Conscious Choice: Crossing the Line

April 1999

Crossing the Line

by Brooke Russell

Every morning at about at about four or five o’clock my baby daughter wakes up and is ready for some milk, a walk around the apartment, and, unfortunately for my husband and me, a little playtime. On the days when I really want to indulge her, and don’t try to coax her back to sleep, I bring her over to the window to look out at the lake, the horizon, and the road below. "Who are all those people driving at this hour?" I thought last time, as we gazed bleary-eyed at the lights streaking by. Then, to my amazement, my eyes began to focus on the little figures jogging determinedly along the frigid lakefront path. About the only response I could register was, "Wow."

Most of us have heard many times the litany of benefits exercise can bring. They include more energy, strength, and endurance, better sleep, improved digestion, greater peace of mind, increased creativity and happiness, and lower stress. People who lead active lives also greatly reduce their risk of coronary heart disease through lower blood pressure, higher HDL (good) cholesterol levels, and increased cardiorespiratory fitness. From that perspective, it seems as if the exercise habits of these early morning runners might represent an exemplary lifestyle. In general, avid exercisers are perceived to be dedicated, high-achieving, disciplined individuals who are models of health and productivity.

But health professionals also know that exercising to excess is a dangerous thing. Beyond the emotional cost of straining or neglecting personal relationships or commitments, the physical risks of exercise compulsion are serious because they can lead to a state of overtraining. Symptoms of the overtraining syndrome range from fatigue, depression, and eating disorders to hormonal imbalances, which can lead to loss of muscle and bone mass, decreased libido, and (temporarily) reduced fertility. According to the American Council on Exercise (ACE), other signs of overtraining include decreased performance, loss of coordination, prolonged recovery, elevated morning heart rate, headaches, loss of appetite, muscle soreness, and a suppression of the immune system resulting in a decreased ability to ward off infection. Ironically, many of the things moderate exercise successfully mitigates — fatigue, depression, anxiety — surge even more intensely when exercise becomes excessive. To some, those early morning runners might seem excessive, rigid, and even worrisome.

Which take, then, is accurate, and for whom? How can one tell the difference between a healthy zest for fitness and an unhealthy obsession, between motivation and compulsion? When does an exerciser cross that line, and why?

According to Dr. Alayne Yates of the University of Hawaii, a leading researcher of exercise compulsions and their links to eating disorders, the obsessive exerciser typically is a workaholic professional in his or her 20s or 30s who is highly educated, achievement-oriented, and a perfectionist. Despite an outward show of success, he or she often is plagued with feelings of inadequacy, low self-esteem, and of having failed in a life-defining endeavor, such as a broken marriage or an inability to find a job that is fulfilling.

Exercise obsessions begin as a positive step, a desire to make a change and to take control. But, gradually, the exercise program itself begins to take control, becoming overvalued in one’s life and ultimately serving as a means of escaping from one’s problems and avoiding emotional expression.

What marks an obsessive exerciser, then, is not necessarily how much one exercises, but what place the exercise program has in one’s life. Is it a source of pleasure, or merely an avenue of escape? Is it in balance with other important aspects of life, such as relationships with loved ones, work, civic activities, and other interests? Is it contributing to, or detracting from, one’s overall health? Most importantly, is it under one’s control?

In order to identify a true compulsion toward exercise, you have to look rather closely; in the circle of your friends, neighbors, or spouses, the compulsive is perhaps a little easier to spot. It is the runner who runs despite injuries, illness, or clear indications of exhaustion. It is the athlete who misses important family events because he runs not one but seven triathlons in a summer. It is the friend whom you haven’t seen in months because every hour of spare time is devoted to training. It is the neighbor who seems increasingly gaunt but who trains for hours every day, even when the weather is extreme. Most of us know someone who fits one of these descriptions. The fact is that exercise addiction is a growing trend just beginning to come into public awareness.

Some of the most disturbing manifestations of exercise compulsions are the dangerous habits and behaviors that so often accompany them. A trainer at a gym on Chicago’s north side described the disturbing number of clients who use over the counter steroid-like substances to achieve rapid bodybuilding and performance results. Virtually unregulated by the U.S. Food and Drug Administration, these so-called nutritional supplements such as chromium picolinate and DHEA have not been subject to thorough scientific scrutiny, may contain impurities in manufacturing, and may have seriously adverse health effects. Still, with demand on the rise, particularly among high school and college male athletes and gay men, business in this niche market is booming.

