SPECIAL ISSUE ARTICLE Excessive Exercise: From Quantitative Categorisation to a Qualitative Continuum Approach Olwyn Johnston 1 * , Jackie Reilly 2 & John Kremer 3 1 Hampshire Partnership NHS Foundation Trust Eating Disorders Service, UK 2 School of Education, University of Ulster, UK 3 School of Psychology, The Queen’s University of Belfast, UK Abstract Researchers have yet to reach a consensus on the definition of excessive exercise, and many questions remain about the relationship between excessive exercise and eating disorders. Understanding of excessive exercise may be furthered by adoption of a broader, dimensional perspective. The current qualitative (grounded theory) study explored the continuum of women’s exercise experiences, ranging from casual to more extreme regimens. Thirty- two women were interviewed, aged 16–77. Participants described stages in a continuum of exercise experiences. Overlaps were described between participant perceptions of ‘normal’ exercise, excessive exercise and exercise addiction. Excessive exercise and disturbed eating were described as arising from common concerns about the need to control the body, with exercise viewed as a more acceptable alternative to disturbed eating. The results provide support for a continuum approach to the understanding of excessive exercise, and highlight the utility of qualitative methods in this area. Copyright # 2011 John Wiley & Sons, Ltd and Eating Disorders Association. Keywords exercise addiction; excessive exercise; eating disorders; grounded theory; interview *Correspondence Olwyn Johnston, Hampshire Partnership NHS Foundation Trust Eating Disorders Service, Eastleigh Community Enterprise Centre, Unit 3, Barton Park, Eastleigh, Hampshire SO50 6RR. Tel: 02380626262, Fax: 02380626279, UK. Email: olwyn.johnston@hantspt-sw.nhs.uk Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/erv.970 Introduction There is a lack of consensus on the definition of excessive exercise, and many questions remain about the relation- ship between excessive exercise and eating disorders. The present study aimed to explore the definition and development of excessive exercise, and its relationship to disturbed eating, through a qualitative investigation of women’s subjective experiences of exercise. Defining excessive exercise A variety of terms have been used to describe excessive exercise, such as exercise addiction (Cripps, 1995), exercise dependence (Veale, 1995), obligatory exercise (Pasman & Thompson, 1988), compulsive exercise (Yates, 1991) and driven exercise (Fairburn, 2008). These terms are not necessarily interchangeable, reflecting different perspectives on aetiology, and carrying different connotations (Cockerill & Ridding- ton, 1996). In the absence of a consensus on aetiology and definition (Loumidis & Roxborough, 1995), it seems logical to use a term which is widely used, easily understood and does not imply a particular aetiology. For these reasons, the term ‘excessive exercise’ is used throughout this paper as far as possible (although reporting of previous research may involve use of the label favoured by the original author). Eur. Eat. Disorders Rev. 19 (2011) 237–248 ß 2011 John Wiley & Sons, Ltd and Eating Disorders Association. 237