Compulsive exercise: When fitness goes too far

Key takeaways:

• Compulsive exercise is an unhealthy addiction that negatively affects physical health, relationships, and overall well-being.

• Warning signs include prioritizing exercise over obligations, exercising despite injury, and feeling distressed when unable to work out.

• Those with eating disorders, anxiety, or trauma are at a higher risk for developing compulsive exercise habits.

• Treatment typically involves therapy to address the emotional and psychological reasons behind the behavior.

• Gradual habit changes, awareness of personal exercise rules, and developing alternative coping strategies can help break the cycle of compulsive exercise.

Exercise is an integral part of a healthy lifestyle, but even this stalwart of good health can cause problems when it becomes compulsive or addictive. Someone with skewed beliefs about exercise may let their physical health, relationships, and finances slide to maintain their obligatory exercise routine. Compulsive exercise is a complex issue that goes beyond exercising to look good or stay fit. Overcoming this issue often requires a deeper look at the motivators behind exercise with the help of a licensed therapist. Keep reading to learn more about compulsive exercisers and what you can do if you find yourself or a loved one sliding into this unhealthy territory.

What is compulsive exercise?

First recognized clinically in the 1970s, compulsive exercise has been and is still known by several different terms, including exercise dependence, exercise addiction, and running addiction. In short, exercise interferes with a person’s ability to meet their daily obligations despite injury, medical complications, or other significant negative consequences of the exercise habit. However, it’s not currently a recognized mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), the handbook for mental health professionals. That’s in part due to the fact that exercise compulsion can manifest with symptoms of several other mental health disorders.

Signs and symptoms of compulsive exercise

There’s a fine line between compulsive exercise and an exercise enthusiast. Certain behaviors, like using exercise to reduce or control stress and other uncomfortable feelings, can potentially increase the risk of developing an exercise addiction. Using exercise to cope with stress isn’t inherently bad. However, someone with an exercise compulsion may become distressed, irritable, or guilt-ridden if they don’t exercise. Just because you love to exercise and spend a significant amount of time doing it doesn’t mean you’re addicted. Rather, symptoms of compulsive exercise can include:

• Increased tolerance for exercise
• Withdrawal symptoms
• Longer and more frequent exercise sessions than initially intended
• Lack of control over an over-exercise habit
• Excessive time spent exercising
• Choosing exercise over important social, recreational, or occupational activities
• Continuing to exercise despite recurrent physical injuries
• Exercising at inappropriate times

I believe anyone is susceptible to developing compulsive exercise . . . It’s fair to say compulsive exercise habits do not discriminate. Any of us are susceptible to it. Divorced? Less time with your kids? A family member died? Just kicked alcohol? There’s so much grief, anger, and fear going on that jumping into working out, which is healthy, is a great escape.

- Mindy Hall Czech, LPC

There’s also evidence that certain personality characteristics affect your relationship with exercise. The personality traits that have been linked to exercise addiction include neuroticism and high extraversion paired with low agreeableness, among other traits.

Who is at risk for compulsive exercise?

Mindy Hall Czech, a licensed professional counselor with Grow Therapy, says, “I believe anyone is susceptible to developing compulsive exercise . . . It’s fair to say compulsive exercise habits do not discriminate. Any of us are susceptible to it. Divorced? Less time with your kids? A family member died? Just kicked alcohol? There’s so much grief, anger, and fear going on that jumping into working out, which is healthy, is a great escape.” However, Czech points out that those with any eating disorder, such as bulimia nervosa or anorexia nervosa, are at higher risk. Exercise addiction occurs 3.5x more often with an eating disorder than without. In fact, 90% to 95% of college students with a diagnosed eating disorder have a gym membership, and 40% to 80% of anorexia nervosa patients are prone to excessive exercise.

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Czech goes on to say, “Others who are high at risk include trauma survivors, those with OCD, addictive personalities, and those in recovery from addiction. Compulsive exercise may start out as healthy for someone in recovery, but it can quickly become a way that they trade one addiction for another. It may go unnoticed at first due to the healthy nature of exercise, but it may become a transference of addictive thinking from drugs or alcohol to compulsive exercise.” According to Czech, it can be a quick descent that you don’t see coming. What starts as healthy behavior becomes a way to “push down” other struggles, to drown out overwhelming thoughts and feelings. She says, “We can pop in our earbuds and drown that out while working out, walking, or running . . . What once was the start of something small, slowly, or quickly, becomes a constant focus in our daily lives.” Other predictors of compulsive exercising include:

• Anxiety
• Obsessive passion (someone who throws themselves into a single interest)
• A physical appearance orientation

Another factor that plays into developing an exercise obsession is additional addictions, such as nicotine, alcohol, illicit drugs, shopping, sex, and work, among others.

Risk factors for athletes

Athletes spend considerable time exercising and focusing on their physical health. That focus can quickly become an unhealthy obsession because of heavy criticism about weight or physique. Athletes in sports where maintaining a low weight or physical appearance gets emphasized, like wrestling, figure skating, and gymnastics, are at higher risk. Additionally, those whose identity surrounds their role as an athlete are more susceptible to overtraining.

