Biological factors of exercise addiction
Reward Neurotransmitters
Exercise releases feel-good neurotransmitters, endorphins and dopamine, which elicit a reward response, similar to the effect of opioids. The positive effects of physical exercise include stress relief, mood elevation, and reduction in the symptoms of depression and anxiety.
When a person stops working out, the “feel good” effects of exercise wear off, and some may experience withdrawal-like symptoms, like irritability and restlessness. This may cause a person to seek out exercise again.
Excessive exercise leads to an increased tolerance to these neurotransmitters, which may result in an individual exercising even more to chase the “high” of the chemical release. (2)
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Environmental factors of exercise addiction
Psychological/emotional/identity
Substance use or other addictions
Research indicates that people with addictive personalities, such as those with existing alcohol or drug addiction, are much more likely to develop an exercise addiction. This may be to fill the void left by a previous addiction.
Research speculates that 15% of people addicted to exercise are also addicted to alcohol, cigarettes, or recreational drugs. (3) Plus, approximately 25% of individuals addicted to exercise have other addictions, such as a shopping or sex addiction. (4)
Eating disorder diagnosis
Eating disorders and exercise addiction have a lot of symptoms in common. A recent study has discovered that the prevalence of exercise addiction is four times higher in those showing signs of an eating disorder, compared to the general population. (5)
This could be because excessive exercise is known to be a compensatory behavior in eating disorders used to prevent weight gain, along with misuse of laxatives and diuretics, and purging. (6)
Being an athlete
The prevalence of exercise addiction in the general population is believed to be around 3%. (7) But certain groups are more at risk of exercise addiction, particularly those who have an interest in health and fitness. (8) For example, research demonstrates:
- 14.2 % of endurance athletes show signs of exercise addiction
- 10.4% of players of ball sports show signs of exercise addiction
- 8.2 % of fitness center members show signs of exercise addiction
- 6.4% of participants of power disciplines show signs of exercise addiction
Muscle dysmorphia
Muscle dysmorphia, also known as megarexia, is a form of body dysmorphia, which is characterized by beliefs of having insufficient muscles. This can lead to the engagement of excessive muscle-building workouts, such as weightlifting and taking anabolic steroids.
Although the literature reports cases of muscle dysmorphia mostly in males, women can also develop the disorder, thanks to a changing Western female body ideal to “strong is the new skinny.” (9)
Obsessive-compulsive disorder (OCD)
Research has discovered that individuals who score highly on an exercise addiction test also have high scores on an OCD test, when compared to non exercisers. (9)
Compulsive exercise has similarities to the behaviors seen in those with OCD, as in obsessions triggered by certain stimuli and distress if these compulsions can’t be maintained. For example, craving a certain exercise in response to social pressure for the perfect body ideal and feeling frustrated or low if they’re unable to exercise. (9)
Certain personality traits
Exercise addiction tends to be more prevalent in those with certain personality traits that are believed to play a role in the onset and maintenance of the condition. These include: (9)
- Narcissism: a high focus on the self, meaning an individual may prioritize working out over other commitments
- Perfectionism: a reduced tolerance for flaws, which may result in compulsive exercising, due to never being satisfied with their performance or gains
- Neuroticism: increased emotional instability, which could increase focus on exercise as a coping mechanism for negative thoughts and feelings.
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Social/peer pressure and competition
Societal pressures
Pressure from society to have the perfect body may drive a person to exercise compulsively to achieve an unrealistic body standard, which results in more negative emotions and low self-esteem. (9)
Fitness technology
Recent research has found that technology designed to help people increase their fitness levels is pushing endurance athletes into exercise addiction. (10) The study found that 4.6% of the variance in risk of exercise addiction was due to the use of fitness technology, especially trackers and social media.
At-risk athletes seek out online communities associated with fitness technology to combat the loneliness of their training. However, this allows them to compare themselves with other athletes, which may result in them feeling pressure to match up.
Furthermore, individuals can become fixated by the data from their fitness wearables, driving them to go beyond their original goals.
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Treatment of exercise addiction
The goal of treating exercise addiction may not be to get the patient to abstain from working out altogether but to return to moderate exercise. In some cases, a different exercise may be recommended to a patient, to help break the addiction. (9)
The most common form of treatment for exercise addiction is therapy to understand the triggers for their addiction and how it is negatively affecting their lives. Types of therapy for exercise addiction include:
- Individual therapy: Dialectical behavior therapy (DBT) and cognitive behavior therapy (CBT) are useful tools in helping patients understand the reasons behind their exercise behaviors and develop better coping mechanisms for potential stressors.
- Group therapy: Providing support from others in a similar situation, group therapy allows individuals to discuss their thoughts and feelings.
- Motivational interviewing - This form of therapy encourages a person with exercise addiction to make positive changes in their behavior.
Treating co-occurring disorders, such as disordered eating behaviors and body dysmorphia, will improve the chances of recovery from exercise addiction, as these symptoms often overlap and interact. Without proper treatment for these co-occurring conditions, people may relapse following a program for exercise addiction.
Seeking help for exercise addiction is difficult, and can result in withdrawal symptoms, such as anxiety, depression, and irritability. Each individual will need support, compassion, and empathy and a safe space where they can discuss their concerns without fear of judgment.
