Enduring love or destructive addiction?

Dr Adam Nicholls, explains what exercise addiction is, and how you can assess whether you’re at risk of becoming addicted to exercise...

Are you addicted or committed to exercise? There’s actually an important difference⁽¹⁾. Committed exercisers participate in exercise such as running for extrinsic rewards (ie achieving a place on a team or winning a race). Exercise is important to such a person, but it not a central part of their lives, and they are unlikely to experience withdrawal symptoms if they are unable to exercise.

Conversely, addicted exercisers tend to exercise for intrinsic motives (ie losing weight, changing their appearance etc, view exercise as being central to their lives, and experience many undesirable symptoms when they are unable to exercise. Further, addicted exercisers continue exercising despite achieving their goals (eg losing weight). The key difference between addiction and commitment to exercise is withdrawal symptoms. Addicted exercisers experience many withdrawal symptoms, such as anxiety, irritability, and depression if they are deprived of exercise⁽²⁾.

Symptoms of exercise addiction

Griffithi developed a conceptual framework for diagnosing exercise addiction, which includes key criteria (see Figure 1).

• Salience – This occurs when a particular activity (eg running, cycling, swimming etc) becomes the most important activity in a person’s life, and which dominates their thinking, feeling, and behaviour. In particular, if a person is not exercising due to work or family commitments, he or she will be spend most of the time thinking about exercising or training.
• Mood modification – Addicted exercisers experience a change in their mood as a consequence of exercising or training. As such, addicted exercisers engage in exercise to change their mood to experience a high or even to calm them down.
• Tolerance – Athletes are required to continuously increase their levels of exercise in order to achieve the effects they used to receive. For example, a person addicted to gambling may have to increase the size of the bet to experience the same euphoria that was previously obtained from placing a smaller bet. This is the same for exercise.
• Withdrawal symptoms – Exercise addicts experience a range of withdrawal symptoms when they are unable to exercise (eg moodiness, irritability, anxiety).
• Conflict – This relates to interpersonal conflicts with spouses, friends, and family due to the amount of time the person dedicates to their sport/training.
• Relapse – Although athletes may cease engaging in extreme exercise, they are susceptible to relapses in which they engage in previous levels of exercise.

Causes of exercise addiction

There is no clear consensus regarding the causes of exercise addiction, although there are several different theories:

• People develop a craving for endorphins (morphine like substances released by the pituitary gland), which are the body’s natural painkillers⁽⁴⁾.
• Addiction to exercise is more likely among individuals who exercise to transform their appearance such as losing weight or are concerned with their body image⁽⁵⁾.
• Some individuals seek out healthy methods to combat stress, such as exercise. The individual has to progressively engage in more and more exercise to accumulate the same stress buffering effects, which results in addiction⁽⁶⁾.
• Addiction to exercise may be the consequence of having a perfectionist personality type⁽⁷⁾.

Assessing your risk of exercise addiction

Researchers from Nottingham Trent University developed a brief screening tool to assess exercise addiction ⁽⁸⁾. You can assess your own levels by completing the questionnaire below, which is an adapted version. It is important that you answer each question as honestly as you can.

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Exercise Addiction Questionnaire

Please answer each question by circling the appropriate number for each question:

1 = Strongly Disagree
2 = Disagree
3 = Neither agree nor disagree
4 = Agree
5 = Strongly Agree

• Training for my sport and competing are the most important part of my life - 1 2 3 4 5.
• Conflicts often arise between me and my family or my partner about the amount of I spend training and/or competing - 1 2 3 4 5 3.
• I use training and/or competing as way of changing my mood - 1 2 3 4 5 4.
• Over time, I’ve increased the amount of time I spend training per day - 1 2 3 4 5.
• If I have to miss a training session or a competition, I feel moody and irritable - 1 2 3 4 5.
• If I cut down on the amount of training or competing that I do, and then start up again, I always end up training or competing as often as I did before cutting down - 1 2 3 4 5.

Scoring of the Questionnaire: Scores on this questionnaire range from 6 to 30. The authors of this questionnaire suggested that if you scored between 24-30 you are classified as being addicted to exercise. If you scored between 13-23, you are displaying some symptoms of being addicted to exercise, whereas if you scored between 6 and 12, you are not displaying any symptoms.

If you are particularly concerned about your exercise addiction levels, you can visit your GP, who may be able offer advice and even medication, such as tranquilizers, which have been used to treat the anxiety associated with this disorder. It should be noted, however, that the solution is not to stop exercising completely. You should find a level of exercise that you can sustain in the long-term.

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Practical Solutions to Help Treat Exercise Addiction

There are a number of evidence-based solutions that may help in the treatment of exercise addiction:

Resting - Scholars suggested that those with an exercise addiction, or who display symptoms of being addicted to exercise should adopt a healthier exercise/competition regime⁽⁹⁾. This can be achieved through incorporating sufficient rest and ensuring that you allow your body to recover sufficiently after heavy sessions. You can do this by re-devising your training schedule and incorporating compulsory rest days within it. Rather than viewing rest as something that irritates you, view this time as allowing your body to re-generate in order to enhance your sporting performance. A common mistake made by many athletes is not allowing sufficient rest time.

Cross training - Take up different activities. If you are a runner, try other activities that are different in nature (eg tennis, golf, squash), which test different muscles and tendons in your body. Athletes who spend all of their time on one activity are much more likely to become addicted to exercise⁽¹⁰⁾.

 Change your views about training - In addition to adopting different physical approaches to exercise and training, it is important that you consider your thoughts and beliefs about exercise. Consider the damage that excessive training can cause you:

• Physical problems such as injury
• Health problems - eg increased susceptibility to illness
• Relationship problems eg arguments about the amount of time spent exercising
• Work problems such as not dedicating enough time or thought to work

Training in moderation is not associated with the above problems. As such, do not feel guilty about changing your exercise regime, because you are helping yourself and performance.

Commit to a new training plan - Develop a new training plan, which equates to exercising at a moderate level. This plan should be no longer than four weeks, and then monitor your success in adhering to this plan, so you are able to self-manage your exercise. Develop a plan that allows you time for a social life and commit to doing new social activities.

Find new training partners - Continuing to train with the same people who may have influenced your addiction to training may not be helpful in the future. Finding a new training group may help break the problem of your exercise addiction.

Summary

Athletes addicted to exercise or training, tend to view training and competing as the main part of their life and become irritable, anxious, or depressed if they are unable to exercise for a period of time. There are a number of practical solutions such as incorporating rest within your schedule, devising a new training plan, cross training, and changing your views about training.

References

1. Psychology of Running. Human Kinetics, Champaign, IL, 1981.
2. Sports Med, 43, 111-119, 2013.
3. Gambling and Gaming Addictions in Adolescence. British Psychological Society/Blackwells,
Leicester, 2002
4. Impulse, 1, 1-9, 2006.
5. Health Promot Int, 10, 177-184, 1995.
6. Aust J Sci Med Sport, 27, 68-75, 1995.
7. Running Fit News, 18, 4-5, 2003.
8. Addic Res Theory, 12, 489-499, 2004.
9. Phys SportsMed, 33, 13-23, 2005.
10. Psychol Today, 22, 22-28, 1988.

For more information on this topic see the article below: