I haven’t missed a day of exercise in 18 years.
I’m afraid I’ll gain weight if I don’t run every day.
I’m injured and can’t exercise. I really need exercise to manage stress.
Many of my clients exercise a lot; perhaps too much. I often question if they are compulsive exercisers or dedicated athletes. Athletes consistently train hard to optimize performance. They follow an effective exercise program with rest and recovery days. In comparison, compulsive exercisers move their bodies for reasons other than to enhance performance.
Compulsive exercise is common among the estimated 30% to 60% of athletes who have dysfunctional eating behaviors such as yo-yo dieting, food binges, or outright eating disorders (anorexia, binge eating). A study of 455 teens with anorexia reports 42% exercised compulsively. That’s almost half of them. Many of these students show up as star athletes—until overuse injuries set in. Compulsive exercise can persist into adulthood, despite significant progress with having improved unhealthy eating behaviors.
If you have concerns about urges to exercise in unhealthful ways, this article might help you—or your teammate or loved ones—tame the extreme drive to exercise beyond that required for health and performance. The ultimate goal is for compulsive exercisers to be able to enjoy better quality of life.
Signs and Symptoms
First, let’s take a look at some signs and symptoms of compulsive exercise:
• Compulsive exercisers have rigid rules related to when, where, and how much they exercise. They may exercise hard every day—and boast about their 5+-year exercise streak. Some may claim to take a “recovery day” each week. But does “cross-training”—such as intensely biking instead of running—really count as a day off?
• Some compulsive exercisers report they have to exercise to relieve stress. Indeed, relieving stress is a healthful thing to do. A hard workout can help a person unwind after a hectic day. But if the stressed person has to de-stress every day with hard workouts, regardless of extreme weather, family gatherings, travel, or injuries, I question if more is involved than simply stress relief. Exercise can be a way to escape from stress-inducing relationships and painful feelings. Working with a therapist can be a better alternative to exhausting one’s body…
• Many people with undesired body fat believe they must exercise every day to be able to lose weight. Not the case. (Sick people commonly lose weight; they are not exercising.) To lose body fat, one needs to create a calorie deficit; this can be done without exercise (albeit less healthfully).
Dieters can easily get hooked into exercising more and more to expend calories. What may start as a simple jogging program to lose undesired body fat can progress into extreme marathon training. Fear of regaining lost weight often creates a relentless drive to exercise compulsively.
Exercise can also become a way to compensate for having eaten. You know, “I just blew my diet by eating pizza for lunch. I’ll have to exercise longer tonight to burn off the calories.”
• Compulsive exercisers can misuse exercise to manage upcoming eating opportunities. (“I’ve been invited out to dinner tonight. I’d better burn off extra calories at the gym before I go.”) Note: Exercise should not be used as punishment for having eaten. Exercise is something you should do FOR your body, not TO your body.
• Compulsive exercisers who restrict their calorie intake may report they have to exercise to get warm. When food intake is sparse, the body conserves energy by lowering body temperature. Cold hands and feet can be a sign of being underfueled. The preferred way for some athletes to warm their bodies is to exercise hard to generate heat.
Looking at the whole picture
In the whole scheme of life, exercise is good. It can promote physical fitness, good health, social connections, and enjoyment. But when the mental and physical energy devoted to maintaining a rigorous exercise program reduces quality of life (for you or your loved ones who complain you spend too much time working out and then are too tired to “do anything”), it’s time to think again. Exercise should not consistently take priority over relationships.
Compulsive exercisers live in what may feel like Exercise Jail; not fun. The best ways to treat compulsive exercise are not yet known. Historically, exercise was banned in eating disorder treatment programs. Understandable, because allowing a patient with anorexia burn off extra calories seems contrary to restoring weight to a healthy level. However, even when exercise is restricted, compulsive exercisers end up fidgeting, standing more, and being more animated. The drive to move the body can be relentless.
Withholding exercise can lead to great anxiety. It eliminates the opportunity to teach the person how to establish healthful activity. After all, exercise is beneficial for health, mood stabilization, reversing bone loss, and building muscles and strength. Working with a registered dietitian (RD) who specializes in sports nutrition can help the compulsive exerciser transform food fears (Food is the fattening enemy) into food being essential fuel that enhances performance. Ideally, the compulsive exerciser also works with a coach or trainer who can educate the athlete about how much training is appropriate to reach the desired performance goal, at what intensity, and how often. Structured and supervised exercise can offer benefits (better mood, more compliance, muscle gain, better performance, and better quality of life) — but it requires careful clinical judgement and an individualized treatment plan.
Ideally, the E in Exercise stands for Enjoyment (not Excruciating or Exhaustive). While dedicated athletes do have to endure some excruciating workouts, the sessions are functional and not done to burn off extra calories. My hope is compulsive exercisers can work with a therapist and sports nutritionist, learn to fuel wisely, train appropriately, and enjoy miles of smiles.
Boston-based sports nutritionist Nancy Clark MS RD counsels both fitness exercisers and competitive athletes (617-962-4382). Her best-selling Sports Nutrition Guidebook is a popular resource. For more information: nancyclarkrd.com