At 39 weeks pregnant, a runner recently made national headlines following the completion of a marathon. She ran 26.2 miles. Her doctor gave her permission to run an impressive 13.1 miles of the race, yet she opted to double her doctor’s orders. She ran the entire race and then embarked on her second endurance event of the day, which was childbirth. It was also the second marathon she completed during her pregnancy. 

Impressive or compulsive?

Compulsive exercise is often overlooked in a health-conscious society. Certainly, pregnant women are encouraged to exercise for maternal and fetal health. Doctors suggest that exercise is a ‘good thing’ regularly for most people. Regular physical activity can reduce health risks and improve overall wellbeing. In moderation, exercise can even positively impact troublesome anxiety and depression. However, this ‘good thing’ can go wrong for some individuals when done to excess.

What Is Compulsive Exercise?

Compulsive exercise is an intense craving for physical exercise leading to excessive behavior around exercise, resulting in negative consequences. Compulsive exercise can adversely impact physical, social, and emotional health. Some of the health consequences and risks of compulsive exercise include

• Osteoporosis 
• Loss of menstrual cycle 
• Combination of disordered eating, amenorrhea, and osteoporosis 
• Relative energy deficiency
• Persistently sore muscles
• Chronic joint and bone pain 
• Increase in injuries 
• Persistent fatigue or sluggish
• Altered resting heart rate
• Frequent illness
• Increased upper respiratory infections 

Serious complications can occur when people are addicted to working out and combine compulsive exercising with disordered eating, including

• Cardiovascular problems 
• Stomach pain 
• Nausea and vomiting 
• Constipation 
• Ruptured stomach or esophagus
• Pancreatitis 
• Intestinal obstruction
• Infections 
• Electrolyte imbalances
• Fainting and dizziness 
• Decrease in hormone levels 
• Anemia 

Physical activity ceases to be a good thing when it negatively impacts major aspects of our lives or hinders the use of other coping mechanisms. Compulsive exercisers often experience significant emotional disturbance if the activity schedule is interrupted. 

Compulsive exercisers may experience withdrawal symptoms because they’ve become addicted to the rush of neurochemicals and the trance-like state that accompanies intense activity. Withdrawal symptoms can include depression, anxiety, lethargy, irritability, insomnia, preoccupation with fitness or bodyweight, etc. Ironically, some of the symptoms of compulsive exercise can mimic withdrawal symptoms. These individuals may also struggle with physical overuse injuries and relationship underuse damage.

Symptoms of Over-Exercising 

Various signs signal when over-exercising becomes a dangerous addiction that can lead to an exercise disorder. Compulsive exercisers will often continue with an intense exercise regimen despite injury, illness, fatigue, or poor weather conditions. They’ll often prioritize their rigid fitness addiction over important events and activities. 

Compulsive exercisers typically exercise at inappropriate times or places and feel distressed or discomfort during rest periods or inactivity. They often use over-exercising to suppress painful emotions, leading to anxiety, depression, irritability, guilt, or distress if other people can’t exercise with them.  

In other cases, excessive exercise is used as permission to eat or purge calories. Many compulsive exercisers will hide their fitness addiction from others or overtrain. Over-exercising is often used to cope with feelings of not being good enough, fast enough, or pushing hard enough when you’re working out. 

As a result of these signs of over-exercising, people will withdraw from family, friends, and socializing. 

Compulsive exercise isn’t currently listed in the DSM-5 as a mental health disorder, and there’s no specific way to diagnose or measure this condition. However, six criteria occur in all addictive behaviors: salience, conflict, euphoria, tolerance, withdrawal symptoms, and relapse. 

Salience occurs when exercise becomes the most crucial aspect of someone’s life. Compulsive exercise can lead to conflict between the individual and other people in their life when their obsession with exercise becomes a more significant problem. Euphoria occurs when compulsive exercisers experience a “high” or “euphoric” feeling from overexercising. 

Over time, these individuals will develop a tolerance and increase their exercise levels to continue feeling the psychological effects. If compulsive exercisers reduce their exercise, they experience withdrawal symptoms, leading to anxiety and irritability. Lastly, relapse occurs when individuals return to their initial levels of exercise after trying to reduce them. 

In addition to these criteria, healthcare professionals use questionnaires and scoring systems to diagnose compulsive exercise. 

The Relationship Between Compulsive Exercise and Trauma 

The roots of compulsive exercise are generally in emotional and relational disturbance. Not surprisingly, compulsive exercise is also highly correlated with eating disorders, perfectionism, neuroticism, narcissism, and obsessive-compulsive traits. Furthermore, relational avoidance can fuel the desire to work out. 

It’s hard to devote energy to the sometimes strenuous work of emotional intimacy if adhering to a time-consuming workout schedule. The following athletic achievement may cost more than running shoes or a gym membership. It may cost a loving and gentle relationship with yourself and your family.

Like other addictions, behavioral intervention and trauma resolution help address issues related to compulsive exercise. Physical activity can be a component of optimal living if done in moderation. In combination with other healthy coping skills, exercise can complement sober living. 

Trama resolution therapies can address the core issues leading to behaviors of over-exercising. Resolving intensity and moderation issues can restore the spontaneity and ‘good things’ to exercise — sobriety, good health, and joy.

About the Author

Anne Brown, a primary counselor at The Meadows since 2008, has a master’s degree in counseling from Johns Hopkins University. She specializes in treating sex addiction, co-sex addiction, eating disorders, co-dependency, and the underlying trauma of addiction. She has worked in the counseling field since 1999.

Anne completed her undergraduate studies in psychology at the University of Maryland. She received an MS in counseling at Johns Hopkins University. In 1994, Anne began her career in the mental health industry, working with adolescents in Baltimore, Maryland. In 1999, she began work in the addiction field as an individual and group counselor working in residential, hospital, and outpatient settings.