Barber et al reported diagnostic criteria for exercise dependence. The authors are from the University of Cambridge, University of Birmingham and Rotherham General Hospital in England.

Core criteria - both of the following:

(1) impaired functioning (see below)

(2) withdrawal (see below)


Exercise dependence is termed secondary if an eating disorder is present and primary if there is no eating disorder.


Associated features of exercise dependence:

(1) tolerance (an increasing volume of exercising required)

(2) high volume of exercising and/or exercising at least once daily

(3) solitary exercising

(4) deception (exercising in secret; lying about exercise volume)

(5) denial that exercising is a problem (insight)


Impaired functioning - >= 2 of the following:

(1) psychological (intrusive thoughts about exercise)

(2) social and occupational (unable to work; unable to engage in other social activities)

(3) physical (continues to exercise even when medically contraindicated)

(4) behavioral (stereotyped and inflexible behavior)


Withdrawal - one or both of the following:

(1) significant adverse response to a change or interruption of exercise habits

(2) persistent desire and/or unsuccessful efforts to control or reduce exercise

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