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Emily Fonnesbeck says her issues with diet and exercise started after her first son was born. “I was a new mom and feeling pressure to recover from the pregnancy body, and I started eating less and exercising more,” she says. “I’m very much a perfectionist, so if I’m going to do something, I’m going to do it one hundred percent.”
At first, 100% meant cardio workouts most days and eliminating unhealthy foods from her diet. But slowly her habits snowballed. Over a period of five or six years, her training progressed until she was working out for at least 90 minutes every day. “There were numbers I had to hit — like a certain number of miles, minutes, calories, etc. — and if I didn’t hit them, my mind would drive me crazy about it all day,” she says.
Meanwhile, Fonnesbeck was also experimenting with elimination diets. First she cut out sugar, followed by dairy and gluten. “I had constant headaches and I was tired and I had digestive issues,” she says. “I thought, well, I’m just not eating the right things — I need to cut out what I’m eating that’s bad.” Eventually, her diet dwindled to just five foods: sprouted-corn tortillas, brown rice, cabbage, tahini, and beans.
Fonnesbeck, 37, is a registered dietician and nutrition therapist. She says she should have recognized, based on her own expertise, that her problem was not eating enough. “I had this idea that there was this perfect way of eating and I needed to find it, and that would fix everything,” she says.
“I think that’s one of the biggest cultural messages — that it’s all or nothing.”
She realized it all needed to stop when her husband approached her about an upcoming vacation. “I was feeling really overwhelmed about going because it meant I’d have to pack all of my own food and try to figure out how to fit in my workouts,” she says. “My husband looked at me and said, ‘Emily, it’s time to get some help.’”
Today Fonnesbeck works with people who have eating and body-image disorders like the one she had. “A common theme [among clients] is that if you’re not obsessive, then you’re lazy or letting yourself go,” she says. “I think that’s one of the biggest cultural messages — that it’s all or nothing.”
People like to quote the truism “everything in moderation,” but they don’t like to follow it. Nearly half of U.S. adults do not exercise enough and most do not eat the recommended amounts of fruits and vegetables. On the other end of the spectrum are people who seek to go well beyond what’s advised for good health. According to Google data, three of the five most-searched-for diets in 2018 involved fasting, reducing or eliminating whole food categories, or a mix of both approaches. “A lot of these popular diets are sensationalized, extreme versions of the truth,” Fonnesbeck says.
Participation in marathons and ultramarathons has also increased exponentially during the past three decades. The number of people running marathons worldwide grew 40% from 2008 to 2018. And while the number of people in the U.S. who signed up for long-distance races peaked in 2013, experts say that probably has more to do more with the rise in popularity of CrossFit, spinning, and other forms of vigorous exercise than with people easing their training habits. Meditative practices are similarly becoming more extreme. “Even though we keep adding centers, we cannot keep up with the demand,” says a spokesperson for the New York Vipassana Association when asked about the center’s multi-day silent retreats.
These trends suggest that many people in the U.S. are pushing themselves to potentially unhealthy extremes in search of self-improvement. The terms “wellness” and “health” are often used interchangeably, but they have different connotations. These days it seems wellness means more than having sound physical and mental health; to be truly well, you need also be slim, happy, energetic, attractive, strong, optimistic, present, engaged, and mentally sharp — and to maintain consistent levels of all these attributes.
Amid such high expectations, experts say a number of psychological and psychosocial factors help explain the appeal of excessive approaches to wellness. “In the U.S., we have this keeping-up-with-the-Joneses mentality,” says Hillary Cauthen, a psychologist with the Association for Applied Sport Psychology. “And it’s all about showing we’re the best and going hard at everything.”
When the World Happiness Report 2019 was published in March by the United Nations Sustainable Development Solutions Network, it showed that, for the third year in a row, the U.S. had fallen in its rankings. In a paper published in conjunction with the report, Columbia University professor Jeffrey Sachs argues that America’s “mass-addiction society” is a major driver of unhappiness. He cites traditional substance addictions, such as alcohol or opioids. But he also highlights unconventional addictions, including exercise and diet-related compulsions.
“My argument is that the U.S. is suffering an epidemic of addictions, and that these addictions are leaving a rising portion of American society unhappy,” he writes.
Most experts agree that when a person’s wellness pursuits interfere with their job, school, or personal relationships — or produce feelings like guilt or shame — then they’re edging toward disorder territory. “If taking a day off makes you feel bad about yourself, that’s a problem,” says Cauthen.
It’s unclear whether levels of disordered eating and exercise are truly on the upswing in the U.S. or if those behaviors are simply more performative today thanks, chiefly, to Instagram. All-or-nothing wellness philosophies now saturate many social media platforms, with users uploading tens of millions of posts with hashtags like #FitnessAddict and #NoDaysOff — many of which glamorize zealous approaches to exercise.
