Compulsive Exercise, Exercise Addiction, Driven Exercise, and Exercise Dependence - What’s It All About?

The terms compulsive exercise and exercise addiction go back to the 1970s, when scientist William Glasser referred to running “addiction” as a positive phenomenon, noting that the pleasurable emotional effects of running heightened motivation and led to increased engagement in the activity. Over the years thereafter, researchers started to question whether a running addiction was indeed always positive. The growing body of research began to highlight the potential for exercise and sport to be taken to the extreme, leading to a host of issues including injury and relationship problems.   

What Is Compulsive Exercise?

Compulsive exercise is best defined as “a rigid and highly driven urge to be physically active, in association with a perceived inability to stop exercising despite the individual being aware of the possible negative consequences.” The terminology used to describe this phenomenon also includes exercise dependence and exercise addiction. Some suggest that exercise addiction is the most accurate descriptor because it captures the elements of compulsion (the need to do it) and of dependence (the inability to stop doing it). At Columbus Park, we typically refer to the behavior as driven exercise but also use the term compulsive exercise, so for the purpose of this blog, we’ll refer to “CE” for compulsive exercise. It's estimated that up to 85 percent of patients with eating disorders (ED) engage in CE, but CE can also be present in the absence of disordered eating or an ED diagnosis. CE is driven by several factors, the most obvious being the control of weight and shape. Other drivers include mood improvement and affective avoidance (the avoidance/escape of negative feelings). Dependence models suggest that the effect of the endorphin rush or “runner’s high” can be highly reinforcing and can maintain the addictive pull to seek out more. Further, experiencing negative feelings (a kind of withdrawal) when unable to exercise may increase the psychological dependence on the activity. CE is further characterized by an inflexible, desperate pull and, for many, a lack of real enjoyment in the activity itself.  

Six Common Features of Addictive Behaviors

When considering an addiction model to understand CE, Brown et al referred to six features that are common amongst all addictive behaviors:

1. Salience: exercise becomes central and most important 
2. Conflict: referring to conflicts that arise between the addicted person and their social contacts
3. Euphoria: the experience of a “high” from exercising
4. Tolerance: the individual needs more exercise to achieve the same effect
5. Withdrawal: negative affective experience like anxiety or irritability if exercise is reduced or blocked
6. Relapse: bounce back to old, extreme patterns when trying to decrease or stop exercising

A number of different questionnaires have been created to capture attitudes and beliefs associated with CE. CE is difficult to assess since the amount of exercise itself does not tell us anything about the driven or compulsive nature. In addition to the amount or frequency of exercise, we need to consider the physical, emotion, and social impact in order to best evaluate and diagnose the behavior. CE is not a formal mental health diagnosis and there is not yet clear data on how common it is, in part because different researchers use different measurement tools to define it. However, a variety of research indicates that patterns of over-exercise can often be observed among people who exercise on a regular basis.

How to Spot Compulsive Exercise

• Exercising an extreme amount, like going to the gym multiple times every day or doing three fitness classes back-to-back
• Exercising specifically to burn off calories after eating or insisting on exercising in order to give yourself "permission" to eat
• Using exercise as the main way you react to and handle upsetting emotions
• Continuing to exercise even when you are injured or sick
• Refusing to skip a workout, no matter what (for example, skipping a big family event to exercise or going to the gym during dangerous weather)
• Feeling very anxious, irritable, or upset if it's not possible to exercise
• Exercising in secret or lying about workout habits
• Feeling like you can never be fit enough, strong enough, or fast enough, no matter how hard you train

If you’re wondering if your exercise may be crossing the line into a compulsive space, The Compulsive Exercise Test (CET), developed by Lorin Taranis, Stephen Touyz, and Caroline Meyer, is a relatively quick questionnaire you can complete to assess. Thank you to our friend and colleague, Jenni Schaefer, author of Life Without Ed, for making the CET readily available to us. If you are concerned about your eating or exercise patterns – or about the eating/exercise patterns of a loved one – please don’t hesitate to reach out to the team at Columbus Park. References:Fietz M, Touyz S, Hay P. A risk profile of compulsive exercise among adolescents with an eating disorder: A systematic review. Advances in Eating Disorders: Theory, Research and Practice. 2014; 241–263. doi: 10.1080/21662630.2014.894470. Lichtenstein MB, Hinze CJ, Emborg B, Thomsen F, Hemmingsen SD. Compulsive exercise: links, risks and challenges faced. Psychol Res Behav Manag. 2017;10:85-95. Published 2017 Mar 30. doi:10.2147/PRBM.S113093Brown I. A theoretical model of the behavioural addictions – applied to offending. In: Hodge JE, McMurran M, Hollin RC, editors. Addicted to Crime. 1st ed. Chichester, West Sussex, England: Wiley; 1997. pp. 13–65. [Google Scholar] [Ref list]Hausenblas HA, Downs DS. How much is too much? the development and validation of the exercise dependence scale. Psychol Health. 2002;17(4):387.Glasser, W. (1976). Positive Addiction. New York, NY: Harpery Row.