Exercise Addiction: Signs, Causes & Treatment

By The Recovery Village/ Editor Jennifer Kopf/ Medically Reviewed By Krisi Herron, LCDC

Attempts at weight loss made by trips to the gym and changes in lifestyle are a regular part of many people's lives, and many of them around the world are able to maintain a healthy lifestyle that does not interfere with their personal and professional lives.

However, there are some who develop compulsive rituals of over exercise and fitness obsessions that may create conflict with their everyday responsibilities. When something begins to interfere with daily responsibilities, it is often characterized as an addiction.

What is Compulsive Exercise?

An exercise addiction typically results in an unhealthy obsession with exercise and fitness. Injury and illness usually don’t stop someone with an exercise addiction from getting their workout in for the day.

Similar to other addictions, compulsive behaviors and obsessions are also present in people with an exercise addiction. These compulsions and obsessions include thoughts about fitness, body composition and the physical goals the patient is trying to meet. Compulsive exercise also has a high prevalence in people who have eating disorders.

People who are addicted to exercise work out obsessively, sometimes even ignoring injury, illness or disruptions that the frequency of exercise may cause in someone’s life. Even though someone with an addiction to exercise usually ignores illness or injury, they may neglect other areas of life to exercise, such as:

- Time devoted to other responsibilities, like school or work
- Marital or family relationships
- Social life and personal commitments

Signs & Symptoms of Exercise Addiction

Signs and symptoms of an exercise addiction can include:

- Unhealthy focus on exercise, like experiencing cravings for exercise
- A high from the satisfaction of a workout
- Tolerance and the need to increase amounts of exercise to get the same “high” or satisfying effect
- Relationship conflicts because of the obsession with exercise
- Decreased involvement in other activities
- A compulsive need to work out even when injured, ill or exhausted

Someone who is addicted to exercise can experience withdrawal symptoms including depression, body aches, headaches and other issues when they go without exercise.

Types of Exercise Addiction

There are two types of exercise addiction: primary exercise addiction and secondary exercise addiction. An exercise obsession develops differently depending on the type of addiction.

1. Primary Exercise Addiction

Primary exercise addiction occurs as a form of behavioural addiction, but people with this type of addiction do not have any other mental conditions other than an obsession with exercise. Primary exercise addiction is more common in males and usually develops in response to endorphins. Endorphins from exercise allow the body to produce its “high.” This endorphin high is what becomes addictive.

2. Secondary Exercise Addiction

Secondary exercise addiction co-occurs with another mental disorder. This type of addiction is commonly seen with people who have eating disorders like anorexia nervosa and bulimia nervosa. Secondary exercise addiction is more common in females and generally progresses because of body image issues. Lack of nutrients from the coexisting eating disorder can lead to injury and illness when combined with the obsessive exercise.

What Causes Exercise Addiction?

Exercise addiction usually begins with someone having a desire to improve their physical fitness. An eating disorder, like anorexia or bulimia, or a body image disorder may lead to an unhealthy obsession with exercise.

Exercise releases endorphins and dopamine from the brain, similar to the response during drug use. Exercise addiction is rewarded with the feeling of euphoria through neurotransmitters when exercising. When someone stops exercising, these happy feelings often disappear. Exercising more to trigger the chemical release is usually the way someone with an exercising disorder copes with stress and manages symptoms.

Risk Factors for Compulsive Exercise

Certain factors can put a person at a higher risk of compulsive exercise. For example, having an addictive personality that seeks highs from substance use or other activities can increase the risk of exercise addiction. Difficulty dealing with stress or negative emotions may also increase an individual’s risk. Pressure from society to have a perfect body may push someone to exercise compulsively to achieve an unrealistic standard.

Beyond internal struggles, external factors can also play a role in exercise addiction. People in sports — and athletes in general —tend to have a higher risk of exercise addiction.

Exercise Addiction in Athletes

Competitive athletes who develop an obsessive passion and dedication to sports are at a much higher risk of exercise addiction. Compared to the general public or leisure exercisers, exercise addiction rates in sports are significantly higher.

