Exercise Addiction: Causes, Signs, And Treatment

Exercising regularly can be a healthy strategy to promote positive health and well-being. When taken too far, however, this can, unfortunately, have the opposite effect.

Exercise addiction is a condition in which a person may compulsively exercise despite negative consequences to physical health, relationships, mental health, and overall well-being.

Exercise addiction is common among people with eating disorders, but can also develop separately. With treatment, recovering from an exercise addiction is possible.

Learn more about behavioral addictions and treatment options

What Is Exercise Addiction?

Exercise addiction is a condition that can develop when a person feels compelled to engage in physical activity—usually intensive forms of exercise—and feels unable to control it or stop.

People who become addicted to exercise may neglect their work, school, and interpersonal relationships if it interferes with their exercise routine.

Who Develops An Exercise Addiction?

Exercise addiction can occur in anyone, regardless of gender, body size, age, race, or ethnicity. However there are some populations in which this condition is much more common.

People at high risk for an exercise addiction include:

• runners
• marathon runners
• competitive athletes
• fitness center attendees
• people with eating disorders
• people with poor body image
• people with substance use disorders

According to some research, exercise addiction affects between three to eight percent of general exercisers. This is even higher in competitive athletes and people with co-occurring disorders.

Exercise Addiction And Co-occurring Disorders

Exercise addiction, or compulsive exercise, is not officially recognized as a diagnosis in the Diagnostic Statistical Manual of Mental Disorders (DSM).

However, it is known to frequently co-occur with other types of mental health disorders, including eating disorders, anxiety disorders, and substance use disorders.

Exercise Addiction And Eating Disorders

Eating disorders are the most common type of disorder to co-occur with compulsive exercise.

According to some research, an estimated 39 percent to 48 percent of people with an eating disorder compulsively exercise.

Among people with eating disorders, exercise may be used to influence weight, shape, or “purge” calories ingested through the consumption of food or beverages—i.e. exercise bulimia.

It can also be a way to cope with anxiety, depression, or stress related to the eating disorder or body-related trauma.

In athletic populations, the combination of compulsive exercise and restricted eating can cause a condition called Relative Energy Deficiency in Sport (RED-S), which affects bone health, hormonal function, cardiovascular health, and immune function.

RED-S was previously known as the Female Athlete Triad but is now recognized to affect athletes of all genders. Sports medicine physicians and eating disorder specialists are the most appropriate providers for evaluation when RED-S is suspected.

Exercise Addiction And Substance Abuse

People who compulsively exercise frequently misuse substances to improve fitness performance, combat fatigue, or due to pre-existing drug dependence.

Exercise addiction is believed to commonly co-occur with:

• nicotine dependence
• illicit drug use
• alcohol use disorder
• stimulant use disorder (e.g., amphetamines, caffeine, cocaine)

According to SAMHSA’s 2023 National Survey on Drug Use and Health, approximately 48.7 million Americans aged 12 and older experienced a substance use disorder. This makes co-occurring conditions like exercise addiction more clinically significant than previously recognized.

Exercise Addiction And Body Dysmorphic Disorder

Body dysmorphic disorder, including its subtype muscle dysmorphia (sometimes called “reverse anorexia”), frequently co-occurs with compulsive exercise.

People with muscle dysmorphia are preoccupied with the belief that their body is insufficiently muscular or lean, which drives compulsive exercise patterns that may resemble or overlap with exercise addiction. This pattern is more commonly reported in men and is often underdiagnosed.

Exercise Addiction And Other Behavioral Addictions

Exercise addiction is a type of behavioral addiction. People who compulsively exercise are often found to be addicted to other behaviors, such as compulsive shopping, work, or sex.

Many behavioral addictions have similar risk factors. For this reason, it can make sense for a person to struggle with more than one type of compulsive behavior or addiction.

Signs Of An Exercise Addiction

Not every case of exercise addiction looks the same. Among those who are treated for exercise addiction, however, health professionals have identified a number of common signs.

Signs of an exercise addiction might include:

• intense anxiety or distress when unable to exercise
• spending most of one’s time preparing for and recovering from exercise
• continuing to engage in intensive exercise despite injury or other physical health consequences
• unsuccessfully trying to reduce one’s exercise
• feeling guilty about missing a workout
• lying about how often one is exercising
• increasing the amount and intensity of exercise over time
• dismissing concerns from family or friends about their fitness habits
• missing work or school because it interferes with their exercise

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Addiction is marked by a lack of control.

Although people with an exercise addiction may feel in control—and say as much to loved ones—if they’re unable to alter their exercise habits, this can be a clear sign that they are experiencing an exercise addiction.

When Is Exercise Not An Addiction?

Exercising frequently and for long periods of time does not indicate an addiction by itself.

What distinguishes frequent exercise from an addiction is how it affects a person’s life, their ability to control their exercise, and its effects on physical and mental health.

What exercise addiction is not:

• going to the gym
• exercising regularly
• enjoying exercise
• exercising often

People who have an exercise addiction feel compelled to exercise and will feel unable to control how much they exercise and can be unsuccessful in attempts to do so.

In addition, they may also either ignore or be in denial of its negative impact on their health and well-being, failing to adapt their exercise habits in the presence of clear warning signs.

Causes Of Exercise Addiction

Exercise addiction can be influenced by a variety of factors. People generally develop this type of addiction when they’re young, either as a teenager or young adult.

Exercise addiction may be influenced by:

• co-occurring mental health problems (e.g. depression)
• poor body image
• social pressures
• family history of addiction
• environmental factors
• lack of supportive coping strategies

Exercise can boost brain chemicals that can make a person feel good. In some, this may become addictive.

Without other supportive outlets, exercise may be used to increase happiness and reduce distress—even when it comes at a personal cost.

Treatment For Exercise Addiction

Although not recognized as an official disorder, exercise addiction has been treated through a variety of modalities and approaches.

Because it often co-occurs with substance use disorder and eating disorders, exercise addiction will often be treated through a substance use disorder, eating disorder, or dual diagnosis rehab program.

Before beginning behavioral treatment for exercise addiction, a medical evaluation is often warranted. This is particularly true for people who have exercised through injuries, experienced significant weight loss, or show signs of nutritional deficiency.

A sports medicine physician, primary care provider, or registered dietitian familiar with eating disorders can assess physical health status and help inform a safe treatment plan.

Treatment for an exercise addiction may involve:

• behavioral therapy (e.g. Cognitive Behavioral Therapy)
• mindfulness-based therapies
• dual diagnosis treatment
• holistic therapies
• support groups
• medical care

Treatment for exercise addiction focuses on improving a person’s relationship to exercise, and addressing issues caused by their addiction, including consequences to health.

People who have co-occurring issues may benefit the most from dual diagnosis treatment, which can address all of a person’s mental health struggles and improve a person’s chance for recovery.

Eating disorders carry some of the highest mortality rates of any mental health condition. If you or someone you know shows signs of both compulsive exercise and disordered eating, professional evaluation is important.

You can reach the National Alliance for Eating Disorders Helpline at 1-866-662-1235 for referrals to specialized treatment.

Find Treatment For Exercise Addiction Today

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