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Don’t let your desire to have a good body become a dangerous quest for perfection

When does a passion for exercise turn into an obsession and a problem?

Too much time spent in the gym can lead to both psychological and physical problems later on. Photograph: Viacheslav Peretiatko/iStockphoto/Getty Images

Geraldine Walsh
Thu Nov 30 2023 - 06:01

Exercise can be a passion, a commitment that requires dedication, time, and scheduling. While it can be a chore for some, to others the increasing strength and endurance is empowering and uplifting. Undeniably the draw to exercise centres around the multitude of positive effects including a healthier lifestyle, an improved mood, and a better-balanced body. Falling in love with exercise is never a bad thing when managed well, but when does a passion turn into an obsession?

Part of an Irish Times series about addiction

And is there a problem being addicted to such a perceived healthy regime?

“Engaging in physical activity can trigger the release of endorphins and other neurochemicals that produce feelings of pleasure and euphoria,” says Niamh Allen, a cognitive behavioural therapist with Counselling Online. “These natural, ‘feel-good’ chemicals can create a sense of reward and reinforce the behaviour, potentially leading to a cycle of seeking more exercise to experience those positive emotions.”

As with other behavioural addictions, the underlying reasons contribute to the excessive need to exercise and the associated behaviours. When the underlying cause is not addressed, the behaviour can alter, and a lack of control can affect a person’s relationship with exercise. It’s a complicated addiction, as the reigns of control loosen and tighten and derail while everyone compliments the dedication, strength, and the bodily changes whether that is weight loss or muscle building.

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If you or someone you know is struggling with exercise addiction, it’s important to seek professional help from mental health experts

Some may even go so far as to wrongly suggest that it is a “preferred” addiction because of these perceived benefits. The destructive behaviour of exercise addiction can be difficult to heal and recover from when the behaviour is lauded.

“Exercise addiction, also known as compulsive exercise or excessive exercise, refers to a behavioural pattern where an individual engages in an excessive and compulsive amount of physical activity, often to the detriment of their physical and mental well-being,” says Allen. “While regular exercise is generally considered healthy and beneficial, exercise addiction goes beyond a healthy level and can lead to negative consequences.”

While the underlying cause of behavioural addictions need to be unearthed to understand the excessive and uncontrollable nature of the addiction, it is worth recognising that certain personality traits or psychological vulnerabilities can affect a predisposition to addiction.

“Perfectionism, low self-esteem, anxiety and a tendency to seek external validation can all play a role,” says Allen. “Exercise can become a way to cope with negative emotions, or to gain a sense of control over one’s body.”

Allen recognises that the signs of exercise addiction are highlighted by an obsession with exercise. “The individual may constantly think about exercise, plan workouts excessively, and feel anxious, irritable, or guilty when unable to exercise or when a workout is missed,” she says.

As the continuous thinking about exercise continues and increases, so too does the frequency. “There is a noticeable increase in exercise frequency, duration, or intensity,” says Allen. “The person might engage in multiple workouts per day, even when tired or injured. They stick to a strict exercise routine and become distressed if they deviate from it. This rigidity can interfere with social activities, work, and personal relationships.”

Prioritising exercise can disrupt a person’s life in a way that exercise becomes more important than other commitments, including family gatherings, work responsibilities, and leisure activities. Allen notes that a person may “withdraw from social activities or relationships that don’t involve exercise, leading to isolation”.

In addition, overtraining can result in fatigue and physical injury which is compounded by not taking time off to heal and pushing themselves beyond their limits. “Due to overtraining and ignoring bodily signals, exercise addicts are more prone to injuries such as stress fractures, muscle strains, and joint issues,” says Allen who also advises that excessive exercise can suppress the immune system, making individuals more susceptible to illnesses and infections.

While regular exercise is generally considered healthy and beneficial, exercise addiction goes beyond a healthy level and can lead to negative consequences

“Intense and prolonged exercise can disrupt hormonal balance, leading to irregular menstrual cycles in women and decreased testosterone levels in men,” she says. “Overtraining and the physical stress it causes can lead to sleep disturbances and insomnia. While weight loss can be a goal for many, exercise addiction can lead to unhealthy and extreme weight loss, resulting in an underweight or malnourished state.”

Exercise addiction is not recognised as a formal mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, Allen highlights that “it does acknowledge that excessive exercise can be a symptom of other disorders, such as an eating disorder or obsessive-compulsive disorder. Various screening tools may be used to identify individuals at risk of exercise addiction and these tools often incorporate questions about exercise frequency, intensity, motivations, and the impact on physical and mental health”.

Some of the commonly used methods for measuring exercise and assessing the risk include a self-reported questionnaire referred to as the Exercise Addiction Inventory. This includes questions related to the frequency, intensity, and consequences of exercise, as well as psychological factors such as tolerance and withdrawal. The Exercise Dependence Scale is modelled after the Diagnostic and Statistical Manual of Mental Disorder’s protocol for identifying substance addictions. Again, this is a self-reported instrument that evaluates the psychological aspects of exercise dependence, and assesses factors such as tolerance, withdrawal, lack of control, and intention.

The Commitment to Exercise Scale measures the commitment and positive aspects of exercise behaviour without focusing on negative consequences, in order to help distinguish between healthy commitment and problematic exercise behaviours. Finally, the Compulsive Exercise Test is an additional self-reported tool designed to assess the presence and severity of compulsive exercise behaviours.

“Treatment for exercise addiction, typically involves a combination of psychological, behavioural, and sometimes medical interventions,” advises Allen. “If you or someone you know is struggling with exercise addiction, it’s important to seek professional help from mental health experts, such as psychologists, therapists, or psychiatrists, who are experienced in treating addiction and eating disorders.”

General approaches often used in treating exercise addiction include Cognitive Behavioural Therapy (CBT), mindfulness-based therapies, and establishing healthy routines.

Due to overtraining and ignoring bodily signals, exercise addicts are more prone to injuries such as stress fractures, muscle strains, and joint issues

“CBT can help individuals identify and challenge unhealthy thought patterns and behaviours related to exercise,” says Allen. “It aims to modify irrational beliefs and behaviours that contribute to the addiction. Techniques such as mindfulness and meditation can help individuals become more aware of their thoughts and feelings, reducing the impulsivity associated with exercise addiction. Also, psychodynamic therapy focuses on exploring underlying emotional issues that may contribute to the addiction, aiming to address the root causes.”

Allen also suggests that “a structured plan that gradually reduces exercise duration and intensity while addressing fears and anxieties related to reducing exercise” can have a positive impact on a person struggling with the behaviours associated with the addiction. In addition, she recommends learning to create balanced routines that include various activities beyond exercise, such as socialising, hobbies, and relaxation.

“It’s important to note that enjoying exercise and being committed to a regular fitness routine is generally positive for physical and mental health,” says Allen. “However, when exercise starts to take over your life and negatively impact your well-being, it might be a sign of a deeper issue.

“If you suspect you might have an exercise addiction, consider reaching out to a mental health professional, counsellor, therapist, or doctor. They can help you assess your situation, provide guidance, and develop a healthy relationship with exercise.”

Addiction series

Geraldine Walsh

Geraldine Walsh

Geraldine Walsh, a contributor to The Irish Times, writes about health and family

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