Is a teen, MaryBeth Moore of West Palm Beach, Fla., didn’t spend her free time at cheerleading practice, gossiping on the phone, or working at the local grocery store. Instead, she exercised. “My routine consisted of a 6-mile run in the morning, a 6-mile run in the evening, and an hour and a half of high-impact aerobics or a personal training session,” Moore says.
That sounds like a lot, but Moore didn’t think she was doing anything unhealthy. “I just wanted to be the best on my track team and get a scholarship for college,” she explains. Like Moore, you may think more exercise is always better. But too much exercise can actually be harmful or even deadly. Here’s what you need to know about exercise in overdrive.
What Is Exercise Abuse?
“Exercise abuse [also called exercise addiction or excessive exercise] is a compulsion to exercise, where you feet you can’t stop,” says Kenneth Littlefield, a psychologist at the Arizona-based Remuda Ranch, a treatment facility for people who have eating disorders. “The part where it becomes an addiction is where you need increasing amounts to feel satisfied. When enough isn’t enough.”
Little research has been done, but experts estimate percent of people in the United States abuse exercise. And it’s definitely a growing phenomenon, Littlefield says. Wonder why? Flip on your local TV news and you’ll most likely hear about the obesity epidemic. Couple that with wanting to fit in and seeing celebrities who are unbearably thin or impossibly ripped, yet who are considered the perfect size, and it’s easy to see how normal exercise can cross the line to abuse.
Many people think it’s better to over-exercise than to be overweight or have an eating disorder such as anorexia or bulimia. But exercise itself can be part of an eating disorder. It can be a form of purging if the exercise is done excessively in hopes of burning off all calories eaten. “Usually, if there’s an unhealthy relationship with exercise, chances are there are also some eating disorder symptoms such as restricting, hinging, and purging,” says Kelly Pedrotty, exercise coordinator at the Renfrew Center of Philadelphia, an eating disorder treatment center.
Too much exercise can be as unhealthy as an eating disorder. Extreme workouts can cause fatigue, hair loss, fainting spells, loss of menstrual periods, dehydration, malnutrition, and overuse injuries such as fractures. “People who exercise excessively typically perform the same activities over and over,” says Dr. C. David Geier, director of sports medicine at the Medical University of South Carolina. “Overuse injuries occur when an area of the body is exposed to excessive stress over a period of time without sufficient rest and time to repair.” Excessive exercise can cause hormonal changes that weaken bones. Combined with extreme physical strain, this can lead to stress fractures.
An even worse outcome is heart complications or death. When someone exercises too much and doesn’t replenish enough calories, the body starts to break down fat for energy. When there’s no more fat, the body breaks down muscle for fuel. Because the heart is the biggest muscle in the body, it’s hit the hardest. Athletes who get enough calories and nutrition have very healthy hearts, but those who don’t compensate for the demands they place on their bodies can experience heart failure or a heart attack.
Excessive exercise also affects self-image and relationships. “People who overexercise usually have a distorted perception of their appearance,” says Theresa Fassihi, a psychologist at the eating disorders program at the Menninger Clinic, a psychiatric clinic in Houston. “They see themselves as out of shape and may become self-conscious and avoid social contact, or they may be so involved in their exercise that they don’t have time for social activity.”
Jason Thomas, 18, of Houston, is a prime example. Two years ago, he started lifting weights to beef up. “I started off lifting 80 pounds, and then when I saw the muscles piling on, I started lifting more and more,” he says. Eventually, Thomas was benching more than 200 pounds and was at the gym multiple times a day. “When my girlfriend complained [I was] not spending enough time with her, I felt she was making me choose between her and exercise,” he says. “Exercise won.”
Not So Easy to Spot
Although female models and actors get the most notice for being too thin and battling eating disorders, exercise abuse isn’t a female-only problem. As Thomas’s story proves, it affects both sexes. And any type of exercise can become an addiction, from strength training with weights to cardiovascular exercises such as biking.
It’s not always easy for someone to recognize that he or she is exercising too much. Frequently, a friend or family member has to point it out. And those around the compulsive exerciser may not realize there’s a problem. “Sometimes people who overexercise can be seen as very high functioning, and they can get a lot of praise and admiration for what they’re doing,” says Fassihi. That feedback reinforces the person’s belief that his or her habits are healthy.
Slowing Things Down
Eventually Thomas’s mom questioned his constant weight lifting. When he kept working out despite a fractured elbow, Thomas saw his mom and girlfriend were right. Still, he couldn’t quit.
“I told myself I wouldn’t go to the gym at all for at least a week, but I got really angry and depressed,” he says. At home, however, Thomas did the same workouts he would have done at the gym. “I just couldn’t stop myself.”
Most people don’t seek treatment for exercise abuse, but it can be hard to stop without help. “The best treatment is similar to what works for treating eating disorders–behavioral therapy and medication,” says Fassihi. Behavioral therapy helps adjust thought patterns, and medicine treats side effects such as osteoporosis or underlying issues such as depression.
For nearly a year, Thomas saw a therapist who specialized in eating and exercise disorders and was able to streamline his workouts. “I no longer feel the need to be a gym rat,” he says. “I go a few times a week, work out for 45 minutes, and then get on with other things in my life.”
Moore kicked her habit too. Two weeks after being recruited by a university, “I gave up a college running career because I was so burnt-out,” she says. But she has no regrets: “Giving up my track scholarship was a life lesson. I started working with a trainer and found interest in other exercise routines and actually started to look healthier.” Now, at age 24, she works out once a day and never for more than an hour. “You can’t base your whole life on exercise,” Moore says. “You have to have fun with it and make it a hobby, not a bad habit.”
Are You in Trouble?
Worried that you may have a problem? Wondering how much is too much? “It can’t really be broken down to ‘if you’re exercising so many hours, you’re overexercising,'” Theresa Fassihi, a psychologist at the eating disorders program at the Menninger Clinic in Houston, says. “It’s more about attitude.”
For people with normal exercise habits, working out can be a way to maintain a healthy weight or improve overall health, or it can simply be something they enjoy. For excessive exercisers, though, working out becomes the first priority. They also tend to have intense feelings, such as “I’ve got to do it” and “I can’t miss my workout;’ Fassihi explains.
Even though there are no hard-and-fast rules, here are some questions and red flags that can help you determine whether you’re exercising excessively.
1. Do I exercise because I enjoy it or because I feel I have to?
2. Do I work out when I’m injured or ill?
3. Do other people express concern about how much I exercise?
4. Do I take days off to rest?
5. Do I blow off friends, family, schoolwork, or other commitments to work out?
Look for these red flags:
[check] constant thoughts or conversation about exercise exhaustion
[check] constant soreness, stiffness, or pain
[check] missed menstrual periods
[check] depression or irritability from missing a workout
[check] neglect of other commitments
[check] need to work out despite illness or injury
[check] need to hide exercising from family and friends
* Have students state whether they believe exercise is always healthy.
* What health problems can exercise addiction cause? (fatigue, hair loss, fainting spells, loss of menstrual periods, dehydration, malnutrition, overuse injuries, bone weakening, stress fractures, heart complications and death, poor self-image, and relationship problems)
* What are the signs of overexercising? (People may center their lives around exercise; get upset when they miss a workout; exercise through exhaustion, pain, or illness; and neglect commitments and other people.)
* Understanding Exercise Addiction: A Teen Eating Disorder Prevention Book, by Marlys Johnson (Rosen Publishing Group, 1999)