For many people, exercise is an important part of a healthy lifestyle. However, in rare cases, physical activity can shift from being an enjoyable choice to a compulsive behaviour that continues despite pain, injury or exhaustion.
A new international review, led by Dr Bhavya Chhabra of Eötvös Loránd University (ELTE) in Budapest, examined decades of research on exercise addiction and concluded that while the condition is real, it is often exaggerated in both studies and public discussion.
When exercise stops being a choice
Researchers define exercise addiction as a loss of control over physical activity, where a person feels compelled to continue training regardless of the consequences.
"The key difference is whether exercise is a choice, or something a person feels compelled to do," said Professor Zsolt Demetrovics of Flinders University.
People affected may continue exercising through injuries, illness and extreme fatigue, treating physical activity as an obligation rather than something they enjoy.
A concept debated for decades
The idea of exercise addiction has been discussed for more than half a century.
Early research in the 1970s found that regular exercisers often experienced anxiety and restlessness when they stopped training. Some experts described running as a form of "positive addiction", while others warned that the same psychological pull could encourage people to ignore serious injuries.
Today, researchers generally identify exercise addiction through a combination of dependence and compulsion, alongside characteristics commonly associated with addiction, including tolerance, withdrawal symptoms and relapse.
They also distinguish between two forms: one in which exercise itself becomes the central problem and another in which excessive exercise serves another purpose, such as weight control.
Prevalence estimates vary widely
Research findings on how common the condition is differ substantially.
Some studies have suggested that as many as 42% of certain groups of exercisers may be at risk of exercise addiction.
However, broader evidence paints a less dramatic picture. A survey involving 3,760 exercisers from 15 countries found that around 9.5% showed signs that might place them at risk.
The review's authors argue that genuine exercise addiction appears to be considerably rarer, possibly affecting closer to 0.5% of the population.
Endurance athletes face greater risk
Risk appears to be concentrated in certain groups.
Endurance athletes recorded the highest rates, with nearly 14% identified as being at risk, substantially above the levels found among team-sport participants, gym-goers and power athletes.
Cultural differences may also play a role. One study found that 21.86% of Indian exercisers screened as being at risk, compared with 5.38% of Hungarian exercisers.
Research into gender differences remains inconclusive, with some studies reporting higher rates among men while others found little or no difference.
Why figures may be overstated
One reason for the wide variation in estimates is the way exercise addiction is measured.
Researchers note that more than 30 different screening questionnaires are currently in use, with no universally accepted standard.
Professor Attila Szabo of Széchenyi István University said that screening tools can highlight potential concerns but cannot provide a clinical diagnosis.
As a result, highly motivated athletes and committed fitness enthusiasts may be incorrectly classified as addicted when they are simply disciplined and dedicated.
The review warns that healthy exercise habits can sometimes be pathologised because of this overlap.
Links to mental health and eating disorders
The research suggests that the roots of exercise addiction often lie beyond exercise itself.
Experts say excessive training may become a coping mechanism for stress, anxiety or depression, rather than a source of enjoyment.
Social pressures related to body image and performance can also contribute.
In many cases, excessive exercise is associated with eating disorders and other compulsive behaviours. According to the review, exercise addiction appears about 3.5 times more frequently among people with eating disorders.
Recognising the warning signs
The review identifies several indicators that exercise may be becoming problematic.
These include continuing to train through injury, experiencing guilt or anxiety when missing workouts and repeatedly prioritising exercise over relationships, work responsibilities or recovery.
Researchers stress that these warning signs can sometimes resemble healthy dedication, making accurate identification difficult.
Treatment and recovery
There is currently no treatment specifically designed for exercise addiction, and the condition is not formally recognised in major psychiatric diagnostic manuals.
The strongest evidence to date supports cognitive behavioural therapy (CBT), which focuses on changing unhealthy patterns of thinking and behaviour.
Other approaches, including mindfulness practices and replacing some exercise sessions with alternative rewarding activities such as volunteering or creative hobbies, may also help.
Importantly, recovery does not necessarily mean giving up exercise altogether. Instead, the objective is to restore a balanced and healthy relationship with physical activity.
A balanced approach to fitness
Researchers say the findings should not discourage exercise but rather encourage a healthier perspective on it.
Their advice is to include adequate rest and recovery, focus on overall wellbeing rather than appearance or performance, and seek support if exercise begins to feel like an obligation rather than a personal choice.
The study was published in the Journal of Behavioral Addictions.
Source: Earth.com
