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Exercise Addiction/Overactivity Disorders

Exercise addiction or overactivity disorders can be diagnosed in patients who attempt to control their bodies and define their identity by overinvolvement in exercise activity. This overinvolvement often has addictive properties, thereby producing a rigid commitment to exercise routines, with symptoms of withdrawal when exercise is reduced or diminished. Experts estimate that at least 4% of Americans struggle with excessive exercise. While women are more often associated with eating disorders and a preoccupation with weight, it is men who are more likely to become addicted to exercise. College-age men are twice as likely as their female counterparts to exercise to excess. They are also more prone to becoming irritable and tense if there is a missed scheduled workout.

Symptoms

Warning signs of exercise addiction include exercising alone, a rigid exercise routine, exercising for more than 2 hours per day, a fixation on weight loss or calories burned, exercising when sick or injured, exercising to the point of pain and beyond, and skipping work or other obligations to complete exercise routines. The symptoms of exercise addiction and overactivity disorders are often the same as those for anorexia and bulimia. These overlapping symptoms are obsessive concerns over being fat, body dissatisfaction, and binge eating. The consequences of exercise addiction can be severe: Most excessive exercisers eventually develop overuse injuries, which can have long-term repercussions. Female exercise bulimics also cease to have periods, a condition called exercise amenorrhea. When a woman's menstrual cycles stop, it means her estrogen levels have dropped to those of a postmenopausal woman. Estrogen, of course, is vital for the normal development of bone—which reaches its peak in women in their mid-20s. If a woman's estrogen levels dip too low during this critical time, she may start losing bone mass instead of building it.

Symptoms that are solely concerned with overactivity are high levels of activity and feeling uncomfortable with rest or relaxation, dependence on activity for self-definition and mood stabilization, use of rationalization and other defense mechanisms to support involvement in an activity, fatigue, decreased concentration, reduction in performance, loss of emotional vigor, soreness, and stiffness.

Causes

Exercise addiction and overactivity disorders are most often associated with body image disturbance. Individuals with a healthy body image have positive self-evaluations and accurate perceptions about their body shape and size. Body image disturbance is marked by negative self-evaluations and is indicated when an individual's perceptions of shape and size differ from reality. Cultural body ideals are defined by the communications media and are largely unrealistic for the vast majority of the population.

Studies also indicate that overactivity disorders can be associated with depression, anxiety, and other mood-related disturbance. Compulsive exercise becomes a way to regulate negative feelings, and this may lead to excessive dependence on exercise.

Diagnosis

Currently, the American Psychiatric Association does not recognize excessive exercise and overactivity disorders as primary disorders. Excessive exercise is known to be a symptom of bulimia nervosa. The current Diagnostic and Statistical Manual of Mental Disorders, fourth edition text revision (DSM-IV-TR), describes excessive exercise as exercise that “significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications.” In the case of bulimia, exercise dependence is a way to control body weight, to maintain appearance, or to compensate for a binge-eating episode as opposed to or in addition to purging. This is known as non-purging-type bulimia nervosa. Rather than purging after episodes of binging, the bulimia patient fasts or exercises excessively to prevent weight gain or to achieve weight loss. Individuals with anorexia nervosa may also engage in excessive exercise as a method to achieve weight loss. There is a continuum of behavior known as excessive exercise and exercise dependence. Many researchers have concluded that exercise dependence occurs in the presence of a formal eating disorder. Other studies have indicated that exercise dependence exists in individuals without body image disturbance or with a preoccupation with thinness. They have concluded that it is a primary disorder that results in exercising for the sake of exercising itself.

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