A branch of psychology known as social comparison theory helps explain the effect of seeing images of super-fit and health-focused people. “When we compare ourselves to others, we are engaging in both upwards and downwards social comparison,” explains Danielle Wagstaff, a health lecturer at Federation University Australia, who has studied the relationships between Instagram use and well-being. “Upwards social comparison happens when we compare with those in a perceived better position than us,” she says. As long as this is balanced by downward social comparisons, it can be motivating and healthy, she says.
But this balance is often missing online. “When we use social media and we see lots of highly curated images, our cognitive perception of what is ‘average’ shifts to the upper end. We come to believe we are in a much worse position than we realistically are.” This can promote a drop in self-esteem, she says.
Some research suggests that, among men, higher frequency of social media use corresponds with greater body image concerns, including so-called “bigorexia.”
“In Western society, the message men are receiving is that muscularity equals masculinity,” says Dr. Harrison Pope, a professor and director of the Biological Psychiatry Laboratory at Harvard-affiliated McLean Hospital. Pope says there’s evidence that more men than ever before are using dangerous anabolic steroids to promote muscle growth, and the images they’re encountering in popular culture are contributing to their unrealistic and unhealthy drive to get huge.
Neurochemistry may also help explain why some people find it difficult to keep their wellness routines in check. In a 2018 study, researchers asked more than 1,300 ultramarathons whether they would give up the sport if they learned “with absolutely certainty” that it was bad for their health. Three out of four said they would not.
Cauthen, the psychologist specializing in sports, says she’s not surprised by these sorts of findings. “The endorphin rush runners get — after a while, it’s addicting,” she says.
She explains that “runner’s high” is a legitimate neurochemical phenomenon. When you run long distances or engage in other forms of vigorous training, your brain is flooded with dopamine and other opioid-like chemicals that induce a pleasant state of euphoria. “But if you train all the time, you develop tolerance to these chemicals, just like people develop a tolerance to alcohol or drugs,” Cauthen says. “So the feeling you used to get after 30 minutes now takes 45, and it becomes this continuous chase.”
“Our lifestyles are out of whack and not harmonious with our natures, and a lot of people are looking for balance.”
Like other addictions, people hooked on exercise can experience withdrawal symptoms if they take a day off. Restlessness, guilt, and frustration are some of the symptoms that turn up among alcohol and gambling addicts, as well as those who are “addicted” to exercise, according to a 2014 study from Denmark.
Some people also rely on exercise or diet to regulate their emotions. “People use these things as a way to respond to feeling unhappy or anxious, or other forms of emotional distress,” says Pamela Keel, a professor of psychology at Florida State University. “But these don’t address the original source of the distress, so these are quick fixes that set you up for a vicious cycle.”
Even activities like meditation or yoga can become problematic, says Miles Neale, a clinical instructor of psychology at Weill Cornell Medical College and author of Gradual Awakening, a book about Tibetan Buddhist meditation. “They can lead to calm and relaxation, but they can also be an escape,” he says. While sometimes an escape is just what you need, it can also be a way of dodging problems or failing to address underlying sources of anxiety or stress. “Even the Buddha says there are inherent dangers with escaping,” he adds.
When life feels frenetic, it’s natural to want to escape or grasp for habits that feel familiarity and that provide comfort. A 2015 study in the journal Current Biology found that when people are confronted by “environmental uncertainty and uncontrollability,” they tend to respond to the resulting distress with repetitive motor activities. These activities include pacing back and forth or praying, and they could also include activities like meditation or exercise. These activities help people “regain a sense of control,” the study authors write.
“When people are generally feeling anxious or out of control in their lives, focusing on something very concrete like what they’re eating or their exercise can temporarily make them feel like they’re exerting some control,” Keel says. That’s not necessarily a bad thing. For a lot of people, it can be therapeutic.
“I think, without a doubt, the interest in yoga and meditation are a reaction to modern living,” Neale says. “Our lifestyles are out of whack and not harmonious with our natures, and a lot of people are looking for balance.” But sometimes, he says, that lunge for balance can send people too far in a particular direction.
Some experts lament the phenomenon of “diagnosis creep” — or the tendency to pathologize an ever-expanding range of conditions or behaviors. U.S. rates of obesity and diabetes continue to linger in “epidemic” territory. Without a doubt, lack of exercise is a more urgent health concern than excessive exercise. For that reason it can feel like piling on to warn wellness-focused folks of the risks associated with going to extremes.
But Fonnesbeck echoes the statements of other experts, saying it’s important to recognize that what starts as a healthy choice can turn into a compulsion. When she was fighting her own battles with disordered exercise and dieting, it was helpful when she realized that moderation often requires more inner strength and self-discipline than going all-out.
“Finding the middle ground can be a lot harder and takes a lot more intention,” she says. “The true sign of strength for me was to leave behind things getting in the way of living a full life.”