Treatment for compulsive exercise

Treatment for compulsive exercise varies from person to person, but most people benefit from working with a licensed therapist. Julia Preamplume, LCSW, a provider with Grow Therapy, says, “I take a team approach by referring clients to both a registered dietitian and a PCP and work alongside them. I work with the client to uncover what purpose the compulsive exercise serves and find alternative ways to meet that particular purpose or need.” Czech adds that if an eating disorder is also present, in-patient treatment may be necessary. Overcoming compulsive exercise goes beyond the exercise itself to the feelings and thoughts behind the behavior, which is where mental health professionals come in. They can offer different therapeutic techniques and tools. According to Czech, “Behavior modification, CBT, compassion-focused and person-centered [therapy] will be very helpful in the process of treating compulsive exercise and then integrating these techniques based on client need.” Preamplume adds, “. . . mindfulness skills can be helpful with being able to sit through uncomfortable thoughts and feelings related to compulsive exercise. Working on self-compassion can also be helpful for addressing any shame. . .”

Tips for overcoming compulsive exercise

Overcoming an exercise addiction is a slow, lengthy process. The associated changes may bring uncomfortable emotions to the surface. Try to be patient with yourself as you work to change deeply ingrained habits.

Talk to a therapist

Therapists design individualized treatment plans based on the specific challenges each of their clients faces. Czech says, “Knowing where the client is with everything — what they are ready to make changes with and what they are willing to try in their daily life — is key. Every client is different, so as a clinician, gathering information from clients is the first step.”

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Some, like Preamplume, may work alongside a dietician or other professionals to get care in other aspects of life. Therapists can use different types of therapy to accommodate your personality, goals, and life circumstances to support you through the whole process.

Make changes slowly

As much as you might want to change overnight, it’s better to be steady and consistent. Czech says, “ . . . making drastic changes quickly is NOT the answer, even if clients want to ‘flip a switch’ and make big changes all at once. It may work for a couple of days, but there is a risk of overwhelming our nervous system . . . Low and slow is the way to go.” Give your mind and body time to adapt and develop new habits and thought patterns. Czech says, “It is a lengthy process because the undoing is usually scary. Anytime we change something that our mind, body, and spirit have been used to for many years, it takes time to first, undo, then second, re-wire to new, healthy habits.”

Become aware of your thoughts surrounding exercise

We all tell ourselves stories about why we do things and what we think about the things that we do. It’s valuable to identify your thoughts about exercise. Are you negative about yourself when you don’t exercise? Do you obsess about gaining weight? The first step in changing thought patterns is recognizing them in the first place. Take notice and write them down to get a realistic view of your thoughts about exercise.

Identify your exercise rules

People who compulsively exercise create strict exercise rules for themselves. For example, they may exercise for a certain amount of time or only rest on specific days of the week. Breaking the rules creates anxiety, guilt, or distress, so it’s avoided at all costs. Identifying your rules lets you challenge them, for example, by reducing your exercise time. Czech says that most people can reduce their exercise time by 10-15 minutes without creating too much distress. Again, if you take it gradually, you can slowly make changes that support your health goals.

Recognize and develop other coping strategies

Exercise is a coping strategy to handle other unpleasant emotions or trauma, but it’s temporary stress, anxiety, or fear relief. Recognize and develop other coping strategies alongside exercise. Remember, exercise is good for your heart and muscles and gives you feel-good endorphins but in moderation. Make a list of potential coping strategies to turn to when you feel uncomfortable emotions. There are all kinds of stress-relieving techniques, from journaling and creating a relaxing playlist to mindfulness meditation. Mindfulness meditation is a key part of many types of therapy because it can help you focus on the present rather than an anxiety-inducing past or future.

Seek balance

Look for ways to bring balance to the different areas of your life by trying activities beyond exercise, such as:

• Setting a lunch date with a friend
• Cutting your exercise routine down by 10 minutes so you can sleep an extra 10 minutes
• Joining a book group

Or, consider taking up a new, relaxing hobby — preferably one you can share with others. Shared hobbies and their associated sense of community go a long way in solidifying our physical and mental well-being.

Surround yourself with positive body image

Be mindful of the influences you let into your life surrounding your body, exercise, and eating habits. Avoid social media that emphasizes being a specific size, shape, or musculature. Consciously make an effort to spend time with friends, family members, and coworkers who have a positive outlook on their bodies, eating, and exercise.

Seek help through Grow Therapy

Most of the time, exercise is invaluable to maintaining physical and mental health. However, compulsive exercisers sacrifice personal and professional relationships and potentially their physical health to maintain a rigid exercise routine. Compulsive exercise can be managed, but it may require the help of a licensed therapist trained to work with the underlying causes of an emphasis on physical activity. At Grow Therapy, we connect you with mental health professionals in your area who are within your insurance network because we believe everyone deserves affordable mental health care. Get the help you need, now.