There’s fit, there’s superfit and there is out-of-control says Susan Welz.
We’ve all come across them in gyms, on the running circuit, at dinner parties the exercise addicts. At social occasions, they only really come alive when the subject turns to their favourite the Two Oceans, triathlons, the spinning challenge from 6-7.30am on Mondays.
Stories of obsessive exercising abound. Maybe it’s not fanatical to leave dinner parties at 10pm because you’re training the next morning. But you’ve got to wonder about someone who regularly does a 30km training run before dashing off to Sunday surf-ski races. Or the runners who, despite serious injuries, will go as far as injecting themselves with painkillers to finish a gruelling race.
While a distinction must be made between fitness enthusiasts and exercise addicts, researchers have, since the 1980s, been looking at exercise addiction as a distinct disorder, along with eating disorders. Similarities have been noted between exercise addiction and anorexia nervosa. According to Eleanor Nash, associate professor in the Department of Psychiatry at the University of Cape Town, these include a single-minded commitment to mastering the body, an abhorrence of fatness, a preoccupation with diet, a distorted body image and an inflexible need for rituals.
Janet Earl, a psychologist and expert on eating disorders, believes exercise addiction is becoming increasingly widespread as another form of control susceptible people would be those desperately trying to avoid uncomfortable emotional states, and striving for more control in their lives.
Earl, who is researching exercise addiction as a treatable condition, says researchers have used various labels to describe this disorder: anorexia athletica; exercise dependence and excessive exercise. Whatever it’s called, Earl believes its going untreated because it is applauded by society.
It’s seen in both men and women, but while extreme anorexia is most notable among pubescent girls and bulimics range from about 18, exercise addiction tends to occur among people of 25 or older. The definition of an exercise disorder is when exercise starts serving a psychological purpose. It’s not just done for health reasons or weight loss although it might be rationalised that way. Excessive exercising can be a way of dealing with uncomfortable emotional states an emotional anaesthetic, says Earl.
While exercise generally makes people feel better about themselves and more in control, when it becomes excessive it may be pointing to an underlying depression. This external activity often serves to make a person who feels emotionally out of control, feel as if they do actually have a measure of control.
And while a balanced exercise routine releases tension and generally gives a feel good kick, the physical effects of exercise addiction can be dire.
The primal instincts kick in. If you don’t eat all day, your body goes into famine and your metabolism slows down, explains Earl. Exercise is an addiction when the primary goal is psychological. Excessive exercising does not reduce weight and the health risks are immense. While physical problems might not be evident now, they will take their toll later. Physiotherapists are busier now than ever. The fact that emotional issues are not dealt with has serious implications.
The exercise disorder is made more difficult to deal with because it is sanctioned by society. Someone who is working out and fit is generally applauded. The addiction therefore often goes untreated because it is not seen as a problem, warns Earl.
While much is known about the benefits of exercise, the criteria to determine how much is too much, must still be established. It is clear, however, when exercise becomes obsessive: there is a rigid schedule of intense exercise; the temptation to lapse is resisted; feelings of guilt arise when the schedule is violated; people compensate to make up for lapses; they push on when tired, ill or injured, and are preoccupied with exercise and detailed record-keeping, said Earl.
Treatment is vital and focuses on the emotional world that is driving the behaviour. The excessive exercise is the visible sore. To treat the sore, we must focus on the illness that has resulted in it.
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