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David Baxter PhD

Late Founder
Obsession with exercise can become disorder
By Anissa Orr

Are you exercise obsessed or just an avid exercise enthusiast?

That depends on your attitude, say mental health experts. If you exercise frequently because you enjoy it and you like the health benefits it provides, you have the right reasons in mind. If you exercise because you feel compelled to do so and in spite of having injuries, you may be at risk for developing an exercise disorder.

"There is no set formula or standard that reveals how much exercising is too much," said Theresa Fassihi, Ph.D., assistant professor of psychiatry and behavioral sciences at Baylor College of Medicine and a psychologist with the Eating Disorders Program at The Menninger Clinic. "But if exercising is interfering in a person's life and it is compulsory, then it may be a problem."

Who is at risk?
Fassihi treats patients in the Eating Disorders Program who overexercise in an attempt to burn off calories, build muscle or attain physical perfection. It is common for patients with exercise disorders to also have an eating disorder, Fassihi said. Problems occur when body perception doesn't match reality.

People involved in activities or professions that require physical beauty or high levels of physical performance ? such as athletes and dancers ? are particularly vulnerable to developing exercise disorders. High achievers with perfectionist personalities are also vulnerable. Both men and women can have an exercising disorder, but they often have different goals for their exercise regimens. Women seek the "lean look" and typically exercise aerobically to become thin. Men want to bulk up and lift weights to increase muscle mass.

"If you have an exercising disorder, you also may be very preoccupied about your body's appearance, weight and muscle mass," Fassihi said. "You spend a lot of time looking at yourself, scrutinizing yourself, measuring yourself and constantly working out to create the muscle mass or lean body that you want."

Distorted body image, also called body dysmorphia, is a common component of an exercising disorder. Persons with body dysmorphia have a distorted view and exaggerated vision of their appearance ? thin women may think they are too big, and muscular men may think they are too scrawny. The obsession with being too small or frail is a subtype of body dysmorphia called muscle dysmorphia, nicknamed bigorexia, which is most common in men.

Effects of overexercising
Many people with exercise disorders also restrict their calories, based on the mistaken belief that they will build a higher proportion of muscle if they restrict their food intake while exercising, Fassihi said. Instead, they lose both muscle and fat, putting their health at risk.

"Overexercising can cause significant damage to the body," Fassihi adds. "It can increase the risk of injuries for both men and women. Women may be more at risk for osteoporosis if they are overexercising and restricting their food intake, and they may stop menstruating completely. Men may use steroids and protein powders to help them achieve their goals, leading to other health problems."

Overexercising can also cause stress fractures and constant repetitive exercise can cause wear and tear on the body's muscle, bones and joints ? in severe cases making joint replacement surgery necessary at a young age.

Treating the problem can be complex
Many who overexercise are reluctant to admit their behavior is problematic, Fasshi said. Exercise provides them with a sense of control, power and, in some cases, superiority. Exercise also relieves anxiety and releases endorphins, which provide a sense of euphoria. Because of the positive aspects of exercise and its value in an achievement and appearance oriented-society, treatment for exercise disorders can be difficult.

"If you give up an addiction that is bad for you, you give it up cold turkey. However, you can't give up exercise completely, because it is healthy," Fassihi said. "You want to learn how to exercise moderately in a healthy way. That's very tough without help from a professional."

Staff members with the Eating Disorders Program at Menninger work with patients who overexercise to help them recognize normal levels of exercise. At the beginning of treatment, patients are limited to the mildest physical activity, such as walking, in an attempt to increase their body weight to normal levels. As treatment progresses, patients may increase their amount of exercise. By the time they leave Menninger, patients are exercising moderately every other day, for about four hours a week.

Patients discover toll of overexercising
Men and women also learn to confront their anxiety about not exercising and learn other methods to help them relieve their anxiety ? like relaxation and breathing exercises. They may also participate in a body image group to identify negative beliefs they have about their bodies and how to dispute those beliefs.

With treatment, patients realize the toll that overexercising has taken on their lives.

"Overexercising interferes with their quality of life because they devote so much of their time to exercise to the exclusion of anything else," Fassihi said. "Their time is not available for socializing, relationships or work. It is all consuming."


This is interesting, I just read an article in a newsletter from a CBT based organization that seeks to help people overcome addictive behaviors, and there was an article in there from a psychologist about substituting one addiction for another and how sometimes that is the more realistic thing to do then seek total indepedence. They compared lots of addictions, one was exercising, as being less harmful than some others (e.g. alcohol). It also said that even when people don't admit it, they typically start engaging in some type, like smoking or coffee. So, anyway, not sure what I think about that, but I can see where it can happen easily. If one must fixate on something, pick something the least destructive I guess.


"Men may use steroids and protein powders to help them achieve their goals, leading to other health problems."

Protein powders??

Question: Can they alone be unhealthy or lead to health problems?

I would consider myself an "avid exercise enthusiast". And I occasionally take protein powders in a drink, but I never touch steroids.


I don't think that the occasional use of protein powder in a drink is, necessarily, harmful. As long as you're careful to eat a balanced diet and take a good multi-vitamin daily to replace any needed nutrient you might have missed, you should be just fine. :)
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