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What causes exercise addiction?

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Exercise in moderation can be a key component in maintaining mental and physical well-being. However, when an individual starts to exercise compulsively, obsess over physical fitness, exercise in secret, or work out when it’s causing pain, they could be experiencing an exercise addiction. People with exercise addiction put their physical and mental health at serious risk. Inadequate rest between training sessions may lead to an increased risk of injury, anxiety, and emotional discomfort. When exercise addiction co-occurs with disordered eating, it increases the chances of malnutrition. (1) Exercise addiction has many causes. Someone can develop exercise addiction due to a myriad of biological, behavioral, psychological, and social factors.

6
 minute read
Last updated on 
June 3, 2024
In this article

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.


Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Elizabeth Hartney, B. S. (2021, January 12). What is exercise addiction and are you at risk? Verywell well. 
  2. Saanijoki, T., Tuominen, L., Tuulari, J. et al. Opioid Release after High-Intensity Interval Training in Healthy Human Subjects. Neuropsychopharmacol, 43, 246–254 (2018)
  3. Sussman, S., Lisha, N., & Griffiths, M. (2011). Prevalence of the addictions: a problem of the majority or the minority? Evaluation & he Health Professions, 34(1), 3–56. 
  4. Stubblefield, H. (2017, August 4). Exercise addiction: Causes, risk factors, and symptoms. Healthline. 
  5. Trott, M., Jackson, S.E., Firth, J. et al.(2021) A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders. Eat Weight Disord, 26, 37–46 
  6. Krisztina Berczik, Attila Szabó, Mark D. Griffiths, Tamás Kurimay, Bernadette Kun, Róbert Urbán & Zsolt Demetrovics (2012) Exercise Addiction: Symptoms, Diagnosis, Epidemiology, and Etiology. Substance Use & Misuse, 47:4, 403-417
  7. Freimuth, M., Moniz, S., & Kim, S. R. (2011). Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. International Journal of Environmental Research and Public Health, 8(10), 4069–4081. 
  8. Di Lodovico, L., Poulnais, S., & Gorwood, P. (2019). Which sports are more at risk of physical exercise addiction: A systematic review. Addictive Behaviors, 93, 257–262. 
  9. Lichtenstein, M. B., Hinze, C. J., Emborg, B., Thomsen, F., & Hemmingsen, S. D. (2017). Compulsive exercise: links, risks and challenges faced. Psychology Research and Behavior Management, 10, 85–95
  10. Athletes online: Research finds technology is fuelling exercise addiction. TriRadar. (2018, August 13)

FAQs

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Further reading

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