Everyone knows regular exercise is good for you, but did you know an addiction to exercise can actually make you sick?

I spoke with Craig Harper about his transformation from a morbidly obese teenager with no self-esteem into a fit young man full of confidence.

The only problem was that Harper, now an exercise scientist, author and prominent motivational speaker, had merely switched one addiction for another – food for exercise.

The teenaged Harper ran morning and night and it was only when he suffered an ankle injury and was told to refrain from running for four to six weeks that his addiction became apparent.

To get his “fix” he ignored the doctor’s advice and continued to run, or hobble, each day despite the pain.

“I was always overweight and by the time I reached 14 I was 90kg,” Harper says.

“It got to the point where I hated my life – I hated being picked last for every team, hated coming last in every race and being held up to public ridicule.

“So I started running and lost 30kg over five months and in doing so turned from fat to fit, from unhealthy to healthy, from coming last in the race to coming first, from having no confidence to having some confidence.

“Problem was it became addictive and when the doctor told me to rest my injured ankle, well, he might as well have told me not to breathe for four weeks.

“I carried on regardless and really I kept exercising obsessively for years.”

The term exercise addiction (now also known as anorexia athletica or athletica nervosa) was coined in 1976 by American psychiatrist Dr William Glasser when he was studying long-distance runners and their “exercise high”.

He noted that many of them experienced low moods when they couldn’t train and he came to differentiate between positive and negative addictions.

A positive addiction involves a love of the activity and the exercise is scheduled around other everyday activities – you run your training schedule, it doesn’t run you.

With a negative addiction the exercise overrides everything, an enforced day off causes much distress and overtraining leads to injury and illness.

Parker has used his personal experience to help his own clients as well as those who attend his motivational workshops throughout the country.

He says while many of those with an exercise addiction come from a background of being obese, the condition is also relatively common among those with eating disorders such as anorexia or bulimia.

“However, what I’ve learned over the last two decades from working with all types of people is that anyone from any background can become an exercise addict for all sorts of reasons,” he says.

“Although exercise addiction does not affect the majority of the population, and to some people it may not seem like a serious issue, it is definitely on the rise, it’s very real, its consequences can be dire and people need to be aware of it.

“Anorexia athletica is a condition which is affecting an increasing number people on a physical, psychological, emotional and sociological level.”

Wollongong exercise physiologist and personal trainer Rob Battocchio is aware of the condition and makes sure the clients of his business, Altitude Peak Health and Fitness, have a sensible attitude to training.

“Exercise is a healthy behaviour and one that should be encouraged,” Battocchio says.

“However, some individuals become addicted to physical activity and engage in excessive exercise that is extreme in frequency and both physically and psychologically impairing.”

Battocchio says the problem is there is no formal definition or universally recognised set of symptoms for exercise addiction, and professionals may differ on their opinions, making prognosis the more difficult.

Also he says what is healthy for one person may not be for another.

“Whilst exercise frequency is certainly a factor (in exercise addiction), it goes beyond how much a person exercises but rather a person’s attitude towards their exercise habits,” he says.

“Triathletes (elite and everyday enthusiasts) can easily exercise 20 to 30 hours a week, and in many ways demonstrate obsessive behaviour towards their training, diet and lifestyle, but typically this is not a (negative) addiction to exercise.

“A person demonstrating exercise addiction, is more the one whom loses sight of why they are exercising, and becomes obsessive to the point it controls their life.”

Or, as Harper points out: “That’s the difference between obsession and discipline – discipline is when you are in control, with an obsession you are not in control.”

Symptoms of anorexia athletica may include doing excessive volumes of exercise, feeling overly guilty and anxious when a workout is missed, fitting in exercise at every spare moment, sacrificing other activities in order to work out, continuing to exercise when injured or sick and feeling depressed if exercise is compromised.

At later stages fatigue, lethargy, possible extreme weight loss, loss of concentration, irritability and ill health are all too real consequences.

“Your workout obsession is a problem when friends, family, work and career all fade into insignificance when compared to exercising,” Battocchio says.

“For most, the psychological torment of not exercising is greater than the negative consequences that affect their physical and social well-being.”

Battocchio agrees with Harper that exercise addiction is an increasing problem and believes the constant media images portraying muscle-bound men and trim and toned women could be part of the problem.

“Every where you turn from The Biggest Loser, to celebrities regaining their amazing physiques a few weeks post-birth, all through exercise, places pressure on everyday people to do likewise,” he says.

“Whilst by no means this can be called exercise addiction, it is certainly a contributing factor.”

Indeed, body image is a bigger concern for 11-24 year olds than issues such as family conflict, bullying and physical/sexual abuse according to Mission Australia’s 2007 National Survey of Young Australians.

The survey tested the views of almost 29,000 young people – one in three of whom regarded body image as a major worry.

So what is the solution? Firstly, says Harper, the person needs to acknowledge that they have a problem, then they need to do what’s necessary to fix it including changing their exercise behaviour or enlisting outside help.

“If you think a friend or family member has a problem first try and talk to them,” he says.

“Don’t criticise, judge or accuse them, simply say ‘I think it’s great you exercise but I think you may be overdoing it’. That can be enough for someone, but they need to be in a place where they are receptive to that.”

If they are not receptive, and their physical or mental health is at risk, the intervention of a health professional may be the answer.

“The key to prevention (and managing) this condition, would be to have a fitness professional monitor the individual, and providing a suitable exercise program without pushing the level into the extreme,” Battocchio says.

“Limits should not be placed on people, but a sensible and managed approach is the answer.

“Your GP and allied health professionals such as exercise physiologists, dietitians and qualified fitness trainers should be the first line of contact.”

Unfortunately, Battocchio says, exercise addiction is a poorly managed area and one that is all too often swept under the carpet.

“Many trainers are more interested in pushing the client to the limit, but in our defense this is often what paying clients want,” he says.

“Neither trainers, nor fitness centre staff are trained psychologists, but should be aware of telltale signs and ensure professional discretion on whether to discuss this with their clients.

“Trainers play a critical role and need to ensure that potential exercise addicts have sensible exercise plans, regular check points and outside help where appropriate.”

As with most things in life, it’s all about finding the right balance.

“The recommended approach to exercise is 30 to 60 minutes of moderate exercise a day, and to ensure a variety of activities,” Battocchio says.

“Include a minimal three to five days of aerobic activities … and an additional two to three days of weight-bearing exercises. Yoga, Pilates, stretch classes and recreation all fit in the mix too.”

And always seek appropriate medical advice prior to commencing any exercise regime.