We all know them. They arrive at the gym quietly and go about their routine. Two hours later, they're still going about their routine. They work out alone and have the same pattens of exercise. They are in the gym every day, without fail. Their primary concern is weight loss and they can tell you to within five calories how much they burned that day. You know they are injured, but there they are, working out as hard as ever. You wonder-do they have a life? Sure, they look amazing, but something isn't right.
From Healthy To Addicted
Many people suffer from a behavior that is becoming more prevelent over time-an addiction to exercise that goes beyond healthy. It is true that exercise is an important part of the equation of healthy lifestyle choices. However, some people are compulsive and exercise to such an extreme that it is dangerous to them physiologically as well as psychologically. Exercise takes over the compulsive exerciser's life, often isolating them from the day-to-day affairs of their own reality. Family, friends, sometimes even work or school, may be pushed to the back burner to accommodate the need to exercise.
Bulimia Nervosa And Exercise Dependence
Exercise dependence is, to date, not considered to be a "primary disorder" in terms of psychiatric understanding. It is, however, linked to bulimia nervosa as well as anorexia nervosa and compulsive overeating disorder. Excessive exercise is considered a symptom of bulimia nervosa and The Diagnostic Manual, the DSM-IV-TR, defines it in this context as exercise that "significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complication." Tying this to eating disorders such as bulimia, excessive exercisers use it because it helps with weight control. Binge eaters use it as a way to balance their overeating (along with or instead of purging). Anorexics use it as an additional way to lose weight.
A Disorder That Stands Alone
All of this has resulted in many researchers arriving at the conclusion that exercise dependence happens in concert with an eating disorder. However, there is evidence to suggest that exercise dependence occurs in people who do not seem to have body image issues nor suffer with eating disorders. This has lead to a conclusion that compulsive exercising is a disorder that comes from exercising for the sake of exercise itself. As yet, there is no formal description because so little is really known about the disorder. Until such time as there is a definition with standards that are measurable, the results of any studies will likely show conflicts in information.
What is known is that whether the dependence is caused by an eating disorder or by OCD, the net effect is harm to the person, physically, psychologically, and socially. It is a dependence that needs specific treatment and it is important that research be conducted to that end.