply by logging onto Facebook. The best we can do is be honest with ourselves about why we're working out. Is it to feel good, be stronger and healthier? Or is it to avoid being intimate with others, and punish ourselves in ways that lead to potentially permanent damage? I think we all need to realize that the fitness industry kind of wants us to feel fat and horrible about our bodies, then offer us solutions to our woes in the form of gym memberships, personal training sessions, and other physical activity outlets that promise to make us "better." These resources are great, as long as we don't go about using them compulsively or in a way that introduces more stress (and pain) into our lives than they take away.
You have to be savvy about the pro-fitness media attempts to create a problem that you don't actually have. Do the exercises you enjoy. (Bonus points if they put you in nature.) And if you feel like your physical activity habits are making you crazy, don't feel guilty about taking time off, reaching out to a mental health professional, or looking for an outlet beyond your fitness center's walls.