Chapter 11

"I Am An Exercise Addict"

by Pamela Schein and Jeff Copeland

Learning Objectives

1. Describe the behavioral pattern of an exercise addict.

2. Identify the similarities between the profile of an exercise addict and that of a bulimic or an anorexic.

3. List 5 telltale signs of exercise addiction.

"I work out two or three times a day, seven days a week... I'm up just as early on weekends as on weekdays to get to the gym, no matter how much my boyfriend begs me to stay home. I have passed up social engagements with friends that interfered with my exercise schedule. I've even planned vacations around the availability of a gym. I keep an exercise diary in which I record all of my workouts. If I fall behind, I make myself work out that much harder the next month"

Most of my friends admire me. They say they wish they had my discipline. But I hate the way I am. I hate most of the exercises I do. I hate thinking that if I don't get to the gym one day I may wake up the next day with an extra 10 pounds on my hips. I want to stop, but I can't.

There are a lot more of us than you may think. Although there are no concrete statistics, trainers, doctors and psychotherapists all say they come across significant numbers of people like me. "More and more, I see people in the gym, usually women, who seem totally driven and don't enjoy exercising," says Johnny Bowden, a personal trainer at the Equinox Fitness Club in New York City. Dan Zeman, an exercise physiologist at the Minneapolis Sports Medicine Center, believes that "of the 30 percent of Americans who say they exercise regularly, at least a third are addicted to exercise.'' The American Anorexia/Bulimia Association estimates that about 50 percent of women with eating disorders also over exercise to lose weight. In fact, the profile of the exercise addict is very close to the profile of many bulimics and anorexics— that is, female, in her 20s or 30s, intelligent and intensely driven.

There has even been debate about including exercise addiction in the standard diagnostic manual for psychiatrists, along with eating disorders and drug problems. Proposals have been made suggesting that psychiatrists be on the lookout for these telltale signs: a rigid daily schedule of exercise; domination of exercise over other activities; an overwhelming need to increase exercise activities when the same quantity no longer delivers the desired results; withdrawal symptoms such as anxiety or mood swings when exercise is curtailed and relief from those feelings when exercise is resumed; and, finally, a rational understanding that exercise has become a destructive compulsion counterbalanced by a deeper feeling that it is nonetheless a necessity.

Why is this happening to me? I'm bright and motivated. I have a good career in the making and a wonderful man in my life. I know on one level that I am attractive, and I certainly must be healthy—I spend much of my life working out. But I have no real idea what I look like or how I am perceived by others. I often compare myself with women on the street, and I get frustrated because I don't know how my body looks. It's frightening to look in the mirror and not see what others see, and to undress in the dark so you don't catch a glimpse of your reflection. And it's terrifying to feel so out of control that you don't even know who you are.

Other exercise addicts have similar stories, similar fears. "I get up at about five every morning so I can run before work," says Irene Dorosh, a 35-year-old blond, green-eyed beauty who lives in New York City. "If I didn't run first. I wouldn't be able to make it through the day." She always runs at least 5 miles, and ten on weekends. At the end of the day, even though she leaves her job as a financial assistant for an electrical contracting company feeling exhausted, she takes at least one evening aerobics class. On weekends, she may go to three classes in a day.

"I never miss a day," Dorosh says. "If it's absolutely necessary, like if somebody died, then I will. But I get crazy and I feel so guilty. If someone asks me to go to dinner on a day when I didn't exercise, I won't go—I won't eat dinner. The next morning, I'll jump out of bed and look in the mirror to see if I've gained any weight. I know that exercise controls my life, but I guess I'm not willing to do anything about it."

Dorosh started exercising six years ago after abdominal surgery. "It was totally innocent," she says. "I felt like it was time for me to get in shape, so I went to an aerobics class with a friend. I didn't even like it, but I went back the next day, and the next, and now here I am." Dorosh may have been a prime candidate for an obsession with exercise, though. Between the ages of 19 and 28 she was bulimic. "It used to be that I never cared how much I ate because I knew I was going to throw it up anyway. Exercise gives me that same freedom: I'll burn off whatever I eat."

Now, she says, "Most of the time I wake up and don't want to work out, but I feel like I have to. What would happen to me if I didn't? I just don't know.''

Sharon Yensko, a slim redhead in her mid-30s who is marketing manager for a telecommunications company in New York City, started doing aerobics eight years ago. Her goal was to become "cut and toned. I want to be able to crack an egg on my ass." Yensko belongs to four gyms because "that way, there's always a class for me to go to, even if I'm busy."

Yensko sees herself as an aggressive person who needs an outlet for her pent-up energy. She takes 10 aerobics and body sculpting classes, two boxing and several weight training sessions every week. "My schedule is a little excessive," she admits. "I used to worry that if I missed a day or two my muscles would atrophy or I'd lose some of the stamina and endurance that I worked so hard to build. Now I know these things won't happen because I won't let them."

That fanaticism is taking a toll on her body. "I've had all kinds of injuries," she says. "I really bang myself up, but it doesn't stop me." Recently her excessive exercise led to a stress fracture, but she continued until she tore a hip flexor and other muscles. "The doctor said I had to take at least four weeks off," Yensko says. But she couldn't stop exercising entirely. Though she stopped aerobics just long enough for the fracture to heal, she continued a full schedule of boxing and upper body work.

It often takes a physical injury like Yensko's or the realization, like Dorosh's, that her social life is suffering to show an exercise addict that she's in serious trouble.

I knew I was hooked when I fought to change the time and date of a luncheon for my grandfather's 97th birthday so I wouldn't miss a particular class.

