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How Training Addiction and Disordered Eating are Connected

BY Phil White

Learn why endurance athletes are susceptible to training obsessively, where this might intersect with similarly self-destructive beliefs about food, identity and body image, and how you can help avoid pitfalls.

There is an increasing amount of content examining how runners, cyclists and triathletes are prone to unhealthy attitudes to nutrition, including a recent TrainingPeaks article on how a coach helped one athlete overcome disordered eating. But too little attention has been paid to the link between this phenomenon and compulsive exercise. In this article, I’ll explore why endurance athletes are susceptible to training obsessively, where this might intersect with similarly self-destructive beliefs about food, identity, and body image, and how you can help when a client is habitually overtraining.

Getting Hooked on Doing More  

While endurance sports have become wiser about the need to incorporate short, high-intensity sessions and strength training, there’s still a prevailing “more is better” attitude, and triple-digit weekly mileage remains a badge of courage for many competitors. In a recent Instagram post, former Lakers S&C coach Tim DiFrancesco, who now trains a lot of runners at TD Athletes Edge, wrote, “It amazes me how many people overestimate the amount of working out that’s necessary to be healthy and get results. #stopovertraining.” He went on to explain that “Over-trainers think they’re losing progress if they don’t work out daily, so they never stop.”[i]

Initially, this faulty belief can lead to your athletes overreaching. The concept isn’t always negative. A temporary overreach can be functional if you make a programming decision to progressively overload an athlete for a brief period to prompt a desired adaptation. But non-functional overreaching is the more likely consequence of compulsive exercise and happens when someone accumulates too much volume with insufficient recovery. If this pattern continues, it leads to overtraining “that results in a prolonged performance decrement (>two months) and more severe symptoms,” according to a paper published in ACSM’s Health & Fitness Journal.[ii]

The author shared one reason someone might be tempted to first acutely overreach and eventually chronically overtrain: “Exercise can become addictive because of the effects of endorphins, dopamine and other exercise-generated factors on the brain. This addiction can easily result in frequent intense training sessions that are not interspersed with adequate recovery periods.”

Misreading Coaches’ Expectations

Another cause of feeling obligated to overexercise and under-fuel could be the combination of what an athlete expects of themselves, what they believe you want from them as their coach and what they think it takes to be successful in training and competition. When framed correctly, these factors can create positives like training adherence, long-term commitment and intrinsic motivation. But when viewed through the wrong lens, real and perceived expectations can quickly take an athlete to a bad place.

“Athletes and coaches often reinforce maladaptive behaviors (i.e., dietary restriction, excessive exercise) because they believe that certain aspects of sport participation, such as mental toughness and continuous engagement in intense training, are pivotal in reaching optimal performance,” the authors of a review in The Sport Journal wrote. “As a result, athletes may perceive compulsive exercise as a demonstration of high commitment to their sport rather than a symptom of an eating disorder. In addition, athletes and coaches falsely believe that weight loss achieved through food restriction and excessive exercise will imminently lead to increased performance.”[iii]

Compounding Body Image and Identity Issues

Another factor that could be causing some of your clients to exercise compulsively is that it’s linked to distorted beliefs about body image, identity and eating. Suppose someone believes that they’re taking in too many calories, and this will impact their weight, body composition or how they look in an undesirable way. In that case, they might overtrain to compensate — even if the perception is inaccurate.

A team of British researchers investigated the possible links between athletic identity, compulsive exercise and eating disorders. Among 501 male and female runners, they didn’t find that those athletes who tied their identity to sport were more likely to change their nutrition habits but did observe that they were more likely to overtrain to control their weight.[iv] The authors advised that “coaches might need to be vigilant to the welfare of endurance runners that have a strong athletic identity since this could be linked to them exercising compulsively.”

This notion is supported by another trial conducted at Southern Illinois University, which found that people who identified themselves as “obligatory runners” were more likely to overtrain and undereat than those who ran regularly but didn’t feel compelled to. “Exercising to maintain identification with the running role may be associated with pathological eating and training practices,” the authors concluded.[v]

Much of the evidence about the intersection of body image, identity, and compulsive exercise centers on women, but men are also affected. Researchers from the University of California, San Francisco and the University at Albany investigated the similarities and differences of how compulsive exercise, eating restriction, and weight suppression were connected among 277 male and female runners.[vi] They found that while women were more likely to report exercising addictively and eating in a disordered way, men had a greater incidence of trying to control their weight and body shape through compulsive training. They suggested that such issues are more prevalent in sports like running that emphasize leanness.

