Exercise addiction can be a serious threat to employee health

Wellness directors should advise balanced workouts, cross-training

Even in wellness, there can be too much of a good thing. While wellness professionals spend much of their time trying to get employees into the gym, they also need to keep a wary eye out for exercise addicts - those employees who overdo it to the point of threatening their own health.

"People who exercise too much can end up with overuse injuries such as tendonitis, shin splints, knee or ankle problems, or bursitis," says Susan Johnson, EdD, director of continuing education at the Cooper Institute for Aerobics Research in Dallas. "You can also deplete your glycogen levels to a point that is so low you may become chronically fatigued, because you don't give your body the time it needs to `reload' for rest and repair, for living and thinking. You may even begin bumping into walls."

Too much exercise can also result in lowered immunity - or worse. "We're beginning to speculate that a possible excess of free radical activity over several years can even lead to early death from cancer or heart disease if there is prolonged, addictive exercise behavior," notes Johnson.

Is there truly such a thing as an exercise addict? And if so, how is the diagnosis made? "There is a litmus test I have for addiction," says Cynthia S. McNeill, an exercise specialist in Atlanta. "That is when it interferes with your quality of life. If it interferes, for instance, with family time or work time, then that individual needs to seek professional help."

The body is not designed to work out three times a day, or run 50 miles a day, she notes. "If it breaks down [due to overuse], and the individual still continues to exercise, that's when you know it's become addictive."

Jan Elliott Evans, PhD, national account executive for Richmond, VA-based Health Management Corp., says that exercise addiction is real, and has been identified in scientific studies.

"Exercise addiction can arise in several different ways," she explains. "It can be physiological - an addiction to the endorphins secreted during exercise. Or, it may be emotional or psychological, arising from a pressure to lose weight or to maintain it, never being satisfied with your physical self, or a perfectionistic way of living. Some people may exercise to void negative feelings about themselves."

"When you look at the literature, what it really comes down to is endorphins," adds Johnson. "There is research showing blood levels of certain chemicals that bears out the fact that exercise addiction does exist."

"I've run into two types [of exercise addicts] in my career," says Fran Scully, MA, manager of the corporate wellness program for Santa, Clara, CA-based Applied Materials. "Often it is coupled with an eating disorder. You can't really spot the bulimic people, because they look normal, but an anorexic you can see. The other type spends way too many hours in the gym every day."

Often the pressure to exercise beyond reason comes from within, says Tom Sawyer, MS, fitness manager for Massachusetts Mutual Life Insurance Co., in Springfield. "Most people who are physical fitness nuts are individualists. They usually use equipment by themselves, and it's only their inner self who is being let down if they back off from their program," he says.

A wellness professional with a well-trained eye may be able to spot an exercise addict, says Evans. "Working out more than once a day, every day, is a red flag," she says. "If the employee is not enjoying himself, if he has a strained appearance, if he is limping, or if he is pushing himself beyond what would be a normal workout session, he may have a problem."

"I have a good eye for peoples' gaits, how they carry themselves - their posture," says Sawyer. "If they are in some kind of pain, they usually compensate with a limp, lean one way or the other, and their range of motion is limited in their ankles or their hips."

"Sometimes it can be difficult to diagnose," warns McNeill. "Many people, women in particular, may be looking in vain for the `ideal' shape, but that's completely different from someone who has an addictive personality to begin with." (See checklist at right for more warning signs of exercise addiction).

Education may help

Some employees who are seriously addicted may require the help of a mental health professional, but others may simply need to become better educated about the harm they are doing to themselves.

"It is critical to help them understand how important a rest period is to the body," says Evans. "They need to know that it is during those `healing' periods that our body really becomes more fit."

It's also important to express your concern, says Evans, and to tell the employee that they look really tired, that they might want to consider taking a couple of days off. "Provide them with informational pamphlets, or suggest they come by the office for a chat," she suggests.

"In terms of working through the pain, I try to teach them that if they choose to ignore the pain they may very well get worse, and then they will be compelled to go to a health care professional," says Sawyer. "That will cost them more time and more money, and 99% of the time that doctor is going to tell them to stop working out - which is just what they don't want to do. So I ask them, 'Why do you want to put yourself in that position?'"

Sawyer tells his employees that they needn't be embarrassed about backing off a bit. Or, as an alternative, he recommends cross-training. "If you swim, run, bike, and do weight training, and if you mix them up you can be on the edge of `excessive,' but your body can adapt to that much more easily, as opposed to doing the same activity over and over," he explains.

Another option is to moderate the employee's exercise program.

"If they complain about some chronic situation, like a rotator cuff that never heals, then you should look at their workout and see why. A lot of times they can change their exercise program to something more moderate, yet still get the sense they are doing something. Also, you can look at their form, to see if they are exercising correctly," says Scully. (The American College of Sports Medicine has its own prescription for a well-balanced exercise regimen. See the related story above.)

Finally, says Scully, wellness professionals need to recognize their limits. "I had to revoke the membership of one anorexic person I dealt with," she recalls. "I was afraid she would die, or become seriously ill. These people usually don't recognize their problems; they are beyond denial."

How would she handle such an individual in a worksite setting? "I would refer them to an EAP [employee assistance program]," she says. "Any time I hear in someone's tone of voice that they're at some point of desperation, I immediately refer them to an EAP counselor. At a certain point, as health professionals we need to say this is beyond our scope of expertise. It's very precarious for wellness people to try and start dealing with those problems themselves."