Addicted to Sweat

American Fitness, Nov, 1999 by Karen Asp

Although it is seldom discussed, exercise abuse and addiction can have detrimental short- and long-term physical effects.

Disorder is running rampant in health clubs. It's called exercise abuse, or what most people discard as extreme devotion to fitness. Meet Audrey, a 27-year-old who could be standing in the front row of your fitness class. Today, although she's gained some control over her compulsion to exercise, she's scared she'll always have to fight her obsessive drive.

For example, when Audrey ate too much for dinner, she would place a sign on her alarm clock which read, "You are fat." When her alarm rang at 4:45 a.m., she was forced to remember what she had eaten the night before, giving her incentive to exercise at least twice a day. At work, when sales representatives asked her out for dinner, she always declined, making up excuses so she could exercise instead.

Audrey also worked out frequently when injured or sick. After a stress fracture confined her to crutches, she still exercised. Even when a powerful pain medication for an ear infection prohibited her from working or driving, Audrey made it to the gym. She was dizzy and disoriented, but she chose to exercise anyway. What was her motivation? She wanted to prevent weight gain.

"No matter how much I exercised, everyone else was thinner and in better shape," she says. "I just wanted to do more so I could look like them."

Audrey isn't alone. Unfortunately, no one knows how many people abuse exercise. There's also little recognition of the problem, largely because exercising is considered "healthy."

"The problem is underdiagnosed," says Carolyn Costin, M.A., M.Ed., M.F.C.C., founder and clinical director of the Monte Nido Treatment Center in Calabasas, California, which treats exercise abuse and eating disorders.

According to Jack Raglin, Ph.D., associate professor in the department of kinesiology at Indiana University in Bloomington, Indiana, exercise abuse is characterized by one or all of the following symptoms: excessive reliance on exercise, exercising when injured or sick, and experiencing withdrawal symptoms when exercise levels are decreased or temporarily halted.

What is exercise abuse?

Not everyone who exercises becomes obsessive about working out. What separates healthy exercisers from those who abuse exercise is their attitude. For addicts, exercise encompasses their thoughts and moods and dictates their lives.

Exercise is the No. 1 priority in life for exercise abusers, and all activities are scheduled around it. "They make certain life choices based on their exercise routines," says Randi Rotwein, M.A., M.F.C.C., a personal trainer and licensed therapist in Los Angeles, California, who specializes in treating eating disorder and exercise abuse patients.

Exercise abusers may even lie about their exercise patterns. Maybe they weren't able to exercise in the morning, so they make up some excuse and cancel a date that night so they can work out. The more involved they get with exercise, the deeper their addiction becomes. They often feel a loss of control and become so dependent on their workouts that they can't and won't stop, regardless of the cost. In many cases, their dependency on exercise isn't evident until their job, family, injury, etc., interferes with their routine.

Exercise abusers also tend to disregard sickness and injury. No matter how sick they feel or how much they hurt, they continue to push themselves. Sometimes, the consequences of exercising while injured can lead to permanent physical disability which prohibits future exercise, Raglin says.

Like addicts who abuse drugs and alcohol, when exercise levels diminish, exercise abusers experience withdrawal symptoms. Even casual exercisers who don't abuse exercise experience withdrawal symptoms when they can't work out. They may feel antsy, irritated and sometimes become severely depressed. They may also experience sleeping problems, muscle soreness, changes in appetite and mood swings.

Why do people abuse exercise?

Currently, there are no known causes for exercise abuse, or what some call "exercise addiction" and/or "compulsive exercising." Some researchers believe people become addicted to the body's natural release of endorphins when exercising. Those endorphins produce a natural high. However, Raglin says that's unlikely.

"Your body does release endorphins when you exercise," he says. "However, there's no strong evidence that endorphins change the way you feel." Instead, Raglin suggests that psychology plays a larger role than physiology.

In other words, personalities may predispose people to developing an addiction to exercise. People with obsessive-compulsive disorder, for example, may be more prone to developing a heavy reliance on exercise. For others, exercise is a coping mechanism. "They deal with their stress through exercise," Raglin says.

Other factors predisposing one to exercise abuse might include low self-esteem, body dissatisfaction and eating disorders. In fact, Rotwein says some studies suggest that 75 percent of women with eating disorders are also compulsive exercisers.