Exercise Addiction in Sport

Throughout sport, exercise has been universally acknowledged as a healthy habit which can have many psychological and physical benefits for an individual (Szabo & Griffiths, 2007: Bouchard, Shephard & Stephens, 1994).  Paradoxically, exercise behaviour is now being looked at in a different light due to obsessive exercise being seen as a type of addiction (Garman, Hayduk, Crider, & Hodel, 2004; Griffiths, 1997).  People who suffer with exercise addiction feel that exercise helps reduce anxiety about appearance concerns or becoming overweight (Cumella, 2005).  It has been found that exercise addiction raises endorphin levels, which in turn gives a person feelings of well being.  However, this person will also be unaware of the serious health problems that can arise from this condition as they will have a decreased awareness of physical and emotional pain (Cumella, 2005).

Baekland (1970) was one of the first people to study exercise addiction which has been replaced by different terms such as: excessive exercise, exercise dependence, compulsive exercise and obligatory exercise (McNamara & McCabe, 2012).  Glasser (1976) used the term positive addiction which looks at the positive impact exercise has on a person’s physical and psychological well being.  However this positive perception led individuals to believe that being strongly committed to their sport can be labeled as addiction.  Morgan (1979) acknowledged a problem with this definition and introduced the term negative addiction which allows people to realise that long term addiction can lead to negative consequences (Rozin & Stoess, 1993).  It has been argued that existing literature focusing around exercise addiction in fact measured commitment (Szabo, Frenkl & Caputo, 1997).  Sachs (1981) argued that committed exercisers who engage in exercise for extrinsic rewards do not view exercise as the main part of their life and do not suffer withdrawal symptoms.  On the other hand addicted exercisers who will be exercising for intrinsic rewards will see exercise as central to their life and will experience withdrawal symptoms when they stop exercising (Sachs, 1981).  It is therefore important to acknowledge the differences between committed exercisers and addicted exercisers (Terry, Szabo & Griffiths, 2004).

Along with other addictive behaviours there is no standard definition of exercise dependence (Johnson, 1995).  The definition which has gained the most interest was proposed by De Coverley Veale (1987) who recommended that there should be set standards for diagnosing dependence.  These set of standards are based on the DSM-IV diagnostic criteria for substance dependence (American Psychiatric Association, 1994). Exercise dependence must therefore be manifested by three or more of the following:

1. Tolerance: increasing the amount of exercise so that an individual can feel a desired effect from it.
2. Withdrawal: when the individual stops exercising they experience withdrawal symptoms such as anxiety and restlessness.
3. Intention effects: unable to stay to one particular routine and constantly going over the time needed to spend on a routine.
4. Loss of control: unsuccessful at reducing the time spent exercising.
5. Time: too much time is spent preparing for and engaging in exercise.
6. Conflict: social or recreational activities are given up because of exercise.
7. Continuance: Continuing to exercise even though the individual knows that it is having an affect on them physically, socially and psychologically.

To understand the addiction in more depth it is important to look at exercise addiction in relation to other disorders that an athlete can experience.  Much research focused around exercise addiction has been associated with eating disorders (anorexia and bulimia) and there is a large amount of research which shows exercise addiction as a subset of an eating disorder (Adams and Kirby, 1998: Dara, 2003).  This has been called secondary exercise dependence (De Coverley Veale 1987).  Some people with these disorders will use exercise as their purging method as it is seen as more acceptable (Cumella, 2005). As well as looking at secondary exercise dependence it is also important to acknowledge primary exercise dependence which is used to describe someone who is addicted to exercise for reasons associated with doing an activity (De Coverley Veale 1987). Within this section we have seen how problematic exercise addiction can be and what characteristics are used to identify the addiction.

In sport. athletes are constantly training and exercising to reach the top level. However, to what extent does training become an addiction to exercise and how does this affect the athlete’s behaviour?

