Since the 1980s, Americans have recognized the importance of exercise as part of a healthy lifestyle. But for some people, exercise can turn into an addiction. According to a recent study at the George Warren Brown (GWB) School of Social Work at Washington University in St. Louis, symptoms of exercise dependence are common among college-age adults, and significantly higher in college-age women.
While normally associated with eating disorders such as anorexia nervosa and bulimia, exercise dependence can be a serious condition on its own.
“Exercise dependence in individuals with eating disorders can pose serious health risks, but perhaps just as important are those individuals with primary exercise dependence,” says Matthew O. Howard, Ph.D., associate professor at GWB and co-author of the study. “These people include those who work out in the gym for hours at a time, those who always seem to be at the gym, and those who routinely cancel events with family, friends and co-workers so that they can complete their strenuous workout routines.
“While some observers may view them as just extremely dedicated or motivated, many of these persons may be obsessed with exercise.”
Unlike past exercise dependence studies that focused on professional athletes and exercise club members, Howard’s study, “Exercise Dependence and Attitudes Toward Eating Among Young Adults,” studied 237 undergraduate students from a highly competitive, private Midwestern university, most of whom had declared a business major.
Each student answered four questionnaires as part of the study:
- Exercise Dependence Questionnaire: This questionnaire assesses the motivation to exercise, aspirations for good health, need to control and modify appearance, and problematic exercise behaviors.
- Eating Attitudes Test: This questionnaire measures the level of atypical and disordered eating attitudes.
- Weekly Exercise Routine: This brief questionnaire was used to obtain information about the students’ exercise behaviors.
- Exercise Dependence Criteria: Howard used American Psychiatric Association criteria to create this questionnaire to assess symptoms of exercise dependence.
The students also answered a question about their perceptions of control over their exercising behavior.
“Overall, roughly one-third of the students dealt with exercise dependence during the past year,” says Howard. “This finding was higher than what we expected, but, it is important to remember that this is a highly competitive group of students. I think appearance is particularly valued in high competitive business environments and perhaps in more upwardly mobile academic institutions. It does mean that some of our best and brightest students may be most at risk for the deleterious effects of exercise dependence.”
The female students scored higher than the male students on the study’s questionnaires, showing that women not only exhibited more dysfunctional attitudes toward eating — indicative of possible eating disorders — but also a greater tendency to excessive and dependent exercise. The female students also had more withdrawal symptoms associated with inability to exercise when they wanted to.
“I was surprised at the proportions of students who exercise even when it is physically or psychologically damaging, and by the fact that about three percent of the women reported that they couldn’t cut down on the amount they exercised even though they wanted to,” notes Howard, who is the senior researcher at GWB’s Comorbidity and Addictions Center.
His study, co-authored with Christine Zmijewski, a master’s student at GWB and professional athletic trainer, was published in the August 2003 journal Eating Behavior (Volume 4, Issue 2).
Howard thinks that awareness of eating dependence and more realistic attitudes about appearance will help control the problem.
“It would be good if future research examined the possible negative effects of exercise instead of presenting a wholly positive image of exercise,” says Howard. “There has to be a middle ground between the obesity epidemic we are currently experiencing in the U.S. and the potential problems of exercise dependence.”