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Exercise: Healthy habit or dangerous addiction?

Too much exercise can be as harmful as too little, fitness experts say, causing osteoporosis, undernourishment, frequent injuries and in extreme cases, death. (Special to Forum News Service)

FARGO, N.D. — Jamie Smith has seen people working out at the gym a few times a day, sometimes for long stretches at a time, even through injuries and illness.

The group fitness instructor at Courts Plus Fitness Center in Fargo, who has been in the personal training industry for 10 years, has learned to recognize when someone’s healthy habit could be crossing the line into an exercise addiction.

“It often starts with peer encouragement, trying to achieve a happier state. Exercise wards off tension; it’s supposed to ward off stress; it’s supposed to make you look better,” she said. “For a while, that happens, and most people probably feel that way when they’re exercising, but I think with certain people, it gets to a point where that is no longer met through exercise so they have to do it longer.”

Eventually, exercise becomes an addiction, Smith said.

Related: Signs someone may be exercising too much

When people push themselves too hard or too far, it can lead to problems like osteoporosis, undernourishment, frequent injuries and in extreme cases, death.

“Anything good can become bad,” Smith said. “Anything that is considered healthy can be taken to an extreme of ruining someone’s body.”

It’s not a common problem. Exercise addiction is present in 0.3 to 0.5 percent of the adult general population, according to a study published in the journal, Psychology of Sport and Exercise.

Dr. Robyn Knutson Bueling, a Sanford Health physician in sports medicine and orthopedics, said there’s a fine line between exercise addiction and just doing too much. Where it crosses into an addiction, she said, is when it interferes with someone’s job, relationships and health.

“They’re actually sick and ill from having too much exercise and not enough recovery time,” she said.

Recovery time is essential for repairing muscle damage and bringing your heart rate and blood pressure back down to where they belong, Knutson Bueling said.

“Even Olympic athletes have recovery time built into their training program,” she said.

If you’re not sure whether your exercise routine is an addiction, Smith suggests cutting back to see how you feel.

“If they do feel horrible for cutting down their exercise a little bit, maybe they need to talk to somebody because it could be something a little bit deeper,” she said.  

When someone exercises too much, to the point where menstrual periods stop or become irregular, they could be putting themselves at risk for developing osteoporosis, a disease in which bone density decreases and bones are vulnerable to breaking, according to the National Institutes of Health.

Some athletes see amenorrhea as a sign of successful training, the NIH said, but the absence of menstrual periods is often a sign of decreased estrogen levels, which can lead to osteoporosis.

Even if bones don’t break when you’re young, low estrogen levels during the peak years of bone-building, the preteen and teen years, can affect bone density for the rest of your life. And studies show that bone growth lost during these years may never be regained.

“If you’re not getting somewhere between six and nine periods a year, then that’s not enough,” Knutson Bueling said. “The most important time for building bones is the 15- to 25-year-old age range.”

Another indication of a problem is excessive fatigue or poor performance despite training hard, she said.

“If your time when you’re running a race or the amount you’re able to lift is actually getting worse no matter how hard you try, that means you’re not recovering, and that would mean you’re doing too much,” Knutson Bueling said.

Though too much exercise can be harmful, Knutson Bueling cautions not to let a fear of an exercise disorder keep you from exercising.

Adults need at least 150 minutes of moderate-intensity aerobic activity, like brisk walking, every week and muscle-strengthening activities that work all major muscle groups two or more days a week, according to the Centers for Disease Control and Prevention.

Exercise makes people feel better and reduces confusion, fatigue and bad moods, according to an abstract in the U.S. National Library of Medicine.

But, the abstract stated, improvements in vigor, fatigue and mood occurred after 10 minutes of exercise, with progressive improvements in confusion over 20 minutes and no additional improvement after that.

Athletes training for an event may spend hours exercising, but for most people, Knutson Bueling said there is no benefit to working out more than 90 minutes to two hours a day.

Those most prone to exercise addiction are perfectionists who are focused on meeting an unrealistic body ideal and people with anxiety disorders vulnerable to obsessions and compulsive behaviors, said Dr. Julia Samton, a New York neuropsychiatrist. People who don’t have healthy ways of handling negative emotions, she said, also may turn to addictive behaviors as an outlet to relieve mental pain.

If you suspect someone has an exercise addiction, Knutson Bueling said, like with any other type of addiction, the important thing is helping the person realize he or she has a problem. In a gentle manner, point out things such as numerous injuries, canceled plans or working out more often, she said.

For help with an exercise addiction, Knutson Bueling recommends talking to a physician, counselor or sports medicine physician.