Are you addicted to exercise?
Experts acknowledge that compulsive training can be harmful in its own way. So how do you know when you've crossed the line from healthy habit to harmful obsession?
Last year, fitness blogger Erin Thomas - aka 'Queen City Sweat' - took to Instagram to show her followers what happens when a healthy habit metamorphoses into a harmful addiction.
Thomas posted two photographs - side by side - and the contrast was striking, (pictured below).
In the first photo, taken in a gym mirror, the blogger looks gaunt and sinewy. In the second photo, taken almost a year-and-a-half later, she has gained a little weight and reclaimed her vitality. She looks healthier and, in her own words, happier.
"I was not eating close to what I should've been eating and ended up with a severe case of anemia, causing a lack of energy to the point where I could barely get out of bed," she admitted in the post. "Yet, I still forced myself to go to the gym, although I felt like a zombie.
"I was addicted to working out and was running myself into the ground."
Addiction isn't a word you hear too often in 'Fitspo' circles, where 'harder, better, faster, stronger' is the unofficial mantra. But things are beginning to change, and with women like Thomas sharing their stories on social media, the often trivialised concept of exercise addiction is starting to be taken seriously.
Exercise addiction is not a formally recognised mental health disorder, but many experts consider it to be a behavioural or process addiction, which is defined as a compulsion to continually engage in behaviours despite the negative impact on one's life.
"Neither the DSM-5, (Diagnostic and Statistical Manual of Mental Disorders), or the ICD-11, (International Classification of Diseases), have accepted exercise addiction as a real construct and that is because there isn't enough empirical research done," explains Professor Colin O'Gara, consultant psychiatrist and Head of Addiction Services at Dublin's St John of God Hospital.
"With regards to clinical presentations for ourselves - and I think this would reflect nationally - this is a very minor presentation at present and I think the reason for that is because of the general lack of awareness around exercise being an addiction."
For Tadhg MacIntyre, chartered sport and exercise psychologist and lecturer in the Physical Education and Sport Sciences Department in Limerick, exercise addiction is not about the dosage or the physical activity per se. "It's this pattern of behaviour and the fact that they are over-identifying with this one facet of their lives," he explains.
However, there are certain activities that exercise addicts are more likely to partake in, he adds. "They typically become addicted to low-skill, high intensity or low-skill endurance activity. And this can be anything from HIIT sessions to aerobics to long-distance running.
"They become behaviourally addicted so that exercise rules their life and becomes their only means of not just stress reduction, but stress regulation."
"It allows them to control their emotions," he continues. "And the issue is that it's basically the only key they have to unlock their emotional world in a healthy way."
Exercise addicts can also have addictive personalties, says psychotherapist Emma Doyle of MyMind. "They will lose one addiction and then cling on to another," she explains. "It isn't the worst thing in the world for somebody who was once going out drinking all the time, but they need to look at the compulsion around it."
Personal trainer Karl Henry is in agreement. "You'll see with a lot of the influencers online that they have gone from one extreme to another," he says.
"They were overweight and leading a bad lifestyle and now they are flying the flag for fitness and clean eating. But their approach is excessive and their posts are excessive. It's just another addiction."
"They need to focus on what is causing the addiction," he adds, "because if there is something they haven't dealt with, it's a perfect way of distancing themselves from the issue."
Henry says he has learned to spot the red flags of exercise addiction among his clients. Sometimes they want to train twice a day; sometimes they want to train seven days a week. In this scenario, he takes the client aside and suggests that they take a few well-needed days off. "Go home, relax and have a pizza", is how he puts it.
But not all compulsive exercisers are working under the guidance of a qualified personal trainer, which is why the issue can easily escalate without intervention.
MacIntyre says women who compulsively exercise are at risk of the Female Athlete Triad, a surprisingly common syndrome characterised by three factors: amenorrhea (absence of menstrual periods); osteoporosis and disordered eating.
More recent research suggests that men who exercise compulsively may go on to develop Real Energy Deficiency Syndrome (RED-S), which occurs when there is an imbalance in energy intake and energy output, and which leads to several health and performance consequences. "The men tend not to suffer from the eating disorder per se, but they have body image distortion," adds MacIntyre.
Disordered eating tends to occur in the latter stages of an exercise addiction, says O'Gara. There is generally a "restriction of calories, and a loss of insight into the fact that the BMI has gone way down", and this is sometimes coupled with the use of steroid injections, stimulants, pre-workout supplements, amphetamines and excessive amounts of caffeine.
The long-term consequences can be devastating, but still we labour under the delusion that if a little exercise is good, more must be better.
The trivialisation of over-exercising with terms like 'fitness fanatic' and 'gym bunny' doesn't help matters. "One of the adages over the last few years is 'strong is the new skinny'," says MacIntyre.
"Actually, that's a distorted and maladaptive adage because it basically says we are what our body is. Our identity shouldn't be wholly determined by our physicality."
Another bugbear for MacIntyre is the ubiquitous mantra about nobody every regretting a workout. "That's not true," he says. "Loads of people [regret a workout] either because they are injured or distressed, or because it's part of compulsion."
