Regular exercise is healthy, but obsessive-compulsive exercise can be dangerous and indicative of underlying health issues, such as eating disorders and other mental ailments, according to an Australian psychiatrist.
Dr Phillipa Hay, an eating disorders academic, psychiatrist and director of Wesley Eating Disorders Centre at Wesley Hospital in Ashfield, NSW, said that a compulsive drive to exercise excessively may often stem from underlying weight or food-related issues, which when put together, can be detrimental to physical and psychological health.
Studies have shown, Dr Hay noted, that compulsive exercise occurs in half of all patients with an eating disorder, up to 80 per cent of anorexia nervosa patients and up to 57 per cent of patients with bulimia.
“Obsessive-compulsive exercise also causes higher levels of psychological distress, including depression and anxiety, in people with an eating disorder, and in some studies it has also been related to increased rates of suicide and self-harm,” she explained.
“For this reason, it’s important to get help if you or a loved one is showing symptoms, which often include increased anxiety and mood changes if unable to exercise, rigid and unrealistic exercise rules or goals and the drive to exercise even when ill or injured.”
Specialised clinics can help in the recovery, management and prevention of such exercise patterns, particularly for those who have eating disorders, by way of “exercise therapy”, whereby patients are taught about better expectations.
She outlined six signs and symptoms of obsessive-compulsive exercise to be aware of:
“Exercise becomes ‘unhealthy’ when the inability to exercise causes mood changes,” she said.
“Feelings of guilt, anger or irritability may arise when a person is unable to engage in physical activity.”
Fear of stopping or reducing exercise
“People may have an overwhelming fear of the negative consequences that may result if they stop or reduce exercise, such as becoming fat, or a feeling of inability to cope,” she explained.
“Not being able to exercise may cause heightened levels of anxiety.”
Strict exercise rules
A common sign of obsessive-compulsive exercise is following rigid exercise rules to avoid negative consequences, she noted.
“These are often linked with food consumption. For instance, a person might decide they should spend extra time exercising if they ate something unhealthy, or miss a meal if they do not exercise.”
Setting difficult exercise goals
“A fitness goal such as losing excess weight, training for a race or gaining muscle is healthy. Exercise goals become unhealthy when they are unrealistic and inflexible,” she said.
Failure to meet high standards often leads to self-criticism, heightened anxiety and negative feelings, she advised.
Skipping other engagements
“Exercise becomes compulsive when physical activity becomes the central focus of a person’s thoughts to such an extent that it takes precedence over other responsibilities,” she noted.
“People may spend too much time thinking about, planning and engaging in exercise that they miss social engagements, or it gets in the way of work or study.”
Exercising in poor health or circumstances
While an injury or illness may cause a healthy exercising person to rest and recover, an obsessive-compulsive exerciser will continue to workout even when it is detrimental to their physical health, she concluded.
“The compulsion will motivate them to exercise even in bad weather despite the increased risk of other infections or ailments.”