Exercising Demons
When does exercise go from healthy habit to dangerous obsession?
by Maria Martino Evans


Bill Hauser, founder and head coach of Mid-Atlantic Multisport in Malvern, knows all about training hard.


He was selected to the 2001, 2002 and 2003 Triathlon All-American Teams and represented the United States at the 2002 Long Course World Championships. He competed in the Ironman World Championships in Hawaii three times and has run nearly 20 marathons around the world. (His best time for the Ironman was 9 hours 38 minutes, and his best marathon time was 2 hours 42 minutes.)


Now he coaches athletes of all ability levels, from beginners to the elite, from weekend warriors to those running their first 5K to grizzled Ironman competitors.


“Because of the distances involved, some of them need to do a lot of training to prepare for their events,” he says. “You draw the line when someone is exercising to the point where it is harmful to them. They can’t stop. They get injured and continue to train through it.”


Although it is getting more attention these days, the phenomenon is by no means new. The term “exercise addiction” was first introduced in 1976 by Dr. William Glasser, who studied long-distance runners and found out that most of them had this obsessive-compulsive disorder. Statistics suggest that 1 percent of the population is affected by the disorder.


Although there is no clinical definition, people are addicted to exercise, Hauser says, “when they don’t have control over it, when they don’t know when it’s too much, when they organize their life around their exercise instead of organizing their exercise around their life, when it's detrimental to their families, their health, their work.”


Exercise addiction is not so different than any other serious debilitating addiction, according to Brigitte Weil, owner of b-Fit Personal Training in New Hope. Weil is an ACE-certified personal trainer, who also holds certificates from The American Council on Exercise to instruct Pilates, weight training, pre- and post-natal exercise and senior fitness. She is also a graduate of The Culinary Institute of America, where she specialized in nutritious food preparation and planning.


“Although the benefits of exercise are widely known, the act of addiction, no matter what the substance or vehicle, is unhealthy if it affects our daily life in an unhealthy or chaotic manner,” she says. “If addiction to exercise alters our perception of reality and includes outrageous hours and efforts, this is clearly not a healthy approach to fitness and well-being.”


But there are differences. “Unlike some addiction therapy where abstinence is encouraged,” says Weil, “such as with alcohol, exercise addiction therapy is approached with an attempt towards balance, similar to a food addiction.”


A human being can live without alcohol but not without food, she explains. With addictions to either exercise or food, one can be “cured” through re-education and moderation. Complicating the issue further is that both addictions can be intertwined. With women, exercise addiction is often tied into eating disorders and weight-management issues, and can then lead to malnutrition as well as other complications.


“Sometimes,” Hauser says, “they fear that if they cut back on exercising, they will gain weight.”


Psychological Factors

There are also psychological factors that cause mood improvements in people who do physical activity, which can stoke such an addiction. Distractions from one’s daily activities while exercising actually helps humans become more satisfied with their bodies and their lives. In other words, exercise can clear our minds. Besides, we feel emotionally better when our bodies are firmer, stronger and healthier. We also do not have to care about our weight too much if we live an active life, sources suggest.


After all, numerous studies have demonstrated the physical and emotional health benefits of regular exercise. Unlike other potentially addictive behaviors, most people are encouraged to exercise more—up to a point, that is.


“Exercise is thought of as a good thing, so there is positive reinforcement that comes from it, until their performance begins to decline,” Hauser says. “Then the body becomes fatigued and can’t perform.”


Hauser makes sure his clients get the “proper recovery,” which he says is “as important as doing the long rides and long runs; that’s where the physical adaptations take place. I’m designing their program so I make sure to build recovery into it.”


If he sees someone who thinks “the more, the harder, the better,” he advises them to dial it back so they don’t get injured. If they don’t, he may refer them to a sports psychologist “who is able to help put things in perspective.”


Exercise addicts tend to exercise for hours every day, regardless of fatigue or illness. It becomes their main way of coping with stress, and they may become anxious if they are unable to do so. Often it is not the individual who recognizes a potential problem; it may be a coach, a spouse, someone at work. Like Hauser, Weil recommends those who overdo it to seek out professionals who specialize in addiction and compulsive behaviors.


At Risk

Many experts balk at the idea that excessive exercise can constitute an addiction, believing that there has to be a psychoactive substance that produces symptoms—such as withdrawal—for an activity to be a true addiction.


Research shows exercise releases endorphins, and excessive exercise causes tolerance to the hormones and neurotransmitters released. In addition, neurotransmitters have been implicated in exercise and other addictions. For example, dopamine plays an important role in the brain’s reward systems, and regular, excessive exercise has been shown to influence parts of the brain involving dopamine.


Indeed, exercise addiction is not in the “Diagnostic and Statistical Manual of Mental Disorders,” which is the gold standard for psychological diagnoses, although several authors have suggested diagnostic criteria.


“The endorphin release—the runner’s high—is a very real thing,” Hauser explains. “After people exercise, they feel good. People who have an exercise addiction want to feel good. But their tolerance increases, so to get the same feeling, they need to increase their level of exercise.”


Only 8 percent of gym users in the United States meet the criteria for exercise addiction, studies suggest. They say they increase their amount of exercise to re-experience feelings of escapism or the natural high they had previously experienced with shorter periods of exercise. They also report withdrawal symptoms when they are unable to exercise, and tend to go back to high levels of exercise after a period of abstinence or control.


People at risk for exercise addiction have difficulties in other areas in their lives that drive them to exercise to dangerous levels. They may use exercise to express emotions including anger, anxiety and grief, and to deal with work and relationship stress. Some say their excessive exercising has caused conflicts with their family members.


Furthermore, fitness addicts may seek the sense of control—over one’s mood, body or environment—that exercise provides. Ironically, as with other addictions, the attempt to exert control eventually leads to a loss of control and balance with other priorities in life.


Maria Martino Evans is a writer based in Pipersville.