The prevalence of exercise addiction in the general population is about 3%. Current research reveals that competitive athletes and gym-goers are at a much higher risk of developing exercise addiction:

- Runners: 25%
- Marathon runners: 50%
- Triathletes: 52%
- Endurance athletes: 14.2%
- Fitness centre attendees: 8.2%

Exercise Addiction and Technology

Research shows rates of exercise addiction to be higher among those who use technology to aid in their related sport or exercise program. Fitness technology in the form of various apps, trackers and social media platforms are used frequently by the general population and athletes.

Trackers and other apps can help people log workouts, track accomplishments and connect to online fitness communities. Problems can arise from this type of technology when a person begins comparing themselves and their goals to others, which can increase stress and pressure and encourage unsafe exercise practices. Overexertion can lead to injury, burnout and the decreased enjoyment of working out.

Exercise Addiction and Related Health Conditions

Exercise addiction is not listed as a condition in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, when the motivation for exercise addiction is evaluated, it is often present alongside other mental health conditions, such as:

- Anorexia and bulimia, with 39–48% of those with an eating disorder engaging in compulsive exercise
- Muscle dysmorphia
- Obsessive-compulsive disorder

Exercise addiction is also more commonly seen in people who exhibit certain personality traits, such as perfectionism, neuroticism and narcissism.

Exercise addiction can cause a person to become overly anxious about missing a workout session. This fear can cause a person to workout and push themselves to the point of illness and injury. The negative effects of exercise addiction may include:

- Pain and injury from overuse
- Social impairment
- Anxiety
- Depression
- Heart problems
- Irregular periods with possible reproductive issues
- Extreme weight loss

Effects of Exercise Addiction

Exercise addiction is associated with several physical and psychological side effects, including:

- Negative social consequences
- Anxious psychological functioning
- Exercising despite medical contraindications
- Prone to injury
- Interference with relationships or work

Even though regular exercise strengthens the muscles and bones, too much activity increases the risk of stress fractures and other bone and muscle injuries. People with existing injuries may aggravate their injuries and increase the duration of recovery time. Some examples of injuries caused by excessive exercise include:

- Joint damage
- Loss of muscle mass
- Sprained ligaments
- Strained or torn muscles or tendons

Exercise addiction may also cause a menstrual disturbance in women. Because of an unhealthy body mass with over-exercise, a female body may stop releasing eggs and the woman will miss one or more periods. This is more common in females who have secondary exercise addiction accompanied by an eating disorder.

Exercise Addiction Statistics

Statistics show that exercise addiction impacts approximately 3 percent of the general population. Athletes are affected at a much higher rate. Exercise addiction affects around 3% of regular gym-goers. When it comes to runners, some research suggests 25% qualify as exercise addicted, with the prevalence doubling to 50% in marathon runners.

Statistics on Exercise Addiction Treatment

Treatment for exercise addiction includes regulating the intensity and frequency of exercise and promoting healthy coping strategies. The goal of treatment is to improve social relationships, job maintenance and overall health.

The main challenge in treating exercise addiction involves follow through, with studies showing a low compliance rate. There are limited studies testing therapeutic and medical interventions for exercise addiction. People will likely have the most success with specialists in behavioral therapy and addictions since these professionals are usually experienced in behavior modification. Treating co-occurring mental health conditions, like addiction, is also crucial to long-term recovery.

Exercise Addiction and Co-Occurring Disorders

The co-occurrence of exercise addiction with an eating disorder or another mental health disorder can add challenges for someone living with addiction. Exercise addiction may also be coupled with substance abuse. Illicit performance-enhancing drugs, like steroids, can be overused by someone trying to fit their unrealistic physical goals. Other people may use alcohol or drugs as another compulsive behavior, like their exercise addiction.

Treatment for Exercise Addiction

As with other forms of addiction, exercise addiction can be treated. The type of treatment most helpful is therapy mixed with other healthy activities including yoga, meditation and walking.

If a co-occurring disorder exists along with the exercise addiction, treating both disorders simultaneously is important for the success of the overall treatment. Only seeking treatment for one of the problems will be a short term solution to just part of the problem. 

Cognitive Behavioral Therapy helps the person understand their problem behaviors, recognize triggers and develop skills to interrupt those behaviors and learn healthier ones. Another effective treatment addition is to engage the patient in healing activities, like writing, painting, dancing, singing, gardening and others to take their attention off of exercising.

Content source: https://www.therecoveryvillage.com/process-addiction/exercise-addiction/