In 2003, U.S. Surgeon General Richard Carmona announced that America was facing an obesity epidemic in which two of every three Americans were overweight or obese. In Carmona's Call to Action to Prevent and Decrease Overweight and Obesity, he recommended adults engage in at least 30 minutes of moderate exercise most days of the week. Since then magazines, talk shows, newspapers and commercials have constantly told Americans to exercise more often. Though many Americans struggle to complete the Surgeon General's recommended daily activity, others are exercising in excess and harming their physical and mental health through overtraining, compulsive exercising and bulimia. While intense exercise training can be done safely, exercisers should know how to distinguish safe training from overtraining.
Over-exercising is "training beyond the body's ability to adapt to the strain put onto the body," said Jeff Dillard, fitness director of Atlantic Sports & Rehab. He added that over-exercising can be a result of exercising at an intensity level that is too high for the exerciser, but added that overtraining is usually a result of exercising too frequently and not giving the body enough time to recover. Instead of helping improve one's level of fitness, too much exercise can have the opposite effect.
"Overtraining would be a point at which the participant ceases to progress and actually goes into a situation where the participant digresses," Dillard said.
Although the exerciser's fitness level can suffer from exercising too frequently or for too long, compulsive exercisers are compelled to exercise for longer durations or more frequently to meet their psychological impulses.
"Over-exercisers tend to experience strong feelings of guilt or anxiety if unable to exercise, ... define their self-worth through their exercise routine, [are] rarely satisfied with exercise achievements, use exercise to compulsively control their weight, ... [or] hide from emotional pain by working out," said Erica Perkins, University assistant director of intramural recreations.
People motivated to exercise excessively by feelings of guilt from eating or by the desire to control their weight may be suffering from bulimia.
"Bulimia is an eating disorder that is prescribed as binging and purging, and the purging can be by exercising," said Melanie Brede, Elson Student Health Center nutrition educator and co-chair of UVA CARES, an organization that addresses eating disorders and body image concerns.
This method of using exercise to purge, as opposed to using laxatives or forced vomiting, is commonly referred to as "exercise bulimia." Brede said people may use exercise to "make up for excess calories" or they may be using exercise to purge what should be considered a normal amount of food. She added that someone suffering from this disorder exercises not for recreation or general fitness but to manipulate calories and weight. Exercise bulimia can be distinguished from a healthy exercise plan for weight loss by the excessive frequency or duration of exercise and by the psychological motives for exercising.
This method of bulimia often correlates with personal characteristics such as "a drive for high achievement or perfectionism that can show up in sports where there is a lot of competition," Brede said, noting that competitive sports that include weight classes. such as wrestling and rowing. and sports that have a judging and aesthetic component. such as gymnastics, dance and diving. tend to see a higher prevalence of eating disorders. While exercise bulimia is prevalent among athletes, it is also seen among non-athletes.
"Culturally, there is a lot of expectations and pressure for exercise and fitness, so a lot of times when people are praised for their dedication to exercise, that can be a contributing factor," Brede said, adding that bulimia is seen at a higher rate among people in their teens and early 20s, which may be related to developmental issues during this time period.
Exercise bulimia and overtraining can cause both long-term and short-term damages to one's health. Perkins said some of the short-term dangers of over-exercising are fatigue, headache, dehydration, nausea, muscle cramps, electrolyte imbalance, dizziness and poor mental and physical performance. The immune system can become depressed if the body does not have adequate time to recover from exercise, thus making the exerciser more susceptible to the flu and other illnesses, Brede said.
Additional dangers can result from repeatedly engaging in this kind of behavior.
"The dangers or consequences of repeated over-exercising include but are not limited to heart rhythm problems, kidney failure, heart attack, stroke, infertility, bone loss, fractures [and] musculoskeletal injury," Perkins said.
Brede said the excessive stress put on bones from too much exercise can lead to osteoporosis, a disease in which bones become fragile and are more likely to break. Women also can face irreversible bone damage because over-exercising can cause an deficiency of estrogen, which is needed to maintain bone density. Other long-term health damages from overtraining, described by The Aerobics and Fitness Association of America in their Basic Exercise Standards and Guidelines, include anemia, an increased resting heart rate, a slower recovery of heart rate and amenorrhea, the absence of menstruation. For those suffering from exercise bulimia, Brede said not consuming enough calories to balance the amount of calories burned while exercising can lead to an iron deficiency.
To prevent overtraining, exercisers should be sure to give their bodies plenty of time to recover after exercising. Compulsive exercisers and people suffering from exercise bulimia, however, generally need help changing their attitudes toward exercise and their bodies. Brede said recovering from this disorder is only part of the picture; the person suffering needs to develop a healthier attitude toward food and exercise with the help of therapy and support.
"There is usually an underlying cause or reason that one needs [to] figure out and address," Perkins said. "That is most successfully accomplished through the assistance of a multi-disciplinary team of professionals like a physician, mental health therapist, dietician and exercise specialist."
Students can learn how to exercise healthily to prevent overtraining and compulsive exercising. AFAA recommends individuals participate in cardiovascular training three to five days per week for 20 to 60 minutes and engage in strength-training activities two to three days per week for each major muscle group for 20 to 60 minutes.
Perkins suggested University students who may be compulsive exercisers or suffering from exercise bulimia seek help through Counseling and Psychological Services, Peer Health Educators or Ainsworth Clinic individual and group therapy.
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