✍ Scribed by Anna Keski-Rahkonen
No coin nor oath required. For personal study only.
I want you to tell me about exercise dependence'. In the middle of a busy day at the eating disorder outpatient clinic, a journalist from a women's weekly magazine wanted to do a quick telephone interview. She had already secured a heart-rending female athlete confessional story, and now wanted the medical facts to ®nish off her piece. For some reason or other, she had chosen to ring me up, thoughtfully during my lunch break. I don't know anything about exercise dependence ± I'm not sure whether exercise dependence exists at all', I told her, somewhat riled and not a little hungry, but if you want to talk about compulsive exercise, that I do know about, because it commonly coexists with eating disorders'. And I proceeded to give her some quick opinions that were based on my experience with anorexic and bulimic patients.
Later, though, I started having second thoughts. I had not bothered to do a Medline search on exercise dependence, nor had I glanced a medical textbook. Nevertheless, I had denounced exercise dependence. I started to remember that in 1980s it was fashionable to write about pathological joggers. Maybe there was something to exercise dependence, after all: had I overlooked an important public health concern? I decided to see what Medline had to say about this condition. My chief concerns were the following: (1) is there a physiological basis to exercise dependence? (2) Is exercise dependence an established independent diagnostic category, or is exercise dependence always secondary to eating disorders?
Using search terms exercise dependence, compulsive exercise, obsessive exercise, extensive exercise, exercise abuse (and possibly some more in a similar vein), I ended up with a less than 20 articles ± and European Eating Disorders Review
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