Compulsive Exercise: When Does Exercise Stop Being Healthy?

Woman with an eating disorder doing compulsive exercise

Contributor: Staff at Timberline Knolls Residential Treatment Center

Getting some exercise can be an excellent way for many adolescent girls and women to improve their health. But if a girl or woman is struggling with an eating disorder, exercise may play a more complicated role in her life. Compulsive exercise is an eating disorder symptom that affects many adolescent girls and women, turning a healthy activity into a behavior that can be devastating to their health and ability to function.

What Is Compulsive Exercise?

The Journal of Eating Disorders notes that experts do not currently have a widely agreed-upon definition of compulsive exercise, but studies suggest that there are several factors that characterize this eating disorder symptom.

Experts originally thought that weight and body image concerns were the primary reasons adolescent girls or women exercise excessively when they are suffering from an eating disorder. However, additional research has revealed that many girls and women who have eating disorders exercise excessively to relieve feelings of anxiety or distress or to avoid negative or overwhelming emotions.

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Psychology of Sport and Exercise likens compulsive exercise to substance use disorders, noting that some people who struggle with this eating disorder symptom first develop a tolerance by needing to exercise more to experience the same effects they did when they first started working out. Many suffer from withdrawal symptoms, such as guilt, depression, anxiety, irritability, or restlessness, if they don’t exercise regularly.

As the behavior continues, a girl or woman may exercise more frequently and for longer than she intends to, and may be unable to stop even if she wants to. She may reduce other activities in her life so that she can fit in more time to work out and might feel a powerful drive to exercise even if she is ill or injured, or her exercise schedule is interfering with her day-to-day life.

This shows that compulsive exercise involves far more than concerns about weight or physical appearance, although these can be factors that influence the drive to exercise as well.

How Common Is Compulsive Exercise?

Because compulsive exercise impacts women and adolescent girls who are struggling with different types of eating disorders, it can affect them at varying rates. Psychology of Sport and Exercise has found that up to 80% of people who have anorexia nervosa and up to 40% of people who have bulimia nervosa report exercising excessively.

Lady doing compulsive exerciseAnd in a study of 166 adults who have ongoing eating disorder concerns, Frontiers in Psychology found that 80% struggled with compulsive exercise. When broken down by eating disorder type, 67% of those who reported compulsive exercise concerns also had anorexia nervosa, while 43% had bulimia nervosa and 52% had an eating disorder not otherwise specified.

The Journal of Eating Disorders has reported similar rates, noting that up to 45% of adults who have an eating disorder struggle with compulsive exercise, while up to 80% of adults who have a restrictive type of anorexia nervosa engage in compulsive exercise.

What Is the Impact?

Exercise is known for its health benefits, but when the drive to exercise stems from an eating disorder, it can do more harm than good. Like other eating disorder symptoms, compulsive exercise can be isolating, pulling girls and women away from their friends and family as they struggle with the urge to work out even if it’s damaging their relationships.

The compulsion to exercise can also interfere with other areas of a person’s life, including her schoolwork, job, or tasks around the house. Focusing on her exercise regimen can keep her from maintaining her regular routine or successfully performing at school or work, so her grades may start to drop, or she may lose her job.

The effects of compulsive exercise can also be devastating to an adolescent girl’s or woman’s physical health as she pushes through the pain of injuries or illness. And these effects can also extend to her mental health, with women and adolescent girls who engage in compulsive exercise at a much higher risk for suicidal thoughts and actions.

But, like other eating disorder symptoms, compulsive exercise is treatable. By finding a treatment facility that tailors her care to her individual needs and treatment goals, a girl or woman can achieve lasting recovery from compulsive exercise and the eating disorder that has disrupted her life.


Resources:

[1] Harris, A.; Hay, P.; and Touyz, S. (2020). Psychometric properties of instruments assessing exercise in patients with eating disorders: a systematic review. Journal of Eating Disorders. 8, 45. https://doi.org/10.1186/s40337-020-00315-2.

[2] Scharmera, C.; Gorrell, S.; Schaumberg, K.; and Anderson, D. (2020). Compulsive exercise or exercise dependence? Clarifying conceptualizations of exercise in the context of eating disorder pathology. Psychology of Sport and Exercise. 46. https://doi.org/10.1016/j.psychsport.2019.101586.

[3] Vrabel, K. and Bratland-Sanda, S. (2019). Exercise obsession and compulsion in adults with longstanding eating disorders: Validation of the Norwegian version of the compulsive exercise test. Frontiers in Psychology. 10, 2,370. DOI: 10.3389/fpsyg.2019.02370.


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At Timberline Knolls Residential Treatment Center outside of Chicago, Illinois, we provide specialized care for women and adolescent girls who are living with eating disorders, substance use disorders, and various mental health concerns. Our residential treatment and partial hospitalization programming (PHP) help our residents achieve lifelong recovery by combining clinically excellent treatment with spiritual and emotional growth. We provide care that is holistic, personalized, and nurturing, empowering women to be active participants in their wellness journeys.


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Reviewed & Approved on October 5, 2020, by Jacquelyn Ekern MS, LPC
Published October 5, 2020, on EatingDisorderHope.com

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.