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Addiction to exercise

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1745 (Published 26 April 2017) Cite this as: BMJ 2017;357:j1745
  1. Heather A Hausenblas, professor of kinesiology1,
  2. Katherine Schreiber, patient with 10 years’ experience of living with exercise addiction2,
  3. James M Smoliga, associate professor of physiology3
  1. 1Department of Kinesiology, School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare Sciences, Jacksonville University, Jacksonville, FL 32211, USA
  2. 2New York, USA
  3. 3Department of Physical Therapy, High Point University, High Point, NC 27268, USA
  1. Correspondence to: H A Hausenblas hhausen{at}ju.edu

What you need to know

  • Addiction to exercise might form part of a broader eating disorder or may occur in isolation

  • Inability to stop or reduce exercising, for example in response to an injury, may indicate addiction

  • Treatment broadly follows the principles of treating other addictions, for example cognitive behavioural therapy and exercise reprogramming

Author’s story

By the time KS entered college, her world revolved around the gym. No sooner would she finish a lecture than she would dash to the campus fitness centre. She would feel anxious if she missed a workout and would go no matter how tired or busy she was. Travelling was very difficult because of her obsessiveness about her exercise routines. She lost many friendships and career opportunities because she was barely available outside her exercise schedule. By the time she was 26 years old, KS had weathered two herniated discs and a stress fracture and had persistent exhaustion.

Exercise has numerous health benefits and is generally viewed as a positive behaviour,1 so patients and clinicians may overlook the dangers of excessive exercise and addiction. This article explores how healthcare professionals can recognise and understand the risks of primary exercise addiction.

Details of literature search

We searched PubMed and PsychINFO using the terms “exercise addiction,” “exercise dependence,” and “excessive exercise” for systematic reviews and experimental, cross-sectional, and case studies. The overall quality of the evidence for this area is modest with a reliance on descriptive and observational studies. Few controlled trials and experimental designs exist.

What is exercise addiction?

People with exercise addiction experience loss of control such that exercise becomes an obligation and excessive.23 Although exercise addiction is not officially classified as a mental health disorder, it is characterised by similar negative effects on emotional and social health as other addictions. Primary exercise addiction differs from excessive exercise seen in people with eating disorders (also known …

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