When a person exercises so much that it negatively affects their physical or mental health, or disrupts other aspects of their life, health experts call this compulsive exercise. Compulsive exercise often occurs alongside eating disorders. Anyone experiencing either of these should consult a doctor to discuss the best treatment plan.
Compulsive exercise is an excessive and uncontrollable need to exercise, which results in negative consequences.
People may continue to exercise despite injury or illness, at inappropriate times, or feel distressed when they are not exercising.
Compulsive exercise may cause people to withdraw socially, feel anxious or depressed, or cause injuries and physical health issues.
In some cases, compulsive exercise may also affect how people eat and consume calories and may increase the risk of, or worsen the effects of, disordered eating.
In this article, we look at what compulsive exercise is, signs and symptoms, health risks, and treatment and support options.
What is compulsive exercise?
According to a
Compulsive exercise is currently not listed as a condition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a manual that many healthcare professionals use to diagnose mental disorders.
Who may it affect?
According to a
Athletes may have an increased risk of disordered eating due to the demands of training, pressure to win, and often an extra focus on body weight and shape. Competitive sports may play a part in psychological and physical stress. These factors may also play a part in compulsive exercise.
Health consequences and risks
According to the National Eating Disorders Association (NEDA), the risks and health consequences of compulsive exercise can include:
- osteoporosis or osteopenia, which is a loss of bone density
- loss of menstrual cycle in people who menstruate
- female athlete triad, which is a combination of disordered eating, amenorrhea, and osteoporosis
- relative energy deficiency in sport (RED-S), when the body is not getting enough energy to carry out the demands of exercise
- persistently sore muscles
- chronic joint and bone pain
- an increase in injuries, such as overuse injuries or stress fractures
- persistent fatigue or feeling sluggish
- altered resting heart rate
- experiencing illness more frequently
- increased upper respiratory infections
If people are exercising compulsively while also experiencing disordered eating, they may develop serious complications, which can include:
- cardiovascular problems
- stomach pain
- nausea and vomiting
- ruptured stomach or esophagus, which is an emergency
- intestinal obstruction
- electrolyte imbalances
- fainting and dizziness
- a fall in hormone levels
Signs and symptoms
Signs and symptoms of compulsive exercise can include the following:
- an excessive exercise regimen that continues despite any injury, illness, fatigue, or poor weather conditions
- an exercise regimen that is rigid and prioritized over important events or other activities
- exercising that takes place at inappropriate times or places
- feelings of intense anxiety, depression, irritability, guilt, or distress if people are not able to exercise
- discomfort or distress during periods of rest or inactivity
- using exercise to manage or suppress a person’s emotions
- exercise that becomes a method to purge or “get rid of” calories
- using exercise as permission to eat
- being secretive about exercising or trying to hide it from others
- feelings of not being good enough, fast enough, or pushing hard enough when exercising
- withdrawing from friends, family, or socializing
Although there is currently no clear way to identify or measure compulsive exercise,
- Salience: Exercise becomes the most important aspect of a person’s life.
- Conflict: There is conflict between the person exercising and other people in their life, due to the compulsive exercise.
- Euphoria: People experience a “high” or euphoric feeling when they exercise.
- Tolerance: People feel the need to increase exercise levels to keep experiencing the psychological effects.
- Withdrawal symptoms: People experience an unpleasant feeling when they reduce exercise, such as irritability or anxiety.
- Relapse: People return to earlier patterns of excessive exercise when they try to reduce their exercise levels.
There are also a number of questionnaires and scoring systems that healthcare professionals may use to diagnose compulsive exercise.
These tools can help assess whether people may have a dependency or addiction to exercise and the type of beliefs they have around exercise.
According to a
Treatment for compulsive exercise aims to reduce exercise to a moderate amount, identify triggers, and develop more positive thinking and behavior patterns.
Successful treatment should also reduce the risk of injuries from overtraining and improve mood and social relationships that may have had a negative impact from compulsive exercise.
The review suggests possible treatment options could include:
- Psychotherapy: To help identify compulsive exercise and triggers, understand the benefits of exercising in moderation, and empower the individual to develop coping tools.
- Cognitive behavioral therapy (CBT): To change behavioral patterns.
- Education: To teach people the need for rest, the dangers of overtraining, and acknowledge the need to alter behaviors.
- Behavioral strategies: This may include increasing motivation with rewards for reducing exercise levels.
- Medication: One case study suggests quetiapine, an antipsychotic, may be effective in treating compulsive exercise in people with bipolar disorder, but there is not enough evidence to confirm this.
Compulsive exercise is a complex condition with different causes and complications. Scientists still need further research into treatment options to find out which methods are most effective in treating compulsive exercise.
When to seek help
People can seek professional help if they think they or someone they know may be experiencing compulsive exercise.
According to NEDA, warning signs and symptoms of compulsive exercise include:
- exercise that has a significant impact on important activities or events
- exercising at inappropriate times or in inappropriate settings
- continuing to exercise despite injury, illness, or fatigue
- experiencing intense anxiety, depression, or distress when not able to exercise
People can also contact the NEDA helpline through calling, texting, or its online chat facility here.
How loved ones can help
If people have a loved one who is experiencing compulsive exercise, they may be able to offer help and support with the following suggestions:
- Set aside uninterrupted time to talk in a private place.
- Use “I” to explain the behaviors they have observed in the other person, such as “I’m worried about how often you are going to the gym,” as this sounds less accusatory than “You are exercising too much.”
- Stay calm and caring, but firm, and avoid making ultimatums.
- Reassure the person there is no shame in compulsive exercise, to remove any potential stigma.
- Be prepared for angry, defensive reactions, or for them to brush any concerns away, as these can be normal reactions.
- Avoid offering overly simplistic solutions, but remind people that treatment is available and can help them recover.
- Encourage them to seek professional help.
If someone is worried about a person they love, it is important to seek professional guidance, especially if they feel their health is at risk.
Compulsive exercise is an excessive and uncontrollable need to exercise that people carry out despite injury, illness, or fatigue.
Although it can affect anyone, there may be a link between eating disorders, obsessive compulsive traits, or personality traits such as perfectionism.
Compulsive exercise can result in overuse injuries, energy deficiency, fatigue, or increased risk of infections. It may also have a negative impact on mood and people’s social relationships.
Although researchers need further evidence for compulsive exercise treatments, psychotherapy methods such as CBT may be effective.
It is important that people seek professional help if they, or someone they know, may be experiencing problems with compulsive exercise.