"I'm wary when people say that exercise is a huge panacea," he adds. "It's more about achieving a degree of positive change in terms of lifestyle, but often we go at it too quickly. And the people who go at it too quickly are the people most at risk."
Compulsive exercisers often look up to fitness role models who promote a monomaniacal approach, adds MacIntyre, who believes we need "more positive role models talking about how sport is just one piece of the jigsaw".
His sentiments are echoed by Dr Mary Rose Sweeney, Senior Lecturer in the School of Nursing and Human Sciences in DCU. Earlier this year, she spoke out about the perils of taking inspiration from online fitness bloggers, especially those who don't have the same commitments as the average working parent.
"The average members of the public have to work or rear families," she said. "They have responsibilities. They can't obsessively exercise.''
Indeed, anyone stuck on the Fitspo treadmill ought to remember that the Victoria's Secret pre-show training routine is regularly described as 'Olympian'.
This isn't to say that young women are the only group at risk. Far from it. MacIntyre brings up the so-called 'Weekend Warriors' who, he says, are prone "not just to injury but to RED-S, (relative energy deficiency in sport)".
"And the reason is because they are white-collar workers or executives working very hard - say 40/50 hours a week - trying to be these Adonis-type athletes," he says. "Moving from being a Tin Man to an Iron Man - that's a big ask."
These would-be Iron Men train like professional athletes, adds MacIntyre, but they don't always prioritise recovery like professional athletes.
"That's why if they are injured they will take a short break, but not long enough," he explains. "So then they will get re-injured and they will suffer huge anxiety and withdrawal symptoms. And this isn't an insignificant part of the population, the people that do this."
Feeling anxious or guilty after missing a training session is one of the earliest signs of exercise addiction.
The language that the person uses is another giveaway, says Doyle. "Look out for people saying things like, 'I have to work out' or 'I should have worked out harder' or 'I can't go and meet you because I have to go to a class'," she says.
"That can be very debilitating for them when they are trying to benchmark themselves unrealistically, so in terms of intervention, it would be to bring awareness to what they are doing and why they are doing it."
For MacIntyre, the way out of exercise addiction isn't to cease behaviour, but to "discover new paths to well-being" and understand that fitness isn't the only outlet.
"These people feel that the only way they can feel good about themselves is by being active," he says.
"But there are many more proven paths to well-being, and we need to start promoting them."
ARE YOU ADDICTED? SPOT THE SIGNS
● Exercise and fitness goals dominate your thinking.
● You sacrifice work and commitments with friends and family in order to
● You experience anxiety, irritability and other withdrawal symptoms if your
exercise routine is disrupted.
● You continue to exercise excessively, despite injury, illness or exhaustion.
● You have symptoms of over-training, including lack of energy, decreased
immunity and muscle fatigue.
'When I can't exercise, it is really hard. You feel anxious'
Ger Copeland is a busy man - a father of three young children (aged 11, eight and six), he is also a building contractor and owns Dublin Bay Running Club. But despite these busy roles, he finds time every single day of the week to engage in several hours of exercise - because by his own admission, he is addicted to it, writes Arlene Harris.
"I would definitely say I am addicted to exercise," says the Dublin man. "I was always interested in keeping fit and then when I hit my mid-twenties I had a bit of a blip because I was living on my own and eating things like breakfast rolls, so the weight piled on and I started exercising less and less.
"I am only 5ft 6' so in 2002 when I was on holiday and a friend asked my waist size and I said it was 36 inches, I realised this was not good. I told her I could easily lose it and would be able to run a marathon in less than three and a half hours - she laughed at this. So determined to prove a point - I started trying to get fit again."
The 40-year-old says this was no easy task, but as soon as he began to see progress, he started craving more and more exercise and began entering and winning races - this further fuelled his passion and before he knew it, he was doing some form of exercise everyday.
"When I started trying to get fit again I was nearly killed after running the length of a football pitch," he says. "But I was determined and kept going. I now own Dublin Bay Running Club and East of Ireland Marathons and between taking out people on runs and doing my own training or going out with the kids, I make sure to do some form of exercise (running for several hours, cycling up to 70km, kayaking, working out) for a few hours everyday.
"I also enter loads of races and hold the record for the most marathons and ultra-marathons in Ireland - I have competed in 160 and won 73 of them, while came second or third in about 30 others. At this stage I'd say I'm as addicted to the winning, as I am the exercise and the adrenalin rush it brings."
As with any addiction, being unable to get a hit can be hard and the seasoned athlete says not being able to exercise causes problems for him.
"During the winter it can sometimes be difficult to get out, but luckily I have a Swift Trainer at home where I can race against other cyclists online," he says. "But there have been times when between one thing and another, I haven't been able to exercise at all and that is really hard. It is like having a sugar low or something like that, you feel really frustrated and very anxious to get the endorphin rush.
"But as far as addiction goes, I'd say it's not the worst of them - I'm teetotal and I don't smoke so being addicted to staying fit isn't so bad. Also I have become somewhat addicted to seeing people in the club get fitter as it gives me a great feeling to know that I have helped them to achieve something for themselves.
"So as long as I am able, I'd say I'll continue to exercise as much as possible, as I'm sure it does more good than anything else."
Health & Living