Sport Addiction

Millions of Britons take part in sport regularly, and for the vast majority of us, it is an enjoyable means of staying fit and a great way to meet people. Unfortunately, for some people, sport and exercise become something much more negative and damaging: an addiction.

What is Sport Addiction?

Sports addiction is a condition in which the affected individual feels a compulsion to engage in sport or physical exercise regardless of any negative consequences this may have on their physical and mental health and upon any other aspects of their life.

The benefits of exercise are well-known, and in today’s society – in which the obesity epidemic is a huge (and growing) problem claiming tens of thousands of lives each year – the idea that people may be suffering (and even dying) as a result of too much exercise may seem a bizarre one.

However, people suffering from sports addiction are either unable to recognise the line beyond which healthier exercise becomes something much more damaging, or can recognise that line but are unable to stop themselves from crossing it.

Exercise addicts are compelled to perform excessive amounts of exercise, with a deleterious impact upon their physical and mental well-being and possibly to the detriment of their personal and professional/academic lives and their financial security. Often co-occurring with eating disorders and/or substance abuse disorders, and featuring behaviours which are often also symptomatic of other mental health conditions and disorders, sport addiction is often difficult to diagnose. Nevertheless, there is little doubt that the behaviours which characterise sport addiction can be dangerous and even in the worst cases deadly, and that anyone suffering from it should seek help as soon as they feel able to acknowledge their condition.

The confusion over and controversy of exercise/sport addiction

As is the case with various problematic behaviours and behaviour patterns, there is no universal consensus within the medical and psychiatric communities as to whether or not exercise addiction should be recognised as a distinct condition. No single classification of the condition exists to which the majority of doctors are happy to refer.

It is not, for example, listed as an independent disorder in the current (fifth: DSM 5) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association, probably the leading diagnostic publication worldwide focusing exclusively on mental health.

Alongside this problematic lack of clarity, many authorities disagree about exactly when healthy exercise becomes unhealthy and subsequently develops into an addiction. This is partly because of a lack of empirical evidence – and even the extent to which behavioural addictions generally merit their own distinct diagnostic frameworks.

Because exercise is promoted as having numerous health benefits as well as being frequently prescribed as part of a holistic addiction recovery programme such as that which may be provided as part of a stay in residential rehabilitation. There is a natural resistance to the idea that it could be an addiction in its own right, even though the biochemical mechanisms driving behavioural addiction have been identified, and exercise addiction has various similarities even with drug addiction, including the phenomenon of withdrawal syndrome.

At present – and until a consensus is reached regarding any possible diagnostic framework for exercise addiction – how any individual’s case is assessed depends to a great extent on the attitude of the diagnosing physician towards exercise addiction’s status as a distinct disorder (or otherwise).

Even including such outliers, only a small proportion (between 3% and 8%) of gym users can be viewed as having a problem which may be considered an addiction, reporting a sufficient proportion of the signs and symptoms described below for their cases to be considered clinically significant.
Many people who engage in harmless levels of exercise share reasons for doing so with exercise addicts: weight management, the quest for a desired body image, stress relief, and general health are all positive reasons to work out. However, those suffering from sport addiction typically report withdrawal symptoms after a short period without exercising, which non-addicts will not.

They may develop cravings for exercise which may have a significant impact upon mood and allow sport and exercise to impact upon their daily lives and relationships in a manner which non-addicts would hardly consider. For example, they could be missing important meetings and/or family or romantic events for the sake of going to the gym.

Types of Sports That People Can Get Addicted to Taking Part In

Theoretically, any sport could become an addiction, though in practice it is sports which require a good degree of exertion which are likely to prove problematic in this area. Sports such as snooker which are much more demanding mentally than physically (indeed, there are significant debate about whether such activities should be described as “sports” at all rather than “games”) do not offer the same health benefits to participants as do sports which require significant physical effort. That is not to say that an individual cannot become obsessed with playing low-exertion sport, with extremely negative consequences for their relationships and life prospects; however, such an obsession would almost certainly result in a different diagnosis from sport addiction.

Logically, a person’s opportunities to participate in a sport decrease proportionally to the number of people required to play that sport, since the greater the number of participants required the harder it is to arrange a game or match of that sport. However that does not of course mean that team sports (for example football, requiring a total of 22 players) cannot be addictive; although opportunities actually to play a team sport may be limited, players can engage in training much more frequently, and in fitness training at any time, day or night.

