Bigorexia: everything you need to know about exercise addiction

Bigorexia is one of the behavioral addictions that insidiously creep into everyday life. Addiction to physical activity is a strategy developed by the psyche to cope, move forward, and sometimes survive. It is a mechanism that can affect all athletes, both amateur and professional, and is particularly prevalent among those who practice individual sports.

✓ Analysis with Marion Baradji L’Arbalestrier, sports psychologist and psychotherapist.

Before answering the question, “How do you know if you have bigorexia?”, sports psychologist Marion Baradji L’Arbalestrier hesitates. “I find it a little difficult to answer, because the people who come to me have been referred or are already asking themselves questions,” she admits. In her practice in Tours, she has been seeing a wide variety of patients since obtaining her master’s degree in clinical psychology and sports psychopathology at Paul-Valéry University some 20 years ago. Athletes, mainly from individual sports, suffering from bigorexia come to her: some pushed by loved ones concerned about the risks to their health, others gradually becoming aware of the hold that sport has on their daily lives. “What I pay most attention to is the relationship to suffering,” says the clinical psychologist. Sometimes, physical pain is annihilated: the body sends messages, but they are no longer heard, a phenomenon called sensory dissociation.

| Factors of dependency

Where does this dependence on physical activity come from? The factors are difficult to pinpoint, often deeply buried in each person’s personal history. “There may be something that caused trauma,” observes Marion Baradji L’Arbalestrier. When a trigger has been minimized, when there has been emotional invalidation, it leaves a mark. “ Bigorexia results from a set of psychological and social mechanisms linked to education and culture. ”Something has destabilized fundamental needs: security, protection, affection, stability, predictability, belonging, self-expression, pleasure, and often the need for boundaries, which corresponds to certain educational deficiencies, with regard to structure and rules.”

To cope with one or more unmet needs, the psyche develops strategies to hold on, survive, and move forward without breaking down. These strategies “become functional in order to prevent collapse, but can become dysfunctional when there is suffering. “ As described by Claire Carrier, former psychiatrist and sports doctor at INSEP, some athletes ”only exist in their muscular sensations.“ Addiction is a dysfunctional pattern, the result of life experiences that have ”rigidified” ways of functioning, whether emotionally, cognitively, or in terms of behavioral strategies. Trauma is therefore not the only factor, as bigorexia often develops on the basis of pre-existing psychological vulnerabilities.

| Who is affected?

Whether amateur or professional, some athletes can develop an addiction to sport. In the book Running Addiction Scale (1990), Mary resumed running two months after giving birth: “The marathon comes first. I have my baby looked after so I can run. Everyone criticizes me and worries about it.” Average athletes are mainly addicted to the activity itself, while top athletes, through their medals and performances, seem to be driven more by a need for security, belonging, and self-expression. Awards validate their legitimacy to exist. But when their career ends or an injury drags on, the threat is serious: “If sport has been a means of nurturing self-esteem, the need for recognition and identity, and there is nothing else behind it, there is a risk of severe decompensation.”

The risk can manifest itself in substance addiction. As William Lowenstein, French director of a treatment center for drug addicts, explains in the book cited above: “Practicing sports induces a state of dependence that leads to withdrawal symptoms. Once training ends, athletes are exposed to an increased risk of drug and alcohol addiction.”

| Signs that may raise concerns

There are several tests, in specialized books or on the Internet, to assess whether a regular runner has a problematic relationship with their sport. For example, the book Running Addiction Scale rates the level of addiction to running on a scale (positive or negative). The principle is simple: add a point for certain statements such as “I run very often and regularly” or “I run even when I am in a lot of pain,” and subtract points for others such as “I don’t cancel activities with friends to go running” or “if I found another way to stay in shape, I wouldn’t run.” The final score indicates a level of dependence, but is not a substitute for a diagnosis. More recent tools, such as the Exercise Addiction Inventory, also explore addiction to physical activity and sports in adults.

However, these tests are not a substitute for the advice of a healthcare professional. Repeated stress fractures, persistent exhaustion linked to “excessive exercise” rather than “lack of training” as some believe, a vague feeling of unease, mood swings, or concern from those around you are all warning signs to look out for. A lack of interest in other activities, feelings of deprivation, or discomfort at the thought of not training are also indicators that should be taken seriously. Some athletes have an altered perception of pain: the central area of pain seems inhibited or dissociated from the rest of the body. “This is why they don’t feel the need to recover or feel the pain of an injury,” explains Marion Baradji L’Arbalestrier.

Consulting a professional does not necessarily mean that you have bigorexia, but can simply help you stay in tune with yourself and your body. If, during the joint process, addictive behavior emerges, this is not an end in itself: the consultation marks the beginning of the therapeutic work needed to get better, step by step. “Addiction has a function at the outset,” says Marion Baradji L’Arbalestrier. “A therapist will never break down their patient’s defenses until they are sure that the patient has the resources to cope.”

| The importance of therapeutic work

Bigorexia, like all behavioral addictions, is treated by specialists in the same way as addiction to gambling, sex, or work. “We work on the symptoms: craving (irresistible urge), impulsivity, guilt, or the underlying depression,” confirms Marion Baradji L’Arbalestrier. Although the consequences differ depending on whether the addiction is to an activity or a substance, the underlying psychological mechanisms are similar. To effectively support her patients, Marion Baradji L’Arbalestrier has set up a precise follow-up program, surrounding herself with doctors, physical therapists, dieticians, and others. “What’s important is to work in a multidisciplinary way.” Trained in IMO, she uses an integrative approach, particularly schema therapy, to understand how her patients function, as they are often divided due to mechanisms of denial or repression.

The goal of therapeutic work is to understand the function of the symptom or syndrome. This listening process involves understanding the strategy that the psyche has put in place to keep itself going. “Defense mechanisms, including addiction, can be dysfunctional, costly, energy-consuming, or have consequences,” says the psychologist. The role of therapy is to explore these mechanisms, understand their origins, and then revalidate and legitimize what may have been out of balance, sometimes due to past emotional invalidation. “For most of my patients, there has been work to be done to re-understand the language of the brain and the language of the body.”

If you have any doubts about your practice, do not hesitate to consult a healthcare professional for advice and support. There are many signs of addiction, but they are often imperceptible and/or inaudible to the person directly affected. The attention of those around you is invaluable and must be taken seriously to protect your health.

Sabine LOEB
Journaliste