A scroll through the #fitfam or #fitspo posts on Instagram will reveal countless images of gym buffs grappling with kettlebells, before-and-after transformations and motivational quotes. If you’re an avid exerciser, perhaps they inspire you to work out harder and longer, to try new moves that will lead to a more defined body, to exercise every day. But where does being fit, healthy and strong end, and an unhealthy attachment to exercise begin?
"Exercise addiction" used to be a relatively innocuous term – a jokey way of saying that you loved exercise – but now it’s a recognised problem and the British Medical Journal has even published a piece about how to recognise and treat it.
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According to an Italian study, people who strongly identify as an exerciser and have low self-esteem are at a higher risk of developing an addiction. Women are more likely to suffer from secondary exercise addiction, meaning that it’s associated with an eating disorder. Over 40% of the 120 gym-goers who completed the study were found to be at risk.
What are the signs?
Those with exercise addiction might exercise even when they’re ill or tired. They might miss out on social or family occasions so that they can exercise. They might feel anxious and irritable if they can’t work out or they might exercise to the point that they experience physical injury, such as a stress fracture. They have an inability to stop or reduce their levels of exercise.
But plenty of people love exercise and train to a high level without a problem. So where does the boundary lie between healthy and unhealthy? "The difference is that a compulsive exerciser works out not to feel good, but to avoid feeling bad," says Dr. Carolyn Plateau, a Loughborough University psychology lecturer who specialises in compulsive exercise. "They rely on it for mood regulation, may get feelings of guilt, failure or anxiety if they don’t exercise, and tend to have a very rigid routine. It comes above all else – exercise will always take priority."
Polly Hale, 33, agrees. In her late teens and early 20s, she was addicted to exercise alongside having anorexia. She attended dance school, where image was all-important, and during the holidays she would exercise compulsively, seeing it as a way to burn as many calories as she could.
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"I started cutting down on the calories I ate," she says, "but I would also take any opportunity to exercise, such as walking everywhere (even if it took hours) or dancing without stopping all night at a club. If I was away with my family, I would have a strict regime of strength exercises to do. My motives were all wrong. I wasn’t exercising to feel good or stay healthy but to stay thin, and I would get overwhelming feelings of guilt and failure if I couldn’t exercise. I lost the ability to listen to my body and pushed on through, even when I was exhausted and undernourished."
The triggers can vary. "It can be a small thing, such as a comment on your body made by a friend or family member," says Carolyn, "up to a dramatic life change such as going to university, having a perfectionistic personality where you’re always striving for high goals, or having a difficult emotional experience and exercise becomes a way of avoiding it."
"Social media can also play a role, particularly in people that use it a lot as they can lose a sense of the real world," she adds. "There has been a backlash against being very skinny; now it’s all about lean and strong. But that can be equally damaging if you’re striving for an unrealistic image of a woman with a six-pack and zero body fat – she could be training for hours a day to look like that."
And because exercise addiction is so often linked with disordered eating, the "clean eating" trend can also play a part. "Hyper-vigilance about what goes into your mouth and a focus on consuming only ‘healthy’ foods can often go hand in hand with compulsive exercise behaviours," says Carolyn.
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A problem with other people recognising it in you, or even a health professional diagnosing it, is that exercise is usually a positive thing. Where starving yourself is clearly a bad idea, we’re encouraged to exercise. "It can go under the radar if it’s not accompanied by an obvious eating disorder," says Carolyn. "It can also be disguised in much the same way as the early stages of an eating disorder – 'I’m just exercising a bit more at the moment to stay healthy'."
"Although my family could see it was part of my eating disorder, they questioned the amount of food I ate but not the amount of exercise I was doing," says Polly. "I recognised it in myself and knew that it wasn’t normal, but I couldn’t stop myself. The desire to exercise was so overpowering."
Where to get help
"The first and often the hardest step is admitting to yourself that you have a problem," says Polly. "Then you can open up to someone else and say you need help."
You can see your GP, who can refer you to an appropriate service. You could even open up to your personal trainer, who may be able to help you devise a healthier schedule and set positive goals, rather than exercising for exercise’s sake.
Treatment can include cognitive behavioural therapy and psychological help to equip you with healthier ways of dealing with negative emotions. "You wouldn’t necessarily have to stop exercising but you might be asked to reduce it or replace it with low-intensity exercise such as yoga," says Carolyn. "It’s about reformulating your attitudes to both exercise and food (if it’s associated with an eating disorder)."
For Polly, her turning point was a night at the pub in her early 20s. She had been hospitalised three times but always relapsed. "That night, one friend announced she was pregnant and another that she was getting married. Something in my head just clicked and I realised that everyone was moving on with their lives and I was going to be left behind. No one would want a relationship with me and I would never have children (my periods had stopped long ago). I suddenly wanted this thing out of my life. I worked with a dietitian to help me see food as a pleasure and as fuel, rather than unnecessary calories, and my attitude to exercise slowly changed."
Change doesn’t happen overnight but Polly proves that it is possible. She’s now a personal trainer and founded The Fit Mum Formula, helping women to learn to love their bodies, exercise and eat well because they want to look after themselves. She’s also married with two children. "It took me about five years to fully recover, but I now exercise and eat well because I want to enjoy life, and I appreciate what it feels like to be strong and healthy, rather than thin and exhausted."
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