Exercise addiction is described as “a pattern of physical activity that exceeds what most fitness and medical professionals consider “normal,” causes immense psychological anguish (either during, following, or anticipation of exercise), engulfs an exercise addict’s personal, professional, and social life, and is experienced by the addict as difficult to control or reduce in frequency – even in the face of illness or injury” (Schreiber & Hausenblas, 2015, p. 3).
Features may include:
- Compulsive engagement in excessive exercise with mental obsession
- Urges or craving to excessively exercise
- Need to exercise more to achieve the desired effect
- Exercises when feeling distressed and/or to avoid feelings (e.g., sad, anxious, jealous)
- Continuing to exercise despite negative consequences (e.g., injuries, work, or relationship issues)
- Loss of control over exercise with failed attempts to cut down
- Withdrawal symptoms (e.g., restlessness, irritability, anger) when unable to exercise
Diagnostic Considerations:
Clinicians treat people who describe their experience as “exercise addiction,” though it is not yet included in the national and international diagnostic manuals. When the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was last revised, there was not sufficient research to include the subcategory of “exercise addiction” (American Psychiatric Association, 2013, p. 481), though lay persons use these terms, and the afflicted are seen by clinicians. It is not unusual that client issues and clinical work precede research. Time lags in research are estimated to be between 15-20 years (Slote Morris, Wooding, & Grant, 2011). Knowledge will continue to evolve through outcomes of research.
Exercise addiction has also yet to be included in the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2018).
Exercise addiction often co-occurs with adjustment disorders, anxiety, eating disorders, body dysmorphia, or obsessive-compulsive disorders. When applicable, counselors often diagnose these other disorders.
Treatment:
Treatment for exercise addiction varies dependent on factors including co-occurring disorders. Common psychotherapeutic approaches support emotion regulation enhancement, coping, calming, and communication skills, distress tolerance, reconnection with one’s body, conscious awareness and appropriate responses to psychological and physical cues such as pain, and a new relationship with fitness and exercise.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
Rosenberg, K.P., & Feder, L.C. (2014). Behavioral addictions: Criteria, evidence, and treatment. Academic Press.
Schreiber, K., & Hausenblas, H.A. (2015). The truth about exercise addiction: Understanding the dark side of thinspiration. Rowan & Littlefield.
Slote Morris, Z., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: Understanding time lags in translational research. Journal of the Royal Society of Medicine, 104, 510–520. https://doi.org/10.1258/jrsm.2...
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/