Jayne Migdal, a New York City psychotherapist who sees a number of women whose lives have become unmanageable because of exercise, says, "For many, their relationships will end; they'll lose their jobs, and their friends. And only then, when they've really hit bottom, will they sometimes try to deal with the problem." This was the case for one professional woman in her mid-twenties who neglected her friends and family to pursue a rigorous exercise schedule. Only after she had damaged a broken hip to the point where she could no longer walk and needed surgery did she accept that she had a problem. At a time when she needed it most, her whole social life and support was gone.

Too often, says Migdal, exercise addicts are driven by unknown forces in themselves or outside, in society, that are just too strong to resist. They may be seeking an escape from an unhappy job or marriage, or from general feelings of low self-esteem and self-worth. Exercise is a great stress reliever, and it's certainly more socially acceptable than taking drugs or drinking heavily. Moreover, exercise builds confidence and is a kind of predictable, ritual activity—both of which are attractive to people who feel their lives are out of their control. Some scientific research indicates that exercise prompts the brain to produce soothing, drug like hormones called endorphins, which has led to the speculation that exercise could literally be a chemical dependency.

Yet that's only part of the explanation. In true exercise addiction, exercise isn't a means to an end, it is the end. "An exercise addict may say, `I've been good today, I ran 10 miles,'" says Migdal. "The value of a person becomes a question of how much she exercised rather than what goals she reached with no acknowledgment of the damage done to the body or social life."

Just as the relentless pressures on women in America to be thin seem to drive women with eating disorders, they also seem to drive exercise addicts. Rather than starve themselves or vomit, they fanatically burn calories by working out. Psychologists even have a term for them: exercise bulimics. They have the same distorted sense of their bodies that women with eating disorders have, seeing fat where everyone else sees lean. What's particularly pernicious about this condition, says Karin Kratina, R.D., an exercise physiologist at the Renfrew Center for eating disorders and mental health issues in Coconut Creek, Florida, is that "the woman who uses exercise as a method of purging may also get a lot of positive reinforcement. People are usually very impressed with her discipline."

In that sense, exercise addiction is really the dark side of the fitness movement which has helped so many to set higher standards for health yet also presented an ideal of beauty that's maddeningly out of reach for some. "Some women will go to any lengths, past what would be considered a normal exercise regime, to achieve their ideal body," says Andrew Brown, MD., medical director of Downtown Physical Medicine and Rehabilitation in New York City. He estimates that about 20 percent of his clinic's patients have injuries caused by too much exercise.

Unlike Dr. Brown, though, many doctors don't recognize that a strained hip flexor could be the sign of a psychological problem. And health-club staffs often won't—or can't—intervene to warn a client that her exercise program may be unhealthy. Exercise physiologist Zeman was involved in a legal case in which a Minnesota club tried to get a woman who had worked herself down to 78 pounds to limit the amount of time she spent exercising. The woman sued claiming that the management discriminated against her because it only wanted "pretty faces" in the club. The court held that as long as a client paid her dues, the management couldn't restrict her access to the club. Michael Schwartz, an aerobics instructor at three of New York City's hippest gyms, says the most he feels he can offer to students who take three or four consecutive classes is some gentle advice. "I say, `It's great that you're so committed but let me give you some dietary and exercise information to help you out.' I try to take a positive approach."

There is a way out of the addiction. The Renfrew Center's Kratina tries to break down the addict's belief in the goal of a perfect body by teaching a new attitude toward working out as a way to nurture the body. She combats the addict's destructive belief in "no pain, no gain" by encouraging body awareness, getting in touch with feelings, finding a comfort zone and recapturing a sense of enjoyment. For instance, Kratina encourages addicts to move from "I have to exercise" to "I want to, I have a choice." "They need to learn to enjoy the feeling and process of moving the body, and what it feels like to be in their body," she says, "rather than exercising to burn calories and escape from feelings." She deals with a distorted self-image by educating a woman about what's a normal level of body fat and why she has body fat, and challenging the person's perception of her body. When a client says "I feel fat," Kratina helps her understand that fat isn't a feeling, and to identify what she's really feeling, typically anger, hurt, sadness. She admits that, though these techniques are helpful, clients usually need a period of psychotherapy to deal with issues around the addiction.

Rochelle Taube, MD., of the Minneapolis Sports Medicine Center, gives her patients "homework"_anything that gets them interested in other things," she says, "like going to the movies or reading a book." The idea, says psychotherapist Migdal, is to stop thinking that "if I have a thinner body, people will like me" and realize the problem "lies in the thought that people don't like me." Or, as Dorosh says, "It's something else in your life that's bothering you, but you don't know what it is because you never stop long enough to figure it out."

But as with any addiction, healing is an ongoing process. "For the truly addicted exerciser, it's like being an alcoholic—you never lose the urge," says Christine Grimaldi, 28, president of Fitness Prescriptions of East Hampton, New York. She checked into an outpatient clinic after over-exercise and anorexia left her with only 109 pounds on a 5-foot-10-inch frame. "I'm in control now, but when I'm really upset my first reaction is still to exercise."

As for me, I've been going through therapy and slowly coming to the realization that exercise does not have to be the critical factor in my life. It isn't essential in order for me to be a good, successful, well-liked, attractive person. Don't misunderstand me_the battle has not yet been won. Even knowing that I have this problem, I still struggle with the compulsion to get to the gym. More important, I am trying to understand the origins of my problem. In the meantime, I've been helped a lot by knowing that there are other women out there who suffer in the same way I do, and I hope that my story can help them, too.

Pamela Schein is a New York City freelance writer and journalism student. Jeff Copeland is a freelance writer living in Los Angeles.

This article appeared in Fitness (March/April 1994).

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