It is, after all, the exercise element of sport which is the addictive behaviour in this condition, so although someone may only play football – to continue the above example – for 90 minutes each week, they may engage in exercise for many hours throughout the week

• Sport/exercise as a hobby: an individual may enjoy engaging in sport and/or working out from childhood onwards, and may incorporate physical exercise as a regular part of normal life. They may enjoy the feeling of exercise and having exercised, and value physical fitness quite highly; they may also set and work towards goals – certain times and/or distances in cardio, and certain weights and/or repetitions in resistance training.
• A growing obsession: they may begin working out with a frequency that means they begin to opt-out of previously enjoyed activities (especially those such as going out for drinks which might be considered comparatively unhealthy) and find decreasing space in their calendars for new social commitments. They may also find themselves feeling disappointed in a way that impacts upon mood if they are forced to cancel plans to go to the gym or exercise in any other way. Their pursuit of their goals will become increasingly single-minded, and they may become increasingly preoccupied with their appearance. They may also begin to demonstrate signs of fatigue which may impact upon, for example, professional performance.
• Abuse: by this point exercise has become the single most important factor in the individual’s life, with most if not all their spare time being devoted to working out. An inability to do so at least once a day will have a pronounced impact upon mood. They may develop an obsession with food and measuring calorie intake (which could itself spiral off into an eating disorder). Failure to meet goals will result in intense frustration, even aggression. They may engage in the consumption of steroids or other drugs which boost performance and weight loss and/or muscle development. They may begin to withdraw socially, with relationships with friends and even loved ones taking a back seat to their compulsion to exercise. Professional/academic performance may suffer severely as a result of absenteeism, and errors resulting from fatigue and/or a lack of concentration.

Addiction: all of the attributes of the “Abuse” stage will intensify; the individual will be aware of the potentially significant negative consequences of persisting in this behaviour but will continue to do so regardless. If they are obliged for any reason to stop exercising even for a short period, they may develop withdrawal symptoms (see below); if they are advised to stop exercising as a result of injury (possibly sustained while working out or playing sport) they may well ignore such warnings and continue to exercise, potentially aggravating the injury and/or causing new publications to develop.

As with any behavioural addiction, sport addiction is a disorder of the brain’s reward system: engaging repeatedly in any addictive behaviour creates abnormal levels of chemicals including dopamine, which act upon receptors in areas of the brain known as the ventral tegmental area and the amygdala in a way which drives the affected individual to engage further in that behaviour, and can lead to the appearance of withdrawal symptoms upon the cessation of that behaviour (see below).

What actually causes the repetition of behaviour which leads to addiction is still a matter of debate, although both genetic and environmental factors are known to contribute to the development of addiction. Heredity is a significant factor: people with a family background of addiction (of whatever type) are several times more likely than the average themselves to develop an addiction of one form or another. Meanwhile, a wide range of environmental factors have been associated with behavioural addiction generally; for example, people who have experienced trauma, either in childhood or as adults, are far more likely to become addicts than those who have not.

Sport addiction specifically can be caused by the emergence of an healthy preoccupation with body image and/or weight (as mentioned above, sport addiction often co-occurs with, and can be mistaken for, eating disorders) in someone who already exercises and/or participates in sport regularly. As noted above, compulsive exercise can also be a symptom or side effect of a substantial array of other mental health conditions.

The enjoyable feelings generated by exercise as a result of the production of endorphins can prove very alluring, and the desire to attain them can drive a person to exercise to excess. The pressure to attain specific goals (either self-imposed or as part of the competition) can drive someone to exercise with ever greater frequency and intensity, and for longer and longer periods. Meanwhile, some people – especially, but not only, women in middle age – see exercise as a means of fighting off the ageing process.

Risk factors for sport addiction

The following are considered some significant risk factors in the development of exercise addiction: low self-esteem; the presence of a pre-existing mental health condition – especially, but not limited to, body dysmorphic disorder, eating disorders and substance abuse disorders; being overweight and/or trying to achieve a target weight; suffering from a learning disability; participating in competitive sport from childhood onwards; being exposed to trauma, in childhood or as an adult; the end of a long-term relationship (for example, divorce).

Similarities Between Sport Addiction and Drug Addiction

While in the case of sport addiction there is no external substance having a psychoactive effect, nevertheless, there are several similarities between sport addiction and drug addiction. For example, the two conditions are driven by the same mechanisms in the brain’s reward system.

