Morbid exercise behavior: Addiction or psychological escape?

This chapter examines exaggerated exercise behavior from the perspective of behavioral addictions. First, the theoretically most appropriate and thorough definition is presented with a perspective on the much needed theoretical and semantic consistency in the field. Subsequently, we differentiate between primary exercise addiction, used as a means of escape from a psychological hardship, from secondary exercise addiction, in which exercise is used as a means for weight loss in addition to dieting. Next, we present and evaluate the most commonly used tools in the assessment of the risk for exercise addiction. Nine theories are forwarded for the explanation of exercise addiction, and are critically reviewed, while it is concluded that the best theory would emerge from knowledge gained from the diagnosed cases of morbid exercise behavior. We stress that morbid exercise behavior may be rather “revolutionary” (suddenly erupting) than evolutionary (slowly building up), because many individuals, including competitive athletes, exhibit an exaggerated amount of exercise without any sign of morbidity. Those using exercise as a means of coping with stress may show signs of addiction. However, it is the task of future research to determine why and who will resort to morbid exercise behavior in dealing with psychological hardship. Lessons from the case studies may be the most productive in such efforts.