Connecting Exercise Addiction, Disordered Eating and RED-S

A study published in Nutrients investigated the possible connections between low energy availability (LEA), compulsive training and disordered eating. They concluded that “compared to female controls, the likelihood of being at risk of LEA was 2.5 times for female athletes with disordered eating and >5.5 times with combined disordered eating and exercise dependence.”[vii] Ongoing LEA can predispose an athlete to Relative Energy Deficiency in Sport (RED-S), which an International Olympic Committee (IOC) position paper stated could increase the risk of injury, decrease performance and disrupt the functions of hormonal, cardiovascular, cognitive and at least nine other major bodily systems.[viii] 

So just how prevalent is compulsive exercise among endurance athletes? A study released via Frontiers in Sports and Active Living found that among 202 female competitors training at least five days a week, 23% tended to go too far in their workouts, 21% were at risk of disordered eating and a whopping 65% were in the LEA danger zone. Considering the interplay of these factors, the authors recommended that “Exercise addiction should be considered as an additional risk factor in the prevention, early detection and targeted treatment of RED-S among female endurance athletes.”[ix] So, while identifying a caloric deficit is necessary to help a client overcome LEA and its side effects, you also need to view obsessive overtraining as a major red flag.

Combating Compulsive Exercise

If a client is compulsively overtraining, this behavior will likely not exist in isolation. So, in addition to carefully reviewing workout logs, examine their eating habits and see if you can find a correlation. You could do this informally or by asking them to keep a simple food journal for a few weeks. When you find a negative pattern, use it as the launching point to follow up and get to the bottom of the issue. Ask many open-ended questions to see what the client believes about their body image, identity and the relationship between training, eating, performance and health.

Part of the problem might be rooted in a mistaken belief that you want them to overtrain or expect them to look a certain way. Try to clear up this confusion. Emphasize that you value them as a person first and that while you want them to achieve their training and racing goals, their overall well-being and happiness are more important. Also, reiterate that to perform and feel their best, they need to avoid overexercising, recover sufficiently between sessions and fuel adequately. If you feel out of your depth, consult with a sports psychologist and/or dietician to help come up with practical solutions.


References

[i] Tim DiFrancesco, Instagram, February 11, 2023, available online at https://www.instagram.com/p/CoiFOUgu_pm/?hl=en.

[ii] Brad A Roy, “Overreaching/Overtraining: More Is Not Always Better,” ASCM’s Health & Fitness Journal, March 2015, available online at https://journals.lww.com/acsm-healthfitness/Fulltext/2015/03000/Overreaching_Overtraining__More_Is_Not_Always.4.aspx.

[iii] Ksenia Power et al., “Disordered Eating and Compulsive Exercise in Collegiate Athletes: Applications for Sport and Research,” The Sport Journal, February 2020, available online at https://thesportjournal.org/article/disordered-eating-and-compulsive-exercise-in-collegiate-athletes-applications-for-sport-and-research.

[iv] Robert Turton et al., “Athletic Identity, Compulsive Exercise and Eating Psychopathology in Long-Distance Runners,” Eating Behaviors, August 2017, available online at https://pubmed.ncbi.nlm.nih.gov/28325645.

[v] Jennifer I Gapin and Steven J Petruzzello, “Athletic Identity and Disordered Eating in Obligatory and Non-Obligatory Runners,” Journal of Sports Sciences, July 2011, available online at https://pubmed.ncbi.nlm.nih.gov/21644168.

[vi] Sasha Gorrell et al., “Compulsive Exercise and Weight Suppression: Associations with Eating Pathology in Distance Runners,” Eating Behaviors, January 2020, available online at https://pubmed.ncbi.nlm.nih.gov/31887559.

[vii] Megan A Kuikman et al., “Examining the Relationship between Exercise Dependence, Disordered Eating, and Low Energy Availability,” Nutrients, July 2021, available online at https://pubmed.ncbi.nlm.nih.gov/34444761.

[viii] Margo Mountjoy et al., “International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update, International Journal of Sport Nutrition and Exercise Metabolism, July 2018, available online at https://journals.humankinetics.com/view/journals/ijsnem/28/4/article-p316.xml.

[ix] Ida Lysdahl Fahrenholtz et al., “Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes, Frontiers in Sports and Active Living, May 2022, available online at https://pubmed.ncbi.nlm.nih.gov/35592590.

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About Phil White
Phil White is an Emmy-nominated writer and the co-author of The 17 Hour Fast with Dr. Frank Merritt, Waterman 2.0 with Kelly Starrettand Unplugged with Andy Galpin and Brian Mackenzie. Learn more at www.philwhitebooks.com and follow Phil on Instagram @philwhitebooks.

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