Meanwhile, the impact of addiction upon an addict’s daily life can be similarly destructive regardless of whether the addiction is to sport or a substance of abuse: social isolation, the breakdown of treasured relationships, negative consequences for professional or academic life, financial troubles, and the development of co-occurring mental health disorders are all common consequences of addiction.

Psychological symptoms

Some of the most common psychological symptoms of sport addiction include: an obsession with fitness manifesting in extremely frequent bouts of exercise in various forms; feelings of isolation and loneliness; mood disturbances – especially extreme irritability and even aggression if unable to exercise; prioritising exercise over possibly important obligations such as work; feelings of guilt, shame and anxiety if goals are not met or planned periods of exercise are missed; the development of other mental health conditions including but not limited to body dysmorphic disorder, obsessive-compulsive disorder (OCD), and major depressive disorder, as well as eating disorders including anorexia athletica (sports anorexia), also known as hypergymnasia.

Physical symptoms

Pronounced weight loss, or muscle gain, can be indicative of a healthy exercise regimen, but can also suggest exercise addiction especially if it takes place over an unusually short period of time. Extravagant muscle development may indicate the use of steroids or other substances designed to increase the effectiveness of exercise in terms of its impact on the body.

Frequent injury – in particular muscle strains – and chronic fatigue (with its own accompanying symptoms) resulting from exercise can suggest that the individual concerned is engaging in too much, or the wrong type of exercise; the condition known as overtraining features one or more of the following: weight loss; insomnia; decreased appetite; increased susceptibility to infections and injuries; persistent muscle soreness; impaired performance; decreased motor coordination; elevated resting heart rate.

How to spot sport addiction in someone else

As noted above, it is possible that anyone displaying some or all of the above symptoms is suffering from a sport addiction. However, many of the symptoms could result from entirely harmless levels of exercise or have causes unrelated to exercise and sport. If you believe someone may be suffering from sport addiction, it may help to contact an addiction specialist to discuss the situation with expert prior to confronting the individual in question, if that is indeed your intention.

How sport addiction affects the brain

As previously mentioned, behavioural addictions are a disorder of the brain’s reward system, with abnormal levels of dopamine produced by repeated engagement in addictive behaviour affecting the part of the brain known as the amygdala and the ventral tegmental area. Over time, tolerance develops: the behaviour in question needs to be repeated with ever greater frequency or greater intensity in order to produce the same effect as originally (and cessation of that behaviour leads to cravings to repeat it, and over the longer term to the development of withdrawal syndrome).
Similarly, high levels of endorphins produced by regular exercise can also lead to the development of tolerance, requiring ever-greater endorphin production in order to feel the same positive effects as previously.
Sport which presents the risk of head injury can also, obviously, have consequences for the brain, with brain damage having a huge variety of potential ramifications depending upon the area/s of the brain affected. Repeated blows to the head such as those which can be sustained in martial arts (including boxing), rugby and even football (by heading the ball) can damage the frontal lobe, which regulates impulse control; consequences can include depression, mood swings, emotional instability and even suicidal ideation.

Injuries sustained whilst participating in sport or exercise can be very painful and debilitating. The treatment of chronic pain with opioids is one of the major contributors to the opioid epidemic currently affecting the USA and other countries, and while that epidemic is not yet being mirrored here in the UK, the abuse of pain medication is still a significant problem – and can lead to an individual’s turning to illegal drugs, including heroin.

Prevention for Sport Addiction

The usual starting point for preventing addiction is abstinence, but in the case of exercise this is not merely challenging but profoundly unhealthy. Instead, firm limits must be set around the frequency and intensity of exercise (a limited number of periods of exercise per week, for no longer than a set time). Goals should be set in collaboration with a sports therapist who can determine which might be attainable within the limited exercise periods available. Eating healthily is a crucial component of staying fit, but a preoccupation with food which risks turning into an eating disorder should be avoided. It may prove useful to speak with an addiction specialist about the optimal approach to exercise and diet.

Sport Addiction Facts/Statistics

• Between 3% and 8% of gym users suffer from an addiction to exercise.
• Fewer than 5% of adults engage in at least 30 minutes of physical activity daily.
• Up to 7% of students studying sports science at university are exercise addicts.
• It is estimated that 25% amateur runners, 50% of marathon runners, and 52% of triathletes suffer from an exercise addiction.
• One study estimates that approximately 33% of sex addicts are also addicted to exercise.