Marathon Madness – Are You Running Yourself To Death?

A young man recently ran into my clinic wearing a sweat-stained athletic singlet and ultra-brief running shorts that bordered on the obscene.   The young man was panting heavily and  dripping bucket loads of sweat all over my imported Persian rug.

“What the f-ck are you playing at!”  I bellowed at him, briefly forgetting for a brief moment my professional status as one of the world’s leading diet gurus and fitness advisors.


After I had recovered my composure, I started to get the feeling that I had seen this young chap before.     He looked vaguely like one of my former students who the other students had nicknamed “The Fat Can’t“, because he would always announce his arrival at the clinic with the words, “I can’t lose any weight!”

But how could this be the same man?

The Fat Can’t  had weighed over 150 kilograms (that’s over 300 pounds in old money).  But this guy looked more like a stick insect, and would be lucky if he weighed more than 60 Kilos.   In fact he looked like someone who had just broken out of a concentration camp and had spent the entire day running away from the guards.


I reached into my drawer and found a box of bin-liners.  I flicked one to him and ordered him to lay it on the floor and stand on it to prevent any more sweat ruining my floor coverings.

I then reached around behind me to the racks of towels and threw a towel at him.    I told him to dry himself down and tell me his story.

It seemed that after dropping out of the Ratchet Diet Clinic, he had given up on diet as a method to lose weight.  Denial was not a word that existed in his vocabulary.    However he had always had a tendency to be obsessive about things.   He had chatted to some people at work who were in a social running club, and they encouraged him to buy some kit and join their club.

He had started his introduction to the running scene slowly, walking at the back of the pack on the weekend runs alongside the crippled and lame runners, and slowly but surely the weight started to come off.

The more success he had and the fitter he got, the more obsessive he became about running.   He started to set his alarm clock for 5 AM and run out the door ten minutes later no matter what the weather conditions.   Initially he would run every other day, but soon he was running 7 days a week and sometimes more than once per day!

After several months and having dropped 50 kilos he entered his first fun run.   He had expected to come last, but was pleasantly surprised to find himself finishing in front of several hundred other runners.

He found himself drawing an almost sadistic sense of satisfaction watching the plodders struggle past the finish line while he sipped on a cool sports drink at the finish line drinks station.

Returning home that night on the train, he fondled his finishers’ medal as if it was cast from 18 caret gold.

He was now hooked on running.

The pattern of daily running was now set in stone. He would rise at the crack of dawn seven days a week, even if his back was aching, the streets outside were covered in snow and his girlfriend had woken up and was fondling him intimately to encourage him to stay in the bed.    Nothing could stand in the way of his iron determination to get out onto the road and do the miles.

For the vast majority of people, exercise is a component of our fitness regime that we should aim to get more of.   Most of us don’t get enough exercise.

But there are a small minority of perfectionist athletes who are compulsive exercisers.   They are really more like addicts than athletes.   And this syndrome is not confined to runners.   It can also affect body builders, swimmer, cyclists and any other form of physical activity.

The current thinking is that thirty minutes a day of moderate exercise is enough to protect us from diabetes, high cholesterol and high blood pressure.

A two hour run is four times longer than a half hour run, but that does not mean that you can get four times the health benefits from the longer run.

Doing too much exercise sets you up for all sorts of injuries.

The over-exerciser can suffer from depression, exhaustion and over-use injuries.   There is only so much cortisol that your adrenal gland can produce as you pound along the pavement for hours at a time.   The law of diminishing returns starts to come into play.


How can you spot someone who has become an exercise junkie?

One easy way is to check how they prioritise their exercise compared to the rest of their lives.  A normal person organizes their exercise around their lives, but an exercise junkie organizes their life around their exercise.”

The practice of excessive exercise seems to attract people who feel an extreme need for control in their lives.


So why was my former student back here in my office dripping sweat everywhere?

It seemed that he had simply wanted to show off.   He had decided to swing by the old Ratchet Diet Clinic, and show his old mentor Hans Ratzenburger that there were other ways to lose weight than the deprivation of going on a strict diet.

I wanted to humour him and let him have his moment of gloating and get him out of my office.   But my professionalism took over again and I felt that I had to warn him about some of the risks that he was taking with his new obsessive running regime.

I told him that there were certainly a lot of good points to his new hobby and complimented him on his weight loss.

But I also cautioned him that he seemed to have gone too far.    There is nothing healthy about looking like you have been starved almost to death.   We need a reasonable level of fat, to act as a buffer if we fall over and to hold stores of hormones that assist our immune system to ward off disease.

When you look at a picture of an aids sufferer or an anorexic you don’t think of them as enjoying great health.

And a person obsessed with exercise starts to suffer in other ways.   they can become locked into their regimes maybe only eating one meal a day.   Everything is measured and logged.  How many carbs how many calories how often they go to the toilet.   They become too focused on their exercise and that can start to screw up the rest of their lives.   There is no longer any time for friends, attending parties or even taking time out for close family.


When it comes to exercise, less is more.   We need to do just enough exercise to help us with our health, but no more.   We don’t want to get addicted to the  “runner’s high”  which is  a feeling of elation caused by the release of hormones.

People who are over exercising need to be informed that they are not contributing to a healthy and longer life.   Quite the contrary.   They are destroying their arteries and their heart and setting themselves up for sickness and ill health later in life.    Some of the most elite long distance athletes have died relatively young.

Don’t kill yourself just so that you can have a good looking corpse at your funeral.

I finished my spiel to my young visitor and scribbled down on a 3 X 5 card a few links to relevant youtube videos that I suggested he watch when he got home.

We shook hands and he left my office.  As I watched the door close on the skeletal individual I pondered how strange life was.  The gentleman leaving my office was older, skinnier and (if he took notice of my advice) wiser than the huge bloated blimp that we had jokingly called The Fat Can’t only a few short years ago.    I wish him well!

Want to know more? Then check out the following videos:

Run for your life! At a comfortable pace, and not too far: James O’Keefe at TEDxUMKC

Dr. James O’Keefe Jr. is the director of Preventative Cardiology Fellowship Program and the Director of Preventative Cardiology at Cardiovascular Consultants at the Saint Luke’s Mid America Heart Institute, a large cardiology practice in Kansas City. He is the co-author of four bestselling books including The Forever Young Diet & Lifestyle (Andrews McMeel Publishing LLC, 2005). In 1989, he became a professor of medicine at the University of Missouri – Kansas City and has contributed to over 200 articles in medical literature. He is also the chief medical officer and founder of Cardiotabs, a company that creates nutritional supplements to aid in a healthy lifestyle. Published on Nov 27, 2012

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