Editor’s note: This story discusses eating disorders.
Jenny Shepherd, 46, had always run to deal with stress. But when postpartum depression struck after the birth of her third child in 2011, Shepherd ramped up her coping strategy. The more she ran, the more she depended on it—to the point where taking a day off left her feeling anxious and depressed.
“I’d squeeze in the miles whenever I could. Even if I felt tired, I’d rather suffer through an uncomfortable workout than deal with the guilt of not doing it,” says Shepherd, of Oak Park, Illinois.
In January 2015, Shepherd committed to a 200-mile challenge through her running group, and ran herself into an ankle injury and a boot. When the boot came off, Shepherd’s doctor gave her clearance to run one mile. She ran four. “I couldn’t seem to stop myself,” she says.
There’s a fine line between being a dedicated athlete and being addicted to running, but experts have come to recognize exercise addiction as a legitimate problem—akin to alcoholism, binge eating, and other addictive disorders.
What is exercise addiction, and how are you diagnosed?
Shepherd’s story illustrates some of the telltale signs, one of which is running through injury, says Heather Hausenblas, Ph.D, former director of the exercise psychology lab at the University of Florida, who has studied exercise addiction for more than 20 years.
“When you are injured, are you able to stop and take time off to heal?” she says. “People who are addicted cannot—or if they do, they experience withdrawal symptoms such as anxiety, depression and trouble sleeping.”
“Another sign is that running becomes all-consuming,” says Hausenblas. “Someone who is addicted will give up all other activities in their life—family, friends, work—to get their runs in.”
Emilio Landolfi, Ph.D.—who has researched exercise addiction for Sports Medicine—says tolerance for aerobic exercise is also a factor. The more consistently you run over time, the further and further you need to run to experience elation.
“Everyone's familiar with the term ‘runner's high,’” says Landolfi. “You achieve that initially through 15 or 20 minutes of doing some kind of continuous aerobic exercise, and then it takes you 30 minutes, and then 40 minutes, and on and on.”
The Truth About Exercise Addiction by Katherine Schreiber and Hausenblas elaborates on the signs of exercise addiction and offers insight into the risk factors and treatment. The book includes the exercise dependence scale, which Hausenblas helped develop. The scale looks at seven factors to determine if an individual is addicted to exercise:
- Do you experience withdrawal symptoms when you stop?
- Continuance: Do you continue to exercise despite recurring problems?
- Tolerance: Do you feel a need to always do more to achieve the same effect?
- Lack of control: Are you unable to control your exercise habits?
- Reduction in other activities: Are you spending less time doing other things?
- Time: Is exercise consuming all of your time?
- Intention effect: Do you exercise more than you intend?
Based on scale responses, an estimated 25 percent of runners suffer from exercise addiction, compared to about 0.3 percent of the population in general, Hausenblas says.
Why are runners more prone to exercise addiction?
There are a few reasons, say Landolfi and Hausenblas.
“The most commonly accepted theory and scientific literature is addiction to the endorphin release,” Landolfi says. The runner’s high boosts mood
It’s also seen as socially acceptable, and even praiseworthy, to complete difficult feats of endurance. “It’s okay to say, ‘I’ve got to do my 16-mile run today because I’m training for a marathon,’” says Hausenblas. “If somebody’s going and lifting weights for three or four hours a day, that's gonna stand out. But it’s almost socially accepted to run extreme distances.”
For the nonexerciser—and even for someone who is exercise dependent—addiction to running might not seem like such a bad thing. But the consequences can be serious.
Physically, these include an increased risk of injury, exhaustion, and even cardiac damage, says Landolfi. While these are similar to the effects of overtraining, a person who is exercise dependent would likely continue to exercise when overtraining symptoms begin to appear. “Consequently, the damage is potentially much greater in the exercise addict versus the overtrained athlete,” Landolfi says.
Types of exercise addiction
There are two types of exercise addiction, says Hausenblas—primary and secondary. Primary exercise addiction means that someone is addicted to exercise, and experiences other negatives as a result, such as an eating disorder. Other patients experience secondary exercise addiction, meaning exercise addiction is a result of their primary disorder. For example, someone suffering from bulimia might obsessively run to lose weight.
Primary exercise addiction looks like this: Hausenblas helped a patient who worked out at one gym in the morning, another in the afternoon, and a third in the evening. He knew he had a problem, and purposefully had three separate gym memberships so the staff wouldn’t notice. Despite how expensive his addiction became, he couldn’t quit.
Unfortunately, exercise addiction isn’t an established mental health disorder yet. However, according to Hausenblas, addiction to behaviors was finally acknowledged in the last edition of the Diagnostic and Statistical Manual of Mental Disorders: “The behavior that they acknowledged was gambling… for exercise addiction, shopping addiction, and a few others, they said there just wasn't enough research on it.”
How to treat exercise addiction
Because exercise addiction isn’t formally recognized as a disorder, there is no standard treatment protocol. “You don’t want to take exercise away altogether, because it is such a healthy thing,” says Hausenblas.
If you believe you are addicted to running or exercise in general, Hausenblas advises keeping a diary of your workouts. Set reasonable goals to gradually decrease your mileage or time spent exercising, and talk to a close friend to hold you accountable. If you still can’t stop, seek professional help, which entails counseling and medication.