Running Addiction with Dr. Heather A. Hausenblas Running Addiction with Dr. Heather A. Hausenblas

Hi Heather!

Hello!

Heather A. Hausenblas. Am I saying that right?

Pretty close. It’s Hausenblas. 

Hausenblas?

Hausenblas.

That’s gotta be one the best names in the business: Heather A. Hausenblas, PhD.

[Laughter]

Thank you! I’ve heard it said in every way possible over the years.

It sounds good however you say it. It looks good on paper, too.

[Laughter]

Anyway, that’s the flattery out of the way. Can you tell me a little about yourself and your work?

Okay. So, let’s see. I live in Florida; I’m originally from Canada. I was working at the University of Florida as a Health Psychology Researcher, so I studied health behaviors. In particular, I did a lot of work with exercise and the psychological effects of exercise, how it can affect your mood, why most people do not exercise, and how we can make them exercise more. I also looked at sleep and stress, as well as our social connections, but the one thing that gets the most interest from a media standpoint is exercise dependence or excessive exercise.

That’s what I wanna talk about. How did you get started in that area?

Well, it began 25 years ago when one of my PhD students and I were in the lab and were talking about designing this exercise integration to get women to exercise more, and we began to think, ‘Well, what about the other end of the continuum?’ Because we’re always focusing on people who don’t exercise, why don’t we take a look at people who exercise a lot and try to understand their motivation to help us get sedentary people to exercise more? And that’s really what got me into the whole excessive exercise or exercise addiction/exercise dependence area, which really, you know, 25 years ago, hadn’t been looked at very well from a scientific standpoint. 

Right.

Some researchers were saying it was a positive addiction, while others were saying it was negative, so it was really all over the place. We tried to bring some conceptual framework to it and a strong way to measure it so we could understand it more.

So, how do you define exercise addiction, and what are you actually addicted to? The endorphin release?

That’s a really good question, and honestly, it’s really difficult to know. What we ended up doing from the very beginning with the research was we developed this framework of primary versus secondary exercise dependence, because you can have individuals that have eating disorders that exercise excessively to either maintain or lose weight, and we classify those people as Secondary Exercise Addicted, meaning their excessive exercise was secondary to their eating disorder. 

Okay.

And oftentimes, we would exclude that group because they have a very different motivation for engaging in excessive exercise, and we would focus on what we called Primary Exercise Addicted individuals because that was their sole thing—

They didn’t have an underlying motivation.

Right. So, the primary group was largely what we would look at. And often, with Primary Exercise Addicted individuals, there are stress, anxiety, and different issues that we could then measure, which helped us develop a scale based on The Diagnostic and Statistical Manual of Mental Disorders criteria for substance abuse, and we called it The Exercise Dependence Scale. It ended up being translated into 20-plus different languages, so it’s really taken off internationally and used as a measure to assess, you know, why people will engage in something like exercise to an extreme and what are the health effects associated with it. Typically, we look at exercise as a really positive thing, and we all should be doing it, but like anything, it can be taken to an extreme and become negative. 

Right, right.

But a lot of people who are engaged in excessive exercise or exercise addiction, they’ll often be praised for it. 

Oh, wow. Of course.

Yeah, people will say, ‘Oh, gosh, I wish I had that kind of addiction.’ 

Right, which is very unhelpful, I imagine.

Right. These people are really in turmoil, you know? For example, I interviewed one gentleman for a study, and he said his addiction was very expensive for him; he didn’t want anyone to know how much he was exercising, so he ended up buying three different gym memberships—

Good god.

He’d go to one gym in the morning, one in the afternoon, and the third one in the evening.

Wow. 

Yeah, it’s beyond just going to the gym religiously every day for an hour or two. It’s really this compulsion where exercise becomes the top priority in someone’s life. Let’s say their flight is delayed, and by the time they get home, they’re supposed to go to dinner with friends or family; well, they’ll cancel that because they haven’t had their exercise, and they’ll go and exercise. Whereas most of us would say, yeah, it’s okay to take a day or two off, for these individuals—

That’s not an option.

It is not an option. And they’ll typically exercise multiple times a day for long periods of time. I just had a wife email me last month—I get a couple of these each month—and she said her husband was exercising six to seven hours per day.

Six to seven?

Yeah. And he knew he had a problem, but he couldn’t stop. So, it’s that kind of extreme behavior. And there are certain things that are kind of related. People who have perfectionistic leanings tend to be more prone to this.

That could be anyone, though. I feel like I have a perfectionistic bent in some ways.

Well, one of the main tell-tale signs is when people experience extreme withdrawal effects. So, for example, if you and I go and exercise, afterwards we’re going to report that we’re in a better mood, right? Or if we’re stressed and we go and do exercise, we’re going to feel better.  

Yeah.

