Fitness + Well-being

Addicted to exercise? 10 signs you're at risk

Exercise has been associated with a slew of positive health effects, like having more energy, getting better sleep, and helping to prevent health conditions like heart disease. Thanks to those benefits, many people at least try to work out regularly (although, of course, sometimes life gets in the way). But one woman wants people to know that there are also serious potential health problems if you regularly overdo it at the gym.

Katherine Schreiber, 28, tells ABC News that she started to exercise as a teenager to combat body image issues. "If I exercised, I could control that feeling," she said. Schreiber started out exercising twice a week, but it quickly spiraled out of control. Eventually, she was exercising three times a day.

Schreiber said she also developed an eating disorder, which she received treatment for in college, but her compulsive exercise habits were never addressed. "No one knew how to treat that back then," she said.

And so, her workout obsession continued after she graduated. "I was functional on paper," she said. "[But I] would go to the gym before the office, [on my] lunch break, and after work. My weight was dangerously low." Schreiber said she was so driven to work out that she had “no social life.” Finally, Schreiber’s frequent workouts started to cause [health issues](http://www.self.com/story/common-athletic-injuries) — her period stopped for two years and she had stress fractures in her feet and herniated discs in her spine.

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She’s now undergoing treatment and coauthored a review in The British Medical Journal with researchers from Jacksonville University and High Point University in North Carolina to alert people to the dangers of exercise addiction.

Exercise addiction is not officially recognized as a mental health disorder by the Diagnostic and Statistical Manual of Mental Disorders, but it's still a devastating condition.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association that lists all classifications of mental disorders. Just because exercise addiction is not in the DSM doesn’t mean a compulsive need to exercise isn't a very real issue, Simon Rego, Psy.D., chief psychologist at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, tells SELF. “A lot of people are writing about how to conceptualize this,” he said. Much like with sex addiction, the semantics of the term used to describe this condition vary, but the people who exhibit symptoms still need help.

In general, people with an exercise addiction are driven by persistent compulsion to work out. “They feel unable to resist doing it," Rego said. That can lead to them developing a tolerance and needing more exercise to get the same desired physical or mental effects, psychologist Paul Coleman, Psy.D., tells SELF. They also can’t cut back — if they try, they fail. “Most importantly, the person's exercise regimen has negative consequences that they overlook or rationalize,” he said. “It is actually harming them in some way, but they continue to work out excessively anyway.”

Another main indicator that someone has crossed into potential exercise addiction is when it interferes with the normal and essential functioning of their life, John Mayer, Ph.D., a clinical psychologist and president of the International Sports Professionals Association, tells SELF. That can include their ability to perform basic responsibilities and take care of their physical health, but it can extend beyond that, he said. Addicts tend to lose sleep and often alienate friends and family because they will give up social events in order to make sure they get their exercise, Coleman said. They may even limit their vacations to certain spots or hotels so that they can be guaranteed to follow their exercise regimen.

Of course, this is completely different than simply loving to exercise. Competitive athletes, for example, may work out excessively but they typically know how to take care of themselves and slow down or stop exercising if they think they might be overdoing it. Exercise addicts will often either push themselves to the point of injury or suffer withdrawal symptoms like anxiety and stress if they can’t work out as much as they feel they need to.

Since exercise addiction isn’t an official mental health disorder, it’s difficult to know how common it is.

But a survey of more than 6,000 people in Denmark, Hungary, Spain, the U.K., and U.S. published in the journal Sports Medicine Open estimates that symptoms of exercise addiction range from 0.3 to 0.5 percent in the overall population, and 1.9 to 3.2 percent among people who exercise regularly.

Certain people are more at risk for developing exercise addiction than others. Those with body image problems, low self-esteem, lack of confidence, and an addictive personality in general are at a higher risk than those without, Mayer said. Exercise addiction can also be associated with an eating disorder, Rego said. In fact, Schreiber's review even identified two different types of exercise addiction: primary, which is not associated with eating disorders, and secondary, which is seen in people with eating disorders as a way to control their weight.

Either way, a compulsive need to exercise can wreak havoc on a person's life.

If you suspect that your workout habits have ventured into a potential addiction or you’re worried about a loved one, Mayer said it’s important to seek help from a mental health professional who is experienced in addictive disorders. But Coleman points out that it’s often friends or family members that notice the addiction. “The addict may actually see no problem in what they are doing despite injuries, being late for work or important meetings, and having relationship squabbles,” he said.

How often you work out is worth considering, but Rego said it has to be placed in the context of what’s driving it and whether there’s a sense of control affiliated with it. “Do you feel like you cannot resist the drive to exercise? That’s when we get into the definition of a compulsive behavior,” he said.

Therapy is often helpful when treating a compulsive need to exercise because an addict will likely have a difficult time stopping on their own. Coleman said it can be helpful to undergo cognitive behavioral therapy, in which a mental health professional attempts to change a person’s negative thoughts and actions into something more positive. “Helping the person to reduce exercise frequency and intensity is essential,” he said. “Addicts will resist that but must learn how to make do with less exercise and discover they can be happy anyway.”