I'm Addicted...To Exercise

by Marie-France Hivert, MD, MMSc

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I am so conscious about the health benefits of exercise that some days I feel like an exercise "addict." It turns out that I'm not alone. There are plenty of people who have the same urge that I do, who are excited about going up and down stadium steps, jogging 10 miles, or making the gym part of their daily routine. Sometimes we have a goal, but sometimes we do it just because it feels good.

Dr. Marie-France Hivert (in blue) at the World Ultimate Club Championship for Ultimate Frisbee 2014

Lucky for me and others like me that the term exercise addiction is not part of the DSM-5 (Diagnostic and Statistical Manual). According to the medical definition, compulsive engagement into rewarding behaviors to the point of impairing adversely other aspects of life and having adverse consequences can be classified as an addictive disorder. So, very few of us actually get to that point. Most of us who feel we need to exercise daily are more "fervent exercisers" than "addicted" to exercise.

Yet, there are real physical and psychological impacts that most fervent exercisers seek and miss deeply on days when they can't work out. Some of us are hooked on what is called the runner’s high. Others love that feeling of muscle soreness the day after a big workout. Many are committed to a team sport or group activity for the social aspect. Those of us who experience these know they are real physical and emotional phenomenon. What does the science of exercise tell us about possible exercise addiction? There are still few data from human studies and whether this activation is related to release of endorphins, catecholamines, endo-canabinoids or other hormonal response remains debated.

Here's the bigger question I have: How can we get more people hooked on that exercise feeling? Let’s be honest, if exercise addiction was common, Americans would exercise more than they do.  And it would be easier to encourage people to make exercise part of their routine, leading to less sedentary behavior and better health. According to an objective assessment of physical activity in US, only 8% of teenagers achieve the recommended 60 minutes per day of physical activity and less than 5% of adults achieve 30 minutes per day. So, obviously, it’s not that easy to activate exercise physiological responses to the point where we get addicted—or even off the couch.

My literature search on the topic left me very unsatisfied. I found a few pointers from "athletes development" science. I learned that the number one reason for kids to play sports and continue to be active through life is FUN. I don’t think this changes much for adults. Is there a link between the FUN factor to be active as a kid and the possibility to activate the reward circuits in exercise practice through life? If anyone has good data, please share with us. This is a critical area in need of research.

I’ll keep thinking about all that on my run today.