When Too Much Exercise Becomes a Problem

Regular exercise is a vital part of a healthy lifestyle and sound weight-loss program. In fact, most experts suggest that we get 60 minutes of exercise each day for optimal health. But while a little exercise is a good thing, taking exercise to the extreme can cause serious health issues, even death. When few adults exercise regularly, and many struggle to find just 20 minutes to dedicate to a workout, it may be hard to believe that some people place exercise at the center of their lives. But some people feel compelled to exercise above and beyond normal levels, often in a desperate attempt to burn every calorie they consume.

Compulsive exercise is more than a desire to get in the ultimate shape or manage one's weight. Sufferers of exercise bulimia use excessive exercise to purge or compensate for eating binges or simply regular eating, often working out multiple times per day or for three or four hours at a time. Deep down, this disorder has more to do with control than it does the desire to fit into a smaller size of jeans.

The scary thing about an addiction to exercise is that it creeps up gradually, usually among everyday people who start exercising, feel good afterward, revel in the calories they're burning, have a desire to get healthier or lose weight, and therefore start believing that more is better. Oftentimes, people who develop an exercise compulsion don't feel like there's anything wrong with what they do. They think that what they're doing is healthy, and can't understand how others don't see it that way.

Compulsive Exercise Vs. Exercise Bulimia: What's the Difference?

Although the terms are often used interchangeably, compulsive exercise and exercise bulimia are two different things.

Compulsive exercisers build their lives around working out and are genuinely distressed if they can't exercise as much as they feel they need to (or should be). Exercise bulimia is similar, but involves eating binges. People who suffer from exercise bulimia often binge on food and then exercise obsessively to make up for it. Exercise becomes a way to control calories, justify eating, and punish oneself for eating too much or eating the "wrong" things.

Both conditions are indicated by the following symptoms:

• Choosing to exercise instead of going to work or enjoying social activities with friends or loved ones
• Refusing to take any rest or recovery days, even when injured
• Continuing to exercise even when ill
• Exercising to the point of exhaustion
• Never exercising for fun
• Experiencing severe stress and emotional upset, including depression, if unable to exercise
• Obsession with calories eaten and calories burned
• Preoccupation with burning calories throughout the day, even when not exercising

How Much is Too Much?

There is no certain amount of exercise that is automatically "too much" for every person. In general, exercising for up to 60 to 90 minutes, most days of the week is reasonable and healthy for most people as long as recovery and downtime is built in. Competitive athletes may exercise for hours each day without any problem. The right amount of exercise for you may differ from your friend or neighbor and should take into account your fitness level, lifestyle, current health status and more.

So how do you know if you're exercising too much? It's a matter of attitude and whether your thoughts and behaviors about exercise mirror the list of symptoms described above. When exercise becomes one of the most important aspects of your life, and when your life revolves around exercise, it could be more than dedication—it could be an unhealthy obsession.

Associated Health Problems and Diagnosis

Exercise is usually a good thing, but rest and recovery are very important, too. Excessive exercise can weaken the body and cause a host of problems, including:

• Fatigue
• Suppressed immune system
• Lack of menstruation (amenorrhea) in women due to a lack of body fat
• Reproductive problems
• Heart problems (such as muscle wasting and rhythm problems)
• Dehydration
• Arthritis
• Osteoporosis
• Stress fractures and sprains
• Kidney failure

Beyond physical ailments, excessive exercise can cause mental and emotional upset, interfere with normal, healthy relationships, and is often associated with anxiety and depression, too.

If you experience health problems like these that could be tied to excessive exercise, talk to your doctor and take some time off from fitness. If the thought of taking a few days or even a week off from your exercise routine upsets you, that too could be a sign that your dedication to fitness is unhealthy.

Compulsive exercise and exercise bulimia can affect both men and women of all ages, races, body types and weights. Because adherence to an exercise program is usually a positive thing that is admired and encouraged, exercise bulimia is often difficult to diagnose. A doctor may ask if the person is exercising and get the right answer (yes), never knowing the extent to which the patient is actually jeopardizing his or her health by taking exercise to the extreme. A physician may first suspect a problem if a woman stops menstruating due to a drop in body fat, which affects estrogen levels, but the condition may be virtually undetectable in men whose body fat levels can be much lower without creating any health problems.

Even if your physician doesn't pick up on these signs, if you read the list above and think that this may sound like you, it's important to discuss your concerns, habits, and feelings with your doctor to find out if you may have a problem—and get help.

Treatment Options

Exercise bulimia can be a symptom of deeply rooted emotional problems. Studies have found that sufferers often come from families where food was used as a way of controlling behavior and battles surrounding food were common. Some bulimia sufferers are highly self-critical and aim for perfection in many areas of their lives. Because they feel they are never good enough just the way they are, they may exercise compulsively as a way to feel worthy and good about themselves.

Traditional treatments for exercise bulimia include support groups, cognitive behavior therapy, psychotherapy, and/or medication, such as anti-depressants. Other treatments include hypnosis and guided imagery, which allows the individual to create a new, positive, body image. The purpose of any treatment path is to gain awareness of the underlying reasons that caused the disorder in the first place, such as feelings of panic or being out of control. It is also important to lower the perfectionist standard and become more self-accepting so that exercise can serve its purpose in your life—not be the center of it.

To learn more about eating and exercise disorders and receive a referral to a health practitioner in your area, contact the National Eating Disorders Association at: 1-800-931-2237 or visit: www.edap.org.

This article has been reviewed and approved by behavioral psychologist Dean Anderson, certified personal trainer Jen Mueller and certified personal trainer and health educator Nicole Nichols.