When exercise becomes necessary: a dual-gate approach to understanding harm-persistent compulsive exercise

Exercise-addiction research has been criticised for conflating high exercise involvement with clinically meaningful dysfunction, particularly when risk is inferred from screening scores alone. This study examined why exercise persists despite recognised harm among recreational exercisers with elevated addiction-related risk. To improve clinical interpretability, we used a dual-gate, impairment-linked sampling strategy: participants were eligible for qualitative follow-up only if they showed elevated addictive tendencies on the EAI-3 Addiction Tendency subscale and reported exercise-related negative consequences. In Phase 1, 368 recreational exercisers completed a quantitative screening survey. Of these, 119 met the recommended Addiction Tendency cut-off, and 29 additionally reported at least one exercise-related harm. Fourteen participants completed semi-structured interviews exploring emotional experiences, identity processes, perceived control, and exercise-related consequences. Reflexive thematic analysis generated three interrelated themes: Emotional Dependence, Addicted Identity, and Loss of Control. Participants described exercise as a primary strategy for emotional stabilisation, a central part of self-definition, and a behaviour that continued despite recognised physical, psychological, or social costs. These themes formed a descriptive triadic configuration rather than a causal model, in which relief-based regulation, identity fusion, and reduced behavioural flexibility appeared mutually reinforcing. The findings suggest that harm-persistent compulsive exercise is not adequately captured by exercise volume or commitment alone. Rather, clinically concerning patterns may be better identified by the co-occurrence of elevated addictive tendencies and self-reported harm. This dual-gate approach may help distinguish adaptive high involvement from impairment-linked compulsive exercise.