Drugs, booze, fags…and exercise?

Why do people become addicted to sport?

Eneko Larumbe Zabala, a Spanish sport psychologist and editor of the Spanish publication Revista de Actualidad de la Psicologia del Deporte, says people can be addicted to sport for the same reasons they have other types of addiction: “It's not the addiction itself, but personal needs, expectations, and frustrations that maintain addictive behaviour. The addictive conduct could be thought of as the tip of the iceberg, the way in which it manifests as a problem, but it is nevertheless more important to get to the root of the problem, which will be different in every case.”

Self esteem, exaggerated motivation, and distorted body image can all be psychological aspects of exercise dependence. Zabala says that there can be many other advantages to spending hours in the gym cultivating your body--to excel in a sport or activity and to gain social recognition and a feeling of superiority. On the other hand, some people try to compensate for deficiencies within their game by training to excess, eventually injuring themselves.

Attila Szabo, senior lecturer in sport and exercise psychology at Nottingham Trent University, says that dysfunction implies that exercise can be a coping mechanism, where people try to run away from their problems in the same way they might use alcohol or drugs.3 But exercising takes much more self discipline and strong determination than taking drugs and is rare in contrast to other escape behaviours.

There are theories of physical dependence to ß endorphins, the “runners' high.”4 Szabo explains that this theory is hotly disputed, with both evidence and counterevidence and thought to be unlikely. There are plausible theories of a physiological addiction, called “sympathetic arousal hypothesis.”5 This means that with regular exercise, the body has decreased sympathetic arousal at rest. This is an adaptation that causes lethargy with lack of exercise, and, to overcome this, the amount of exercise must increase.

Yet the controversy continues. Research in late 2003 was reported in the Guardian as “exercise is as addictive as booze and fags, say scientists.”6 Researchers had looked at effects in the brains of exercising mice. When the mice were denied exercise, scans showed activity in areas that were normally related to drug withdrawal.

Gonna have to face it, you're addicted to …exercise Unlike other addictive behaviours, such as smoking cigarettes, exercising starts out as something to be admired

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Harmful effects

Unlike other addictive behaviours, such as smoking cigarettes, exercising starts out as something to be admired. Once it takes control of a person's life is when it becomes harmful. Starting as perhaps an “organising principle,” exercise takes priority over work and relationships. It becomes a preoccupation. Then the “high” becomes less of a high and needs more activity to sustain it. Eventually, depression, anxiety, and sleep disturbance begin to become symptomatic. Then behaviours can change, and people can be devious, defensive, and secretive about exercising. All of this is rationalised in the mind of the addict.

And there are physical dangers to overexercising. Stress fractures and damage to tendons and joints can affect adults who often, as part of the dependence, continue to exercise despite their injuries. In adolescents who exercise during a growth spurt there may be overstimulation of the growth plate leading to a tightening of the muscles and ligaments putting both these structures at risk of injury as well as the now stressed joint.

Secondary exercise dependence

Exercise dependence can sometimes be part of an eating disorder such as anorexia nervosa or bulimia nervosa. A type of “secondary exercise dependence,” it is used to control weight loss rather than be addictive in itself. Research has shown that compulsive exercise and anorexia nervosa are in fact separate entities.9

Another type of secondary exercise dependence is muscle dysmorphia, which is a form of body dysmorphia.¹⁰ Both men and women become preoccupied with their muscularity, holding perceived defects in their appearance and mount excessive responses to them. Important areas of their life are affected, such as work and relationships.

Treatment

Orthopaedic surgeons and physiotherapists see exercise dependent people in a healthcare setting because they often present with injuries.3 As with most addictive behaviours, the most important thing before starting treatment is for the patient to acknowledge the problem and want to make it better.

Zabala says most patients would benefit from treatment with a clinical psychologist with experience in treating addiction rather than a sports psychologist. Treating the cause of the problem is the key. Getting to the root of the behaviour is the only way to tackle it.

A greater danger

Addiction to exercise is rare and particularly complex. There are no current figures or statistics to show how many people are affected. David Wasley, an exercise and health psychologist at the University of Wales Institute in Cardiff, points out that the exact proportion of the exercising population is not known, and “much larger is the problem regarding the 70-80% of adults who do not exercise at an intensity to improve various health issues.”

So do not worry about your once a week gym habit escalating out of control, it is much more likely to not be enough.