13 Signs That Exercise is Hurting You – Dr. Ralph Carson

If you exercise frequently — despite severe negative consequences — you could have a problem. Do these signs of compulsive exercise seem familiar to you?



“I’ll just go another hour on the treadmill.”
“I don’t need to be social this weekend, I just want to hit my workout goals.”
“Yes, my knee hurts. But a few more miles won’t make things any worse. My knee will heal eventually.”
Do these statements ring a bell? If so, you may find yourself on the excessive exercise continuum. Excessive exercise taken to the extreme is known as compulsive exercise.
Anywhere from one to six percent of the general population exercises excessively and 80 to 90 percent of patients with anorexia struggle with this issue (Cunningham ’16; Davis ’94; ’06; Bratland-Sanda ’10).
It’s important to talk about this issue
Exercise is prescribed for most people as a necessary ingredient to living a healthy life. But when you push your body to exercise to an extreme — without taking time to rest and recover — you put yourself at risk for physical injuries and significant health issues.
While many individuals that compulsively exercise do have anorexia or another eating disorder, there are many people that exercise compulsively that do not have disordered eating habits.


Signs of compulsive exercise

If you exercise frequently — despite severe negative consequences — you could have a problem. Do these signs of compulsive exercise seem familiar to you?

  1. You are underweight or severely underweight.
  2. You are frequently tired.
  3. Your exercise routine interferes with (or has replaced) your social life.
  4. You experience injuries and muscle soreness and still continue to exercise.
  5. You get sick frequently and have many respiratory tract infections.
  6. You experience GI symptoms (bloating, cramps, diarrhea).
  7. You notice hair loss or have pale skin.
  8. You notice an increasing number of medical complications including racing heart, dizziness, fainting, hypotension and others.
  9. You spend what most people agree is an excessive amount of time and energy doing physical activities.
  10. You have an inflexible exercise schedule; “I must work out today; nothing will stop me.”
  11. You experience withdrawal symptoms when exercise is stopped (insomnia, mood or appetite changes).
  12. You deny over-exercising or downplay your exercise routine when someone brings it up.
  13. Females: You notice changes in your menstrual cycles (or your periods stop completely).

Why do people exercise excessively?
Excessive exercise often starts in a seemingly harmless way. People start to exercise excessively for many reasons, like the following:

  • Activity level — Some people exercise compulsively because they are hyperactive; their nature is to always be moving.
  • Mood — Some exercise to control their mood, particularly anxiety issues; intense activity calms them down. Exercise can also have an antidepressant effect.
  • Dependence or Addiction: Some people are even conditioned to a dopamine or endorphin “high” from exercise. Signaling in the pleasure/reward system is genetically wired to increase the likelihood of being physically active and sustaining an exercise program (Herring ’14).
  • Athletic goals — Some athletes exercise compulsively to reach a goal; they may achieve a great deal of success in sports and in athletic competitions.
  • Genetics — Starvation activates certain genes through epigenetics. When a certain weight is reached, the body becomes unfazed by starvation and commences searching for food as a survival technique in times of famine. A foraging behavior of sorts begins and is often accompanied by hoarding. (Baird ’06; Gusinger ’03, Kersting ’04).
  • Weight control or physical appearance — Commonly, especially in people with eating disorders, many people exercise excessively to lose weight, to maintain weight loss or prevent weight gain.

Do you have a problem with exercise?
If you’re wondering if you have a problem, check out the link to the Compulsive Exercise Test, shared below. As you read the test questions, be honest with yourself. Try not to minimize or downplay your exercise habits.
Click to take the Compulsive Exercise Test: Are you a compulsive exerciser?
Have the courage to seek help
Many individuals claim that they don’t like to exercise – but these same people persist with workouts despite injuries or bad weather. This indicates that there could be a serious problem.
The question is: how can you get help for compulsive exercise?
My belief regarding excessive exercise and eating disorders is that it’s better to be safe than sorry. Maybe you don’t have a problem. But what if you do?
There is nothing wrong with meeting with a mental health professional to talk about concerns related to exercise, athletics, eating habits or body image.
If you suspect that you have an issue with excessive exercise, know that it’s always better to catch these types of issues early on. Don’t wait too long, thinking that you are going to get better. Compulsive exercise, particularly when coupled with an eating disorder, can lead to long-term changes that seriously damage the brain and body (Cook ’16; Powers ’08).

Thankfully, help for excessive exercise is available. You may even find help at a local eating disorder clinic near you.
Make an appointment. Talk to a therapist. It won’t hurt.
Note: Those in treatment for eating disorders should have an in-depth discussion with their treatment team before starting or changing physical activity.
Ralph Carson, RD, PhD, is a nutritionist and exercise physiologist with over 40 years of experience. He is currently Vice President of Science and Innovation for Eating Recovery Centers (ERC). Dr. Carson is an active member on the board of the International Association of Eating Disorder Professionals (iaedp) and author of The Brain Fix: What’s the Matter with Your Gray Matter.
The Compulsive Exercise Test is shared with permission from Jenni Schaefer’s website: L. Taranis, S. Touyz, and C. Meyer, “Disordered Eating and Exercise: Development and
Preliminary Validation of the Compulsive Exercise Test,” European Eating Disorders Review 19 (2011): 256–68.


  • Baird JP et al Effects of neuropeptide Y on feeding microstructure: dissociation of appetitive and Consummatory actions Behav Neurocsi (2006) 120: 937 – 951
  • Bratland-Sanda S et al Physical activity and exercise dependence during inpatient treatment of longstanding eating disorders: an exploratory study of excessive nonexcessive exercisers Int J Eat Disord (2010) 43: 266 – 273
  • Cook BJ et al Exercise in Eating Disorders Treatment: Systematic Review and Proposal of Guidelines Med Sci Sports Exerc (2016) 48: 1408 – 1414
  • Cunningham, HE et al Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise Int J Eat Disord (2016) 49: 778 – 792
  • Davis C et al The role of physical activity in the development and maintenance of eating disorders Psychol Med (1994) 24: 957 – 967
  • Davis C and Kaptein S Anorexia nervosa with excessive exercise: a phenotype with close links to obsessive-compulsive disorder Psychiatry Res (2006) 142: 209 – 217
  • Guisinger S Adapted to flee famine: adding evolutionary perspective on anorexia nervosa Psychol Rev (2003) 110: 745 – 761
  • Herring MP et al Genetic factors in exercise adoption, adherence and obesity Obes Rev (2014) 15: 29 – 39
  • Kersting K An evolutionary explanation for anorexia?  American Psychological Association (April 2004) 35 (4)
  • Powers PS and Thompson RA The exercise balance Carlsbad, CA: Gurze Books (2008)
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