Even more prevalent are the eating disorders to which so many compulsive exercisers fall prey. Often thought of as a woman’s problem, men too are now developing unhealthy eating behaviors linked to exercise compulsions. These include semi-starvation, eating far too few calories to fuel their extreme physical activity, or using exercise as a way to purge a meal, in the same way that bulemics vomit after binge eating.

According to Dr. Richard M. Suinn, head of the psychology department at Colorado State University in Fort Collins, this link between exercise and eating disorders is not surprising. In a 1995 Health Magazine article, Suinn drew an analogy between exercise dependency and anorexia nervosa. "The anorexic thinks she’s overweight and is trying to meet a standard. In the same way, those who over-exercise start with a good cause but keep raising the standard, They’re not running for the sake of fitness, they’re running toward an unreachable goal."

Yates describes a downward spiral in which a person begins an exercise and diet program to enhance self-worth, but carries out these objectives so rigorously that he or she risks developing "activity anorexia." This condition is marked by a negative feedback loop in which increased exercise releases hormones that suppress the appetite and increase compulsivity. Ultimately, the person cannot sustain the physical strain of this condition, and the overtraining syndrome sets in.

With so many compelling reasons not to overtrain, why are people doing it? The short answer is that people do not rationally choose to exercise excessively.

Some experts suggest that exercise compulsions are like other addictions and that compulsive exercisers are physically hooked on the endorphins or opiates naturally released by the body during rigorous exercise. Most doctors, however, agree that this so-called "runner’s high" is not what really drives exercise "addictions." Instead, the underlying problem is psychological, a result of personal forces that send some people spinning out of control. While new research has given evidence to the idea that bulimia nervosa is at least in part biologically induced, the carryover to exercise behavior is not altogether clear.

But if the reasons behind exercise addiction are personal, they are also cultural. The cultural emphasis on a certain body type and weight, creating an aesthetic ideal for men and women, reinforces compulsive behavior. In her book The Beauty Myth, Naomi Wolf emphasizes the power of these cultural forces in women’s lives when she discusses how women today are striving for a physical ideal that is unnatural. "This great weight-shift bestowed on women, just when we were free to begin to forget them, new versions of low self-esteem, loss of control, and sexual shame. It is a genuinely elegant fulfillment of a collective wish: By simply dropping the official weight one stone [(roughly 14 pounds)] below most women’s natural level, and redefining a woman’s womanly shape as by definition "too fat," a wave of self-hatred swept over First World women, a reactionary psychology was perfected, and a major industry was born. It suavely countered the historical groundswell of female success with a mass conviction of female failure, a failure defined as implicit in womanhood itself." Whether or not one agrees with Wolf’s hints of conspiracy implied by her use of the passive voice, her argument is compelling.

Where do we go from here?

One trip to the local mall will confirm that exercise compulsions are by no means an American epidemic. Indeed, according to a study published by the Center for Disease Control and Prevention, fewer than twenty percent of Americans engage in regular and sustained vigorous exercise, while as many as 50 percent of us are clinically overweight. But while far too many Americans are sedentary overeaters, fueling talk of a national obesity health crisis, there is a small but growing cadre of women and men abusing their bodies in the opposite fashion, through extreme physical exertion and starvation.

Ironically, the goal for compulsive exercisers is the same as that for sedentary folks: achieving a moderate exercise program and a balanced diet. Because the exercise is an addiction of sorts, it may be difficult to get under control. One woman said that training for and competing in triathlons and marathons were so much a part of her identity that, when she had to stop these activities as part of her exercise and eating disorder recovery program, she felt as though part of herself was dying.

Yet people can, and do, break their compulsions — and remain active. By turning their focus inward, to the body’s responses, exercisers can learn to aim for balance and well-being rather than abstract numerical goals. By working out with a trainer or a buddy, they can learn to moderate the duration and intensity of a workout. By taking up additional interests — even sports — athletes can broaden their perspective and avoid fixating on narrow, inappropriate, or unattainable goals.

Working out and eating right are good things because they help us to be fit and healthy, to live longer, think better and be happier, more active, and, yes, more attractive people. No doubt, all of these things are important and desirable. But physical activity is really only one small part of leading a good, full life. There is much more to life, thank goodness, than the size of our waistlines, biceps, or weights.

There is even a lot of longstanding research out there supporting what our more spiritual and broad-minded sides already intuit: that what we give and produce in our love lives, our work lives, and as members of communities is ultimately a much greater and lasting source of happiness and longevity than any daybreak run on the lakefront. When compulsive exercisers give up the search for perfection and replace it with a quest for balance, they can begin repairing and nurturing not only their own physical and mental well-being, but also the well-being of the other important relationships in their lives. And then, there it is: good health.

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