Within addictions it is important to take into account the personality of an individual. Gossop and Eyensck (1980) examined whether there is an addictive personality type and many studies have been conducted looking at the relationship between personality and exercise dependence.  Results have shown that there is a positive relationship between exercise dependence and perfectionism (Cook, 1996), trait anxiety (Coen & Ogles, 1993) and obsessive compulsivness (Hausenblas & Symons Downs, 2002).  It is also important to understand the athlete’s behaviour of exercise addiction in relation to mood changes that will occur.  When a person is addicted to exercise their mood can be associated to the withdrawal symptoms that they would experience (Guszkowska & Rudnicki, 2012).  Studies have shown that when individuals are withdrawn from exercise they experience high levels of depression, anxiety and tension (Morgan, 1979).  Therefore an athlete might be training longer and harder to feed his perfectionist tendencies and to reduce feelings of withdrawal symptoms.

One problematic issue within exercise addiction concerns the distinguishing of healthy exercise from exercise addiction (Freimuth, Moniz, Kim, 2011).  To understand the differences Friemuth’s (2008) developed a model for distinguishing phases of addiction.  There are four stages which are broken down into three components: motivation, consequences and frequency.

Phase one: recreational exercise

A person will be taking part in recreational exercise because they find it rewarding and enjoyable.  Research has shown that in this stage individuals may be motivated to exercise to increase their levels of fitness (Thornton & Scott, 1995).

Phase two: at risk exercise

Within this stage an individual’s motivation to exercise will change from enjoyment to relief from stress.  Thornton and Scott (1995) found that exercise addiction is more likely to occur for those who exercise to escape feelings of unpleasantness compared to those who exercise to improve their health.

Phase three: problematic exercise

Problematic exercisers will start to revolve their day around their exercise programme.  During this phase the exerciser will be constantly pushing themselves to reach new limits and if they do not have control over their behaviour they will start to experience withdrawal symptoms.

Phase four: Exercise addiction

In this phase exercise becomes a persons life. The main motivation within this phase is to avoid withdrawal symptoms.  Exercise will start to have an affect on the individuals daily functioning and could start to cause problems within their social and work life.

By acknowledging the differences among each stage we are able to understand the athletes motivations, behaviours and relationship with exercise within their sport.

Within sport, not only is there coach, family and peer pressure but there is also societal pressure for an athlete to be at the peak of their physical condition.  As mentioned one of the most problematic causes related to exercise addiction is being able to distinguish healthy exercise from addicted exercise.  From a coaches perspective exercise addiction could be simply seen as over training.  Therefore coaches need to be educated on the key differences and attributes between healthy exercise and exercise addiction.  Specialists must be aware of the signs and symptoms of exercise addiction in relation with substance use disorders and behavioral addictions (MacLaren & Best, 2010)

When treating an athlete with exercise addiction it is important to take many factors into account.  Cumella (2005) identified eight treatment factors which can help a patient with exercise addiction.

1. Nutritional status: nutritionists should assess an athletes diet as they may be participating in disordered eating and lack nutritional knowledge.
2. Medical status: athletes should be assessed on current medical status.
3. Eating disorder behaviours: Individuals with eating disorders are at a high risk of exercise addiction.
4. Body image and self-esteem: individual and group interventions should be used to help an individual develop self esteem which is not focused around appearance and body image.
5. Motivation: people should understand the athlete’s motivations for recovery.
6. Cognitions and skills: to change an athlete’s attitude towards exercise, different cognitive behaviour approaches can be used.
7. Athlete specific issues: people must be aware that athletes may not want to return to their sport because of the recovery risks. In sports where there are weight categories, athletes have greater risk of relapse.
8. Healthy exercise: Once the athlete is in a healthy stable condition, education and practice in healthy exercise is key.

All of these factors show us that there are many processes which can underlie the disorder of exercise addiction.  By sport psychologists educating dieticians, coaches, sport scientists and doctors on the pressures that athletes experience they can help create a supportive environment which will allow an individual to enjoy exercising at a high level.