EXERCISE ADDICTION

MARY ANNE COHEN, LCSW

A NEIGHBOR OF MINE CHALLENGED HER OVERWEIGHT HUSBAND TO LOSE WEIGHT, AND SO SHE BOUGHT HIM AN EXERCISE TAPE. HE RESPONDED CHEERFULLY, “GREAT! I’LL LISTEN TO IT IN THE CAR AS I DRIVE TO WORK!” WE ALL HAD A GOOD LAUGH AT THE LENGTHS HE WENT TO AVOID EXERCISE.

Americans have a complicated relationship with exercise. Mark Twain once declared, “Whenever I feel the urge to exercise come on, I lie down until it passes.” This comment is echoed by Lucy, from the comic strip Peanuts, “Exercise is a dirty word — every time I hear it, I wash my mouth out with chocolate.”

We are amused by these remarks because we all recognize that avoiding exercise is not healthy and that daily exercise benefits us greatly. We burn calories, discharge stress, improve our circulation, and lower our blood pressure; we sleep better and feel a sense of wellbeing from challenging our bodies.

So we then ask ourselves: If exercise is good, shouldn’t more exercise be better?

Not necessarily! Sometimes exercise becomes too much of a good thing. Instead of being a supportive friend, it becomes our worst enemy. Ellen represents the opposite side of the coin from healthy exercise. Ellen sets her alarm for 5:30 A.M. to go out running before school, she plays tennis five days a week, and works out on her treadmill most nights. Ellen cannot stop exercising even when she is tired or sick.

She is one of a growing number of women and men who has developed an exercise addiction. Because we hold exercise in such high esteem, we admire and envy those who devote great amounts of time to working out. Keeping fit has become a national pastime, and we often don’t realize when we, or someone we care about, is out of control with exercise.

Many terms have been put forth to describe behavior like Ellen’s: compulsive exercise, exercise bulimia, or exercise abuse.

Exercise is considered excessive:

1. When it significantly interferes with important activities. Marie often skipped family parties because she had to go to the gym. Sometimes she also cancelled going out with friends in order to finish her workout routine.

2. When it occurs at inappropriate times. In the throes of her addiction, Suzanne exercised late into the night with her bedroom light turned off. While her family slept, she was doing crunches.

3. When it occurs in inappropriate settings. Jessica, another exercise addict, ran in Prospect Park before sunrise — while it was still dark — despite the potential danger.

4. When the person exercises despite injury or other medical complications. Jeff had developed a stress fracture from jogging but continued despite increasing pain. Stacey developed a painful “tennis elbow” but felt compelled to keep playing.

5. When guilt, anxiety, or depression occur if a workout is missed. Exercise addicts use workouts to cope with depression or anxiety, and they experience guilt and distress if unable to perform their exercise ritual.

6. When the person does not take any days to rest or recover between workouts. The driving compulsion to keep exercising prevents the person from moderating their routine to allow the body a chance to recuperate.

Compulsive exercise has little to do with the pleasure of movement and health. Its roots lie in struggles around self-esteem, perfectionism, and control. Marsha described an inner pressure to continue her strenuous jogging regime despite having injured her knee. She had created a punishing routine for herself that was wearing her out but she couldn’t stop. Unlike most exercise bulimics who just want to be left alone to practice their compulsion, Marsha was exhausted and came to therapy to figure out how to help herself.

During the course of her therapy, Marsha expressed deep anxiety about her aging father’s impending death. She felt powerless and out of control to rescue him from his illness but, while jogging, she would find temporary relief from her worry about him. “I feel on top of the world when I’m jogging. But afterwards my body aches and I feel empty inside.” As a teenager, Marsha worried about being fat and had gone on fasts and liquid diets with a brief period of anorexia. We discovered this occurred around the time her grandmother was dying. It was very helpful for Marsha to see her pattern — the loss of someone she loved made her reach for something to take away her pain. Focusing on dieting or fat or calories or weight or exercise presents a temporary sense of control over painful feelings.

As Marsha moderated her workouts, she lost the escape from her fears that jogging provided. She became more depressed as she no longer could hide from her emotional stress. Often patients will leave therapy at this point in an attempt to avoid facing their pain. But Marsha did not “run away.” We helped her through “anticipatory grief” about her father’s looming death and also to resolve some buried guilt about her grandmother’s death that she had never faced. Although Marsha felt sadder before she felt better, she concluded, “Having the courage to face my inner demons actually made me feel stronger. My never-ending need to develop strong muscles ebbed when I felt stronger emotionally.”

If you would like support on your eating, weight, body and/or image journey, please feel free to reach out to the Mindful Eating Project. We will work with you to:

• Custom tailor an individual approach for your unique needs.
• Help you get the control for your eating back inside yourself.
• Develop and maintain healthy eating patterns.
• Regain body confidence.
• Unlock what may be keeping you stuck in your eating problems.

Schedule an initial assessment with The Mindful Eating Project, and we’ll help you determine if you can benefit from treatment. To start a confidential conversation about your eating, please contact us. Feel free to call (718) 336-MEND.

The Mindful Eating Project is a division of The Safe Foundation.

Mary Anne Cohen, LCSW, BCD is Director of The New York Center for Eating Disorders since 1982. She is also author of French Toast for Breakfast, Declaring Peace with Emotional Eating and Lasagna for Lunch. Mary Anne is a professional book reviewer for the largest international resource for eating disorders.