Exercise addiction and anorexia had caused 33-year-old Rebecca Quinlan to be in intensive care, where she was tube-fed to stay alive. She was admitted to an eating disorder clinic after her hospital stay, but it was ineffective. She would wake up at 5 a.m. crying and running uncontrollably back and forth in her kitchen, quietly, to hide from her parents the fact she was pathologically exercising.
Courtesy of Rebecca Quinlan
“That was probably my lowest point,” Quinlan, who resides in Essex, England, says. “I’d go to bed dreading the next day because I knew what was going to happen. It was just going to be a day of exercise and mental torture.”
It wasn’t until Quinlan’s third admission to the hospital that she was discharged under a community treatment order, which provided her with specific goals, a weight she was not able to go below, a supportive community and therapy that saved her life.
A Healthy Habit Pushed to Extremes
Dr. Anna Lembke is a professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. She says that exercise is backed by research as one of the most important routines we can establish for our overall health. It is even well-documented that exercise helps to prevent and treat addictions, such as drug addictions. However, exercise taps into the same neural pathways as drugs by producing the chemical dopamine, which makes us feel good. As a result, in some cases, exercise can actually lead to an addiction.
“Research shows that exercise slowly increases dopamine levels over the course of the activity, and it often remains elevated for hours afterwards,” Lembke says. “But too much exercise causes physical, social, emotional distress, and when it’s compulsive and extreme, can exhaust the brain’s ability to continue to make dopamine. This is probably what happens to some extent with overtraining syndrome.”
A Potentially Life-Threatening Addiction
Lembke says that exercise addiction is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, and therefore data and the number of people affected by it is not well known. In her book “Dopamine Nation,” she unpacks exercise research involving running wheels in animal models. In these studies, some mice compulsively exercise until their tails are permanently curved up in the shape of the running wheel, and others will exercise until they die.
According to Lembke, the most obvious symptom of exercise addiction is if you’re hurting yourself. Other signs of addiction are if the behavior is consuming so much time that you’re not present for your family and friends. You become compulsive about that stimulus, and nothing else is pleasurable.
Quinlan’s addiction to exercise strained her relationships with friends and family. She would often choose exercise over socializing with friends. And her family insisted on being with her when she walked obsessively, which disrupted their lives.
“They would be desperate for me not to exercise, but I would ignore them,” Quinlan says. “I would just be marching around the streets, and my mom would be running to try and keep up with me. I would turn down going anywhere or doing anything if it meant affecting my exercise regime.”
Technology and a Culture of Excessive Competition Fuels Obsession
Quinlan grew up active and began running competitively when she was 14. It was in her youth that she was rewarded to push beyond her limitations and injuries.
“If you’re not hurting, you haven’t worked hard enough,” Quinlan says. “Because I grew up with that attitude; it very much reinforced the exercise addiction I developed.”
She went on to compete in track and field for Loughborough University in 2007, and within a year, her exercise and eating became disordered. She left college to seek help. She believed that the lighter she became, the faster she would run.
“Virtually as much of the day that I could exercise, I would be,” Quinlan says. “I was in a lot of pain physically and mentally, and I reached the point that I was struggling to walk. I knew something wasn’t right. Although I didn’t know what was wrong with me. The thing I did know is that I just had to keep myself exercising.”
In Lembke’s clinical experience, exercise and eating disorders are often experienced as cross-addictions in sports where weight control is advantageous, such as running and sports with weight classes like wrestling.
Lembke says that the rise of technology in tracking apps and watches and the spread of social media make it harder than ever not to infatuate over social status, identity, rank, progress and constantly comparing ourselves to others.
Treatment and a Healthy Return to Exercise
Quinlan spent three years as a revolving door patient in three different eating disorder facilities. The first admission was ineffective for Quinlan because they had her eat more to offset her excessive exercise, rather than treating exercise as an addiction. Her second admission was more successful. However, she had nothing else in her life after treatment, and that made her spiral back into addiction. She completed her third and final round of clinical treatment in 2011, and has been healthy since. It provided goal-setting, therapy and gradually reduced her exercise over time.
“I was so completely exhausted by my life and how I’ve been living and I knew I couldn’t keep doing it,” Quinlan says. “I knew something had to change.”
According to Lembke, everyone is different in how much challenge and passion they need for a healthy, meaningful life. For those concerned about a potentially addictive habit, she suggests a minimum 30-day abstinence experiment. This is where you abstain from a behavior for 30 days to reset reward pathways. Then when you return to the behavior, if you return, you’re more likely to be able to do it in moderation, having reset reward pathways. If not, you should seek out professional help.
Currently, despite her addiction to exercise, Quinlan is able to train safely because she uses a coach and a program with clear boundaries. She also continues to work with doctors to keep her accountable. These tools don’t cure addiction, but they allow her to manage it in a way she could live her life fully.
Quinlan now works in administration at the National Health Service and has goals to continue to improve her athletic performance. She also raises awareness about eating disorders and exercise addiction. And she has a book coming out later this year called “Running Free, My Battle With Anorexia.”
“I can live a relatively good, normal life, but it is just there in the background,” Quinlan says. “Never give up hope. There is hope for everybody. Don’t give up.”