Exercise Addiction: Signs, Symptoms, & Treatments

What Is an Exercise Addiction?

Exercise addiction is not a formal diagnosis, but individuals often experience similar thoughts, emotions, and behaviors associated with compulsive exercise.^1,2 As with any addiction, those struggling with exercise addiction continue despite increased symptom severity and consequences.¹ Researchers estimate that approximately 3% of adults in the United States meet the criteria for exercise addiction.¹

How Exercise Affects the Brain

Exercise releases endorphins (natural opioids our bodies produce to make us feel good) and increases heart rate, pumping more oxygen to the brain.^3,4 Exercise has an antidepressant effect that decreases symptoms of negative emotions and stress, contributing to the natural euphoric sensation known as “runner’s high.”⁴

Additionally, exercise is generally associated with goals. We feel better about ourselves when we strive toward a specific objective, like getting in shape or losing weight. Fulfilling these goals increases our self-esteem and confidence.⁵ We carry ourselves higher, others notice and compliment us, and the exercise cycle repeats.⁵

Exercise Addiction Symptoms

Exercise addiction symptoms vary widely and depend on personal predispositions, the type and amount of exercise, and the individual. Regardless, individuals who feel “addicted to working out” can experience uncomfortable and long-term effects of compulsive physical activity.

Symptoms of exercise addiction may include:^6,7,8,9

• Pain and injury
• Social impairment
• Anxiety
• Depression
• Heart problems
• Irregular periods with possible reproductive issues
• Extreme weight loss
• Feeling buzzed after exercising
• Withdrawal symptoms after a long period without exercise
• Uncontrollable desires to exercise
• Inability to stick with a reduced exercise routine
• Joint damage
• Loss of muscle mass
• Sprained ligaments
• Strained or torn muscles or tendons
• Organ failure
• Suicidal ideations

Signs of Exercise Addiction

Signs of exercise addiction are similar across age groups. However, a clear indication of problematic physical activity includes increased anxiety, irritation, or restlessness when a person reduces or stops exercising.

Some people may increase their physical activity after building a “tolerance” for their current workout routines. For example, they may devote more time or energy to the gym, impeding their ability to fulfill life responsibilities or social obligations. Over time, their behavior can lead to physical, psychological, and interpersonal problems.^{2,10,11,12,13}

Signs of exercise addiction may include:^7,8

• Irritation, anxiety, or depression after missing a workout
• Working out when sick, injured, or exhausted
• Workouts replace relationships
• Continually extending workouts
• Exercise loses the element of play and fun
• Reducing activities in other areas of life to make time for exercise
• Spending long periods of time preparing for and recovering from exercise
• Negative social consequences
• Exercising despite medical contraindications
• Interference with relationships or work

Who Is at Risk for Exercise Addiction?

Exercise addiction generally begins with a desire to improve physical fitness.⁸ However, research indicates an increased likelihood of compulsive exercise in school athletes, gym attendees, and those with eating disorders.¹⁴ Vulnerable populations are continually left wanting to reap the benefits of exercise.

Every cause and trigger is problematic and warrants attention–exercise addiction only exacerbates these problems. The relationship between the underlying issues and exercise addiction is self-reinforcing and should be addressed holistically for a comprehensive recovery effort.

Risk factors of exercise addiction may include:⁹

• Eating disorders (e.g., anorexia nervosa, bulimia, binge eating disorder, orthorexia)
• Low self-esteem
• Body dysmorphia (may also lead to a plastic surgery addiction)
• A craving for endorphins
• Depression
• Anxiety disorders
• Extreme weight loss goals
• Type “A” or “perfectionist” personalities

When Does Regular Exercise Become Compulsive?

What is considered healthy exercise varies from person to person. Exercise addiction is generally progressive, occurring in four stages–healthy exercise, at-risk exercise, problematic exercise, and exercise addiction.¹⁵ For example, adjusting session duration, frequency, and intensity may produce benefits or consequences depending on the person. Some individuals may benefit from more activity, while others experience injuries, discomfort, and unhealthy weight loss.

The initial stage of exercise addiction often begins with activity “motivated by health.”¹⁵ A person may start with a goal of losing weight, staying in shape, or meeting new people. As they continue exercising, they may enter the “at-risk” stage and use activities to cope with anxiety or other uncomfortable emotions.¹⁵

A person in the “problematic exercise” stage will experience negative consequences of their behavior, such as injuries, social conflict, and others. Exercise addiction symptoms are now present and have increased in number and severity. Exercise becomes necessary to avoid guilt, even if physical activity impairs the ability to function normally and fulfill obligations.¹⁵ Individuals obsessed with exercising struggle to break the cycle, furthering their addiction.

Treatment for Exercise Addiction

Fortunately, many treatment options are available for exercise addiction. Depending on the severity of the addiction and personal preference, treatment may be any one or a combination of therapy, residential treatment, or support groups. Motivation to change is associated with intended treatment outcomes and timelines.

Therapy for Exercise Addiction

Treatment for exercise addiction is much more complicated than simply cutting back or abstaining from working out.⁹ Rather, recovery requires a multidisciplinary approach that addresses biological, psychological, social, and spiritual domains. The individual becomes better able to adapt and cope while decreasing problematic beliefs, thoughts, and behaviors.

Therapy for exercise addiction may include:

• Cognitive behavioral therapy (CBT): CBT addresses problematic beliefs, thoughts, and behaviors, replacing them with healthy and positive alternatives.(FN16) The patient and professional work together to modify beliefs (e.g., “My body is ugly”), remove obsessive thoughts (e.g., “I must work out for an hour”), and engage in behavioral experiments to promote positive thinking and behavioral change.
• Dialectical behavior therapy (DBT): DBT offers more structure than CBT by incorporating mindfulness. Clients can learn to remain present when coping with anxiety and stress.

Medication for Exercise Addiction

Depending on the individual and the severity of their addiction, psychiatric medication may prove beneficial.⁹ For those with co-occurring disorders (a combination of mental health and addiction disorders), consult a physician about which medications may offer symptom relief.

Finding Help for a Loved One With Exercise Addiction

Remain supportive and objective during your loved one’s treatment and model the behavior you wish to see. You may meet some resistance, which is normal. If you also struggle with exercise addiction, seeking help sets a positive example.

Below are ways to support a loved one with exercise addiction:

• Educate yourself about exercise addiction
• Note the signs and symptoms you have observed in your loved one
• Conduct some preliminary research on treatment options
• Engage in a supportive, informed discussion
• Encourage them to seek treatment
• Remain empathetic, positive, and supportive

Living With Exercise Addiction

As with any other addictive disorder, exercise addiction is treatable but not curable. The underlying problem still exists, even if symptoms are manageable, minimized, or eliminated. As a result, living with exercise addiction does require intent and consistency–recovery is always an active task.

Lifestyle changes can initiate and sustain change. Consider meeting with a physician to determine healthy workout routines and nutrition requirements. Most importantly, seek professional mental health to help you address the reasons behind your compulsive exercise.

Below are tips for coping and living with exercise addiction:

• Participate in treatment as necessary
• Attend support groups
• Speak with others, especially when struggling
• Avoid triggers pertaining to people, places, and things
• Address any mental health and/or addiction concerns
• Eat whole foods to nourish your body.
• Maintain a positive outlook on life
• Adopt new hobbies not associated with exercise

Final Thoughts

Living with exercise addiction can be challenging, but help is available for those ready to change. Therapy can assist you in recovering from compulsive and unhealthy behaviors, beliefs, and thoughts associated with exercise, yourself, and your life.