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When it comes to exercise, sometimes more isn’t always better. How do you draw the line between healthy discipline and unhealty compulsion?

By Judi Ketteler, Oxygen Magazine

When Brieanna Quinn started at Indiana University, she was a wide-eyed freshman, ready to soak in all that university had to offer. What she wasn’t prepared for, though, was the culture of thinness that hit her in the face. "All the girls were really thin and really beautiful," she says.

It wasn’t until Brieanna joined a sorority that she discovered where all the thin and beautiful girls were hanging out: the gym. When she first signed up, she just wanted to be able to run a mile.  Her sorority sisters went with her, and going to the gym became a social event. Brieanna lost a few pounds and people complimented her – it felt good.

But by sophomore year, everything had changed. "It all snowballed," she says. Going to the gym and running became the focus of her life. She would always choose working out over spending time with friends and couldn’t rest until she ran and put in at least two hours at the gym every day. Exercise had become a compulsion. "I was in total denial," she says. "I actually took pride in trying to burn off every calorie I ate."

Brieanna wasn’t anorexic. While it’s true that, at 120 pounds, she was too thin for her five-foot-four frame, she wasn’t skeletal. Her unhealthy relationship with exercise and food pointed to a lesser-known disorder: exercise addiction (also known as obligatory exercise or exercise bulimia).

Getting a handle on exercise addiction is tricky, even for medical professionals. In the June 2005 issue of the journal The Physician and Sportsmedicine, exercise addicts are defined as "people who will not interrupt their exercise schedule, even when they are injured or when they know that continuing to exercise could cause physiologic or psychological changes that could harm their lives."

The syndrome is most common among high-endurance athletes, such as runners and triathletes, as well as gymnasts, bodybuilders, weight lifters, and dancers. According to David Coppel, a sports psychologist and professor at the University of Washington School of Medicine, exercise addiction affects about one percent of the population, though the tendency toward compulsive exercise may be more widespread. "The line between a healthy attitude and an unhealthy compulsion to exercise is determined not necessarily by how much you exercise, but by what happens if you can’t exercise," he says.

Exercise addicts crave the endorphin release – followed by exhaustion – just to feel normal. And, like any addict, they experience withdrawal if they can’t exercise, including mood swings, anxiety, excessive guilt and even bouts of depression. They can’t deal with the emotional fallout of skipping a workout. And because they almost always choose exercise over anything else, it’s not uncommon for them to have strained relationships with spouses, friends and even employers) especially if they make it a habit to leave work early to get their workouts in).

"Exercise addicts and people who overtrain think only exhaustive exercise is beneficial," says Renee Jeffreys, a clinical exercise physiologist with the Cincinnati Children’s Hospital Medical Center. "They don’t understand rest cycles and don’t allow their bodies time to recover." Basic physiology tells us that building strength is a matter of shortening and lengthening your muscles; when you break them down, they come back stronger. "But whenever you break muscles down, there is trauma at the cellular level," explains Jeffreys. "If you never rest, you don’t give your muscles time to recover and get stronger."

Treating exercise addiction is a matter of empowering the person so that exercise can once again become a free choice, say Coppel. This can be achieved through therapy and, in many cases, it may be the only way a true exercise addict can work through her issues.

But exercise habits exist along a continuum, and many people have some compulsive tendencies – they may not be crippling you, but they may be harmful to your self-esteem (and future health). Reflecting on yourself honestly, reassessing your exercise goals and listening to your body is the best medicine to prevent that slippery slide into full-blown addiction. It’s also about changing your mindset to focus on fitness rather than appearance.

For Brieanna, now 27, it’s about feeling athletic rather than feeling sick. She still runs, but her motivation is fitness, and she has finally learned that she has to take days off to be fit. "I finally feel normal now," she says, "because exercise no longer controls me; I control it."

Overtraining – exercising too much, too fast or with too much volume without enough rest time – can lead to a host of problems, including: