Melissa has been a track fanatic since she was 12 years old. She
has run the mile in meets in junior high and high school,
constantly improving her times and winning several medals. Best of
all, Melissa truly loves her sport.
Recently, however, Melissa's parents have noticed a change
in their daughter. She used to return tired but happy from practice
and relax with her family, but now she's hardly home for 15
minutes before she heads out for another run on her own. On many
days, she gets up to run before school. When she's unable to
squeeze in extra runs, she becomes irritable and anxious. And she
no longer talks about how much fun track is, just how many miles
she has to run today and how many more she should run tomorrow.
Melissa is living proof that even though
exercise
has many positive benefits, too much can be harmful. Teens, like
Melissa, who exercise compulsively are at risk for both physical
and psychological problems.
What Is Compulsive Exercise?
Compulsive exercise (also called
obligatory exercise
and
anorexia athletica
) is best defined by an exercise addict's frame of mind: He or
she no longer chooses to exercise but feels compelled to do so and
struggles with guilt and
anxiety
if he or she doesn't work out. Injury, illness, an outing with
friends, bad weather - none of these will deter those who
compulsively exercise. In a sense, exercising takes over a
compulsive exerciser's life because he or she plans life around
it.
Of course, it's nearly impossible to draw a clear line
dividing a healthy amount of exercise from too much. The
government's 2005 dietary guidelines, published by the U.S.
Department of Agriculture (USDA) and the U.S. Department of Health
and Human Services (HHS), recommend at least 60 minutes of physical
activity for kids and teens on most - if not all - days of the
week.
Experts say that repeatedly exercising beyond the requirements
for good health is an indicator of
compulsive behavior
, but because different amounts of exercise are appropriate for
different people, this definition covers a range of activity
levels. However, several workouts a day, every day, is overdoing it
for almost anyone.
Much like with
eating disorders
, many people who engage in compulsive exercise do so to feel more
in control of their lives, and the majority of them are female.
They often define their self-worth through their athletic
performance and try to deal with emotions like anger or
depression
by pushing their bodies to the limit. In sticking to a rigorous
workout schedule, they seek a sense of power to help them cope with
low self-esteem.
Although compulsive exercising doesn't have to accompany an
eating disorder, the two often go hand in hand. In anorexia
nervosa, the excessive workouts usually begin as a means to control
weight
and become more and more extreme. As the person's rate of
activity increases, the amount he or she eats may also decrease. A
person with bulimia may also use exercise as a way to compensate
for
binge eating
.
Compulsive exercise behavior can also grow out of student
athletes' demanding practice schedules and their quest to
excel. Pressure, both external (from coaches, peers, or parents)
and internal, can drive the athlete to go too far to be the best.
He or she ends up believing that just one more workout will make
the difference between first and second place . . . then keeps
adding more workouts.
Eventually, compulsive exercising can breed other compulsive
behavior, from strict dieting to obsessive thoughts about perceived
flaws. Exercise addicts may keep detailed journals about their
exercise schedules and obsess about improving themselves.
Unfortunately, these behaviors often compound each other, trapping
the person in a downward spiral of negative thinking and low
self-esteem.
Why Is Exercising Too Much a Bad Thing?
We all know that regular exercise is an important part of a
healthy lifestyle. But few people realize that too much can cause
physical and psychological harm:
-
Excessive exercise can
damage
tendons, ligaments, bones, cartilage, and joints, and
when
minor injuries aren't allowed to heal, they often result in
long-term damage. Instead of building muscle, too much exercise
actually destroys muscle mass, especially if the body isn't
getting enough nutrition, forcing it to break down muscle for
energy.
- Girls who exercise compulsively may disrupt the balance of
hormones in their bodies. This can change their menstrual cycles
(some girls lose their periods altogether, a condition known as
amenorrhea
) and increase the risk of premature bone loss (a condition known
as
osteoporosis
). And of course, working their bodies so hard leads to
exhaustion and constant fatigue.
- An even more serious risk is the stress that excessive
exercise can place on the heart, particularly when someone is
also engaging in unhealthy weight loss behaviors such as
restricting intake, vomiting, and using diet pills or
supplements. In extreme cases, the combination of anorexia and
compulsive exercise can be fatal.
- Psychologically, exercise addicts are often plagued by
anxiety and depression. They may have a negative image of
themselves and feel worthless. Their social and academic lives
may suffer as they withdraw from friends and family to fixate on
exercise. Even if they want to succeed in school or in
relationships, working out always comes first, so they end up
skipping homework or missing out on time spent with friends.
Warning Signs
A child may be exercising compulsively if he or she:
- won't skip a workout, even if tired, sick, or
injured
- doesn't enjoy exercise sessions, but feels obligated to
do them
- seems anxious or guilty when missing even one workout
- does miss one workout and exercises twice as long the next
time
- is constantly preoccupied with his or her weight and exercise
routine
- doesn't like to sit still or relax because of worry that
not enough calories are being burnt
- has lost a significant amount of weight
- exercises more after eating more
- skips seeing friends, gives up activities, and abandons
responsibilities to make more time for exercise
- seems to base self-worth on the number of workouts completed
and the effort put into training
- is never satisfied with his or her own physical
achievements
It's important, too, to recognize the types of athletes who
are more prone to compulsive exercise because their sports place a
particular emphasis on being thin. Ice skaters, gymnasts,
wrestlers, and dancers can feel even more pressure than most
athletes to keep their weight down and their body toned. Runners
also frequently fall into a cycle of obsessive workouts.
Getting Professional Help
If you recognize two or more warning signs of compulsive
exercise in your child, call your doctor to discuss your concerns.
After evaluating your child, the doctor may recommend medical
treatment and/or other therapy. Because compulsive exercise is so
often linked to an eating disorder, a community agency that focuses
on treating these disorders might be able to offer advice or
referrals. Extreme cases may require hospitalization to get a
child's weight back up to a safe range.
Treating a compulsion to exercise is never a quick-fix process -
it may take several months or even years. But with time and effort,
kids can get back on the road to good health. Therapy can help
improve self-esteem and body image, as well as teach them how to
deal with emotions. Sessions with a nutritionist can help develop
healthy eating habits. Once they know what to watch out for, kids
will be better equipped to steer clear of unsafe exercise and
eating patterns.
Ways to Help at Home
Parents can do a lot to help a child overcome a compulsion to
exercise:
- Involve kids in preparing nutritious meals.
- Combine activity and fun by going for a hike or a bike ride
together as a family.
- Be a good body-image role model. In other words, don't
fixate on your own physical flaws, as that just teaches kids that
it's normal to dislike what they see in the mirror.
- Never criticize another family member's weight or body
shape, even if you're just kidding around. Such remarks might
seem harmless, but they can leave a lasting impression on kids or
teens struggling to define and accept themselves.
- Examine whether you're putting too much pressure on your
kids to excel, particularly in a sport (because some teens turn
to exercise to cope with pressure). Take a look at where kids
might be feeling too much pressure. Help them put it in
perspective and find other ways to cope.
Most important, just be there with constant support. Point out
all of your child's great qualities that have nothing to do
with how much he or she works out - small daily doses of
encouragement and praise can help improve
self-esteem
. If you teach kids to be proud of the challenges they've faced
and not just the first-place ribbons they've won, they will
likely be much happier and healthier kids now and in the long
run.
Reviewed by:
Mary L. Gavin, MD
Date reviewed: November 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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