When is enough enough?

It interferes with daily activities and relationships.

You believe that bad things will happen if you don’t work out.

You develop a perfectionist attitude toward exercise and your body.

You ignore the signs of illness, injury or fatigue and work out despite them.

You set unattainable goals (miles run, hours worked out, percentage of body fat, etc.)

You ignore friendships or satisfying hobbies in order to exercise.

Overcoming the anxiety

Sprafkin says a distorted body image coupled with fanatical exercising is analogous to Obsessive Compulsive Disorder (OCD). With OCD, recurring thoughts or unrealistic worries cause anxiety and a “ritual” is performed to relieve the anxiety.

Cognitive-behavior therapy can help in both of these cases. Exposure and response prevention are two techniques used to treat intense anxiety and obsessions. “Instead of avoiding the thought of being a few pounds overweight, the person would be asked to imagine that possibility over and over again, until he or she ‘habituates’ and is no longer upset by the thought or image,” says Sprafkin.

Then, for the response prevention element, the ritual the person has done to relieve her anxiety is eliminated. “This might be applied to exercise or body image problems by limiting exercise time or by not looking in the mirror or checking one’s weight.”

Some people can do these techniques on their own, says Sprafkin. But outside help is often needed initially because the person is accustomed to rationalizing the need for excessive exercise.

Regular exercise is healthy. But when a person’s desire to work out blocks satisfying relationships and enjoyment of life in other areas, it’s a serious problem. “It becomes a quality of life decision,” Sprafkin says.