A patient with 10 years’ experience of living with exercise addiction tells her story in The BMJ this week to help doctors better recognise and understand the risks.
Katherine Schreiber’s contribution is part of The BMJ’s aim to encourage doctors and patients to work together to improve healthcare.
By the time Katherine 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 - and she lost many friendships and career opportunities because she was barely available outside her exercise schedule.
At 26 years old, she 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, so patients and clinicians may overlook the dangers of excessive exercise and addiction, say Heather Hausenblas, Professor of Kinesiology at Jacksonville University in Florida and James Smoliga, Associate Professor of Physiology at High Point University in North Carolina.
Exercise addiction should not be confused with a high level of commitment to a physical activity or a healthy habit, they write.
But if the patient expresses a reluctance to take time off of exercise, demonstrates frustration and irritability when advised to reduce exercise, and reports exercise getting in the way of work and personal relationships, or if the patient discloses having tried to cut back on exercise but repeatedly failed, exercise addiction is likely.
Several screening tools are available to determine risk of exercise addiction and severity of symptoms, but they suggest diagnosis should be based on clinical judgement.
They outline questions to ask and treatments to consider, but say the goal of therapy is not to prevent the patient from working out, “but to help them recognise the addictive behaviour and reduce exercise routine rigidity.”
Further investigations may be warranted, they add. For example, involve a dietician if the patient is concerned about his or her weight or consider referral to a psychologist, psychiatrist, or social worker trained in managing patients with behavioural addictions if emotional and interpersonal disturbances are noted.
Note to Editors
Practice: Addiction to exercise https://www.bmj.com/content/
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