Pace Setter : November 2023

Exercise Addiction – The Tail of the Dog

by Russ Ebbets, DC, USATF Level 3 Coach

Addiction generally has the connotations of a dirty word. Whether it conjures up images of a heroin junkie or a skid row alcoholic the images are unsavory, and of course, not you or me. In the later ‘70s and early ‘80s the concept of a “positive” addiction crept into the general parlance. A positive addiction was something beneficial that people did to improve themselves or possibly others through personal discipline, diligent efforts and willfulness. Exercise was seen to be one of the “positive addictions.”

Balance in one’s life has long been represented with the triune of mind, body and spirit. With a fluid give and take among the three qualities life unfolds with sensible decisions made for manageable obstacles. But what if one of the qualities dominates or overshadows the other qualities? The result will be a list of problems that manifest to the detriment of the whole person.

This is where, or how a seemingly positive activity can morph to something negative or detrimental to a person. At first blush this does not seem possible. Involvement in some form of exercise is perpetually championed by the popular media. Benefits include reduced anxiety, weight loss or weight management, self-empowerment, social benefits and of course, cardiovascular health creating increased life expectancy. With all these benefits how could a positive addiction go bad?

The problem arises with a subtle shift in one’s approach to exercise. When one adapts the mantras of “more is better” or “good enough is never enough” one can lose the sense of training and metaphorically the tail begins to wag the dog. Training should be a goal directed activity. If this is so, one will train with intention, meaning training with a purpose. Those purposes may be a faster 5k time or for the more recreational runner the health and social benefits mentioned above. In either case the long-term participation is an important part of one’s life, but not the be all and end all of one’s life. Further complicating the benefits of a positive addiction are when one’s efforts slip into the unhealthy mental states seen with obsessive-compulsive disorders (OCD) or something like the Female Triad.

Hollywood and the photoshopped ideal of the “perfect” male or female body-type proliferate our daily lives. Supermarket aisles, TV ads or social media influencers all have come to represent idealized representations of what we should be and look like.

This striving, combined with poor food selection choices, can create an endless push-pull on the psyche of an impressionable person that some do not handle very well. This perfect ideal can become an unattainable goal that drives some to distraction and into the self-harmful states of OCD or eating disorders like anorexia. Oddly, there is also a distorted body image condition called “bigorexia” where an individual attempts to become as large as possible. This would be more the problems of a body builder or shot putter but nonetheless can present with life changing bodily damage. It would be worth your while to Google “world’s largest biceps” or calves to see examples that will bring this point home.

The prevalence of exercise addiction (EA) varies depending on several factors. Competitive athletes are more susceptible to developing EA than the recreational/leisure athlete. Historically males have had a higher incidence of EA but this is expected to change as the women athletes of today age after having had the lifelong opportunities that political legislation such as Title IX has afforded. Finally, one’s sport (individual v. team) can predispose one to develop psychological traits that predispose one to EA.

Self-coached individual sport athletes with no one to “pull back on the reins” can drift into the “more is better” thought patterns as they drive themselves to oblivion. Team sport athletes, in an effort to always give 110%, or mistakenly out do their teammates, can drive themselves into similar injury states as opposed to doing what they can do.

The Exercise Addiction Inventory (EAI) was developed in 2005 by MD Griffiths. It is a 6-question Likert self-test where the participant answers questions with one of five answers on a scale of 1-5. Most have seen the typical strongly disagree (1 point), disagree (2 points), neither agree nor disagree (3 points), agree (4 points) and strongly agree (5 points) type tests before. The exam takes seconds to complete, minutes to score and can have an impact on one’s immediate future if not for a lifetime.

The EAI addresses the problem by examining six areas: importance of the activity, conflicts participation creates, how one’s mood is affected by participation, if exercise tolerance is increased, does inactivity trigger withdrawal symptoms and if there is a compulsion to complete the activity.

Exercise Addiction Inventory (Griffiths, 2005)
1.     Exercise is the most important thing in my life.	1 – strongly disagree 2 – disagree 3 – neither agree nor disagree 4 – agree 5 – strongly agree
2.     Conflicts have arisen between me and my family or my partner about the amount of exercise I do.	1 – 2 – 3 – 4 - 5
3.     I use exercise as a way to change my mood.	1 – 2 – 3 – 4 - 5
4.     Over time I have increased the amount of exercise I do daily.	1 – 2 – 3 – 4 - 5
5.     If I miss an exercise session I feel moody and irritable.	1 – 2 – 3 – 4 - 5
6.     If I cut down on the of exercise I do and then start again I always end up exercising as often as I did before.	1 – 2 – 3 – 4 - 5
Scoring guide at end of article…..Total points _____

It may seem ludicrous that a 6-question survey can reveal answers that could change the course of one’s life. I don’t think the intent here is to necessarily change course but rather to create an awareness that at the very least a change could be considered and professional help might be productive.

From time to time, when I was coaching, an athlete would show up who was unreceptive to training direction and obviously was using their running as an avoidance activity for some other unresolved issue in their life. A subset of this group showed up and did their best to run themselves into the ground with a daily diet of overtraining. Needless to say, lackluster performances, constant injuries and a forever “glass is half-full” attitude was always there.

Unschooled but aware that something was not “right” I used to characterize these athletes as “hooked on a feeling,” and the “feeling” they sought was unproductive, if not outright destructive. I got the phrase “hooked on a feeling” from a pop song by 70’s singer BJ Thomas. Thomas’ career was temporarily derailed by drug addiction as his pursuit of that “feeling” derailed his career to the point of threatening his life.

Currently the opioid crisis continues to rage on. We survived the pandemic but this legalized drug addiction continues unabated. It seems odd that so little media attention is paid to a crisis that over the last decade has taken over a million lives, continuing at the rate of 100,000 deaths per year. This addiction is a “back burner” issue with the monumental settlements by big pharma seemingly doing little to slow the progression of lives lost, families destroyed and perpetuate a situation with no end in sight.

We all have the capacity to change. But when change is necessary – do we have the resolve to do it or do we stubbornly, steadfastly maintain the same old, same old until a breakdown forces a change, often with far more limited options?

Exercise Addiction Scoring Guide
At risk	24-30 points (top 15%)
Symptomatic	13-23 points
Asymptomatic	Less than 13 points

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Russ Ebbets, DC is a USATF Level 3 Coach and lectures nationally on sport and health related topics. He serves as editor of Track Coach, the technical journal for USATF. He is author of the novel Supernova on the famed running program at Villanova University and the sequel Time and Chance. His book, A Runner’s Guide, a collection of training tips and running articles was a 2019 Track and Field Writers of America Book of the Year finalist. His Runner’s Guide 2 was published in February 2023. Books are available from Amazon.com. His USATF Niagara High Performance presentation on Career Longevity and the Masters Athlete can be found at – USATF Niagara HP Zoom. He can be contacted at spinedoctor229@hotmail.com.