Exercise dependence: when runners don't know when to quit

The health benefits of exercise have been extolled by health professionals. The only concern about regular exercise has been the risk of overuse injuries. As more people have embraced regular exercise, a problem of habituation to the activity to the point of disruption of the normal conduct of daily life has occurred. A neurobiochemical explanation based on endorphins has been hypothesized as a rationale. This explanation seems unlikely based on current scientific understanding. Most likely, the addictive exercise behavior is a function of habit and entrapment in a spiral of exercise to avoid the unpleasantness of guilt and anxiety which occurs when an exercise bout is missed. There are a series of behaviors that characterize the dependent exerciser that assist the clinician in diagnosing the syndrome. Treatment of the obligatory exerciser centers around convincing the exerciser of the extremes of the exercise pattern and its associated destructive behavior. Once the behavior is identified, the exerciser may continue exercising on a controlled basis while relearning other coping techniques.