Somebody who is exercise addicted will experience these emotions to an extreme, and it’s almost like a craving for it. Let’s say they haven’t exercised for a couple of hours—they’ll begin to experience withdrawal effects. So, you see very similar symptoms to what you’d see with someone addicted to a substance or even addicted to a behavior like gambling. The Diagnostic and Statistical Manual of Mental Disorders is the classification system for mental disorders, and in the last edition that came out, they finally acknowledged that people can become addicted to behaviors—it’s called Behavioural Addiction—and the only one they put in there, the only one they felt had enough research, was gambling. 

But not exercise addiction?

No. Well, it got an honorable mention. But part of the challenge, from a funding standpoint, is it’s hard to get funding from the National Institute of Health to do this kind of research.

Why is that?

It doesn’t affect enough people. It affects a very small percentage of the population, and that’s because here in the U.S., we’ve got about 20 percent of adults who are regularly physically active, and out of that 20 percent, you’re looking at less than one percent that’s addicted to exercise, so it’s a really small portion of people, and because of that, it doesn’t get a lot of attention. 

What happens when someone who is addicted gets the flu or something? 

Well, one of the characteristics is not being able to stop exercising, so if they get sick, that’s not going to stop them. And they won’t stop even with an overuse injury. One person that I interviewed ended up with a herniated disc, and her doctor said, ‘Look, you need to take six weeks off,’ and she said, ‘There’s just no way I’m taking any time off.’ And she continued to exercise through excruciating pain. Another doctor said he casted somebody even though they did not have a broken foot because he felt that this was the only way he could get them to stop exercising. 

No way. He put a cast on someone who didn’t have broken bones?

Yeah. So, it really is this extreme kind of behavior. And if someone says, ‘Oh my gosh, I went and did two fitness classes today for an hour each,’ I’d be like, ‘Okay, that’s fine. I wouldn’t worry about it. You’re clearly a committed exerciser,’ but it’s this compulsion and this drive that takes it to a whole other level.

Does it interfere with people’s lives in the same way as gambling or substance addiction does?

Oh yeah. I’ve interviewed people who have lost their jobs because their employers were like, ‘Look, you can’t be leaving your desk multiple times a day to go and exercise.’ And these people doing the exercise, they know it’s an issue, like, they’re well aware that they’re exercising too much, but they can’t stop.

What are some of the strategies to help manage exercise addiction?

Well, for a start, trying to bring it down to a level that is reasonable. And that’s a challenge because often with addictive behaviors, like, let’s say, alcohol or drugs, you completely cut it out. But with exercise, you don’t want to do that because exercise for most people is a good thing, so you don’t want to tell someone who is exercise addicted, ‘You can’t do that anymore,’ because then they’d be sedentary. 

Right, right.

So, it’s a matter of cognitive behavioural therapy, and trying to get them to rethink how they think about exercise and get it down to a reasonable level.

I know a guy named Max who is a professional trail runner, ultra-runner and he’s almost one-thousand days into a running streak. Hasn’t missed a day for almost one-thousand days. Like, he’ll run a 100-miler and then run a mile the next day to keep it going. In fact, he recently had to run on the spot at the back of an airplane so that his streak wouldn’t be disrupted.

[Laughter]

I don’t think Max is an exercise addict—he’s just enjoying knocking off the days. But what do you think of ultra-runners in general?

I would agree with you; he just sounds like a very committed individual. But that’s the thing: just because you go and do ultra-marathons, it doesn’t mean you’re addicted to it. I mean, after you do your 100-mile race, okay, run a mile the next day to keep your streak alive, because it’s not like he’s going out for a 50-mile run. 

That’s what I’m thinking.

So, he ran on the plane. I like that.

He’s a complete beast.

I would also note that we exclude professional athletes because they have a different motivation for engaging in a lot of exercise and a lot of training. My sister-in-law, her sister was an elite triathlete; I think she was ranked third in the world for a while. And it was very common for her to train six or seven hours a day. But I wouldn’t classify her as addicted just because of the large volume—that’s just one piece of it. And literally, the day that she decided she had had enough and didn’t want to do it anymore, that was it. She retired.

She stopped exercising.

Well, she still exercises, but not at that level or volume anymore. 

So, at what point would you say someone should seek professional help? I know you said they know they have a problem, but at what point should they go, ‘Okay, I gotta change this.’

Yeah, well, oftentimes it comes from other people saying, ‘Hey, this is kind of a lot.’

Right. So, it comes from other people telling you, like, ‘What are you doing?’

Yeah. Because, you know, they might not necessarily realize there’s a problem, or they do, but they just don’t want to stop—or they don’t know how to.

In a way, it sucks that it only affects such a small percentage of people because if more people were affected, there’d be more money thrown at research. But maybe if we could get more Americans to be healthy and do exercise, we could jack those exercise addict numbers up—

[Laughter]

—and get some funding!

I know! 

That could work!

Well, we certainly do need a lot more people to be moving their bodies here in the U.S.

Thank you for your time, Dr. Hausenblas.

You’re very welcome.