Exercise and Addiction Recovery: How Much Exercise Do You Need?

By Lori Ryland, Ph.D., LP, CAADC, BCBA-D, chief clinical officer at Pinnacle Treatment Centers

When people with an alcohol or drug addiction problem enter recovery, their overall physical and mental health is often compromised. We know addiction is a disorder of the brain, which means we know it’s directly related to mental health and psychological wellbeing.

We also know addiction can take a toll on all the most important components of our physical health. Briefly, alcohol can destroy the liver, smoking anything at all damages the lungs, and opioids significantly disrupt brain chemistry, impair respiratory function, and cause various problems with digestion, endocrine function, and more.

That’s an abbreviated list that barely begins to cover the adverse physical effects of addiction. There’s another thing worth mentioning here: how addiction affects lifestyle, and the way a person in active addiction behaves day-to-day. This behavioral byproduct of addiction leads to host of peripheral but equally problematic physical health issues.

What is it?

The fact that addiction often leads to a sedentary lifestyle.

That’s why an important element of long-term sobriety and recovery is reconnecting with an active lifestyle, and relearning how to build, maintain, and live in a strong and resilient body. A healthy body supported by regular exercise helps everything: mood, sleep patterns, appetite, endocrine function, cognition, and memory.

But how to get that healthy body can be both intimidating and confusing. Social media doesn’t help: these days it seems like everyone is an elite triathlete, mountain climber, or somehow found a job as a full-time paddleboarder.

For someone who hasn’t done much exercise at all for months or years, a set of pragmatic guidelines designed for regular people would be very helpful.

Thankfully, that exists, thanks to the Centers for Disease Control (CDC).

The CDC Guidelines on Exercise

Published in collaboration with the U.S. Department of Health and Human Services (HHS), the release of The 2008 Physical Activity Guidelines for Americans was a major event, because, in the words of HHS Secretary Michael O. Leavitt, it was “the first comprehensive set of guidelines on physical activity ever to be issued by the Federal government.”

The authors of the 2008 report went out of their way to emphasize important facts about living an active lifestyle. Exercise and activity, the report said, helps prevent illness, reduces risk for coronary disease, hypertension, and diabetes, and reduces the symptoms of mental health disorders such as anxiety and depression. Regular exercise also helps control weight, maintain muscle, joint, and bone health. For older adults, regular exercise helps prevent falls, fractures from falls, and promotes independence.

The guidelines also established minimum recommended time guidelines for moderate and vigorous aerobic activity, weight training, and various forms of intense physical activity. The new guidelines, published in 2019 – Physical Activity Guidelines for Americans, 2^nd Edition – re-emphasize all of the above and include recent research on additional benefits of exercise.

CDC 2019: Recently Identified Benefits of Exercise

1. Reduced risk of several types of cancer.
2. Brain health benefits:
   1. Improved cognitive function
   2. Improved sleep
   3. Enhanced quality of life.
3. For people with various chronic medical conditions:
   1. Reduced risk of all-cause and disease-specific mortality
   2. Improved physical function
   3. Improved quality of life
4. For pregnant women:
   1. Reduced risk of excessive weight gain
   2. Decreased instances of gestational diabetes
   3. Reduced rates of postpartum depression
5. For children:
   1. Improved bone health
   2. Healthier weight
   3. Improved cognitive function

The new report makes something clear for people who are inactive or sedentary:

Any amount of exercise is better than no exercise.

They also emphasize that older people and people with disabilities should follow the guidelines as much as they can, with the permission of their doctors, and adjust their level of activity to their current level of fitness, their overall health, and their fitness goals.

Another point of emphasis in the new CDC report is something we all know, but often ignore when we don’t feel like exercising:

No matter who you are or what your limits are – age, disability, chronic health conditions – you need to start somewhere, try something – literally anything – and gradually increase your level of activity until you meet the CDC guidelines.

This is incredibly important for the people I work with who are in recovery from an alcohol or substance use disorder (AUD/SUD). As mentioned above, addiction often leads to a sedentary and generally unhealthy lifestyle, and many people in recovery think they’re too out of shape to make trying to get back in shape worthwhile at all.

This report calls that attitude out for being, well, nonsense: everyone can benefit from starting where they are and doing wat they can.

Perhaps the best thing about the new CDC report is that it levels the playing field and sets the bar higher for everyone than ever before. As you will see, the guidelines do not change for people with disabilities or older people. They simply indicate that they should try to meet the recommendations, and if that’s not possible, they should get as close to meeting them as possible.

We’re paraphrasing, of course, but that’s the gist.

Now, without further ado, I’ll present the new CDC guidelines.

Exercise and an Active Lifestyle for Everyone

The language in the CDC report is not always the easiest to follow, so I streamlined it so that it makes sense and is easy for anyone to understand. What you’re about to read is adapted directly from the 2019 CDC report I link to above.

Ready to read the new guidelines?

Here they are.

CDC Guidelines for Exercise and Physical Activity: 2019

Key Guidelines for Adults

Adults, in general, should sit less and move more. They should understand that some physical activity is better than none, and that they’ll benefit from any amount of moderate-to-vigorous physical activity the do. For substantial health benefits, adults should:

• Do 150 to 300 minutes of moderate-intensity aerobic activity per week
  • That’s 2.5 to 5 hours of something like swimming, walking, or running, completed at a level of effort where talking/conversation is possible, but not easy
• Do 75 to 150 minutes of vigorous-intensity aerobic physical activity per week
  • That’s 1.25 to 2.5 hours of an activity like swimming, walking, or running, completed at a level of effort where talking/conversation is difficult, but possible in short sentences
• Do an equivalent combination of moderate- and vigorous-intensity aerobic activity as indicated in bullets (1) and (2)

General guidelines for exercise and activity:

• Aerobic activity works best when spread throughout the week.
• Exercising more than the recommended 5 hours per week yields additional health benefits
• At least twice a week, adults should do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups

Key Guidelines for Older Adults

The guidelines for adults also apply to older adults. In addition, they make the following recommendations specifically for older adults:

• As part of their weekly physical activity, older adults should participate in physical activities that include balance training as well as aerobic and muscle-strengthening activities.
• Older adults should match their level of effort and intensity to their level of fitness.
• Older adults with chronic conditions should understand how or if their conditions affect their ability to do regular physical activity.
• When older adults cannot complete two and a half hours of moderate-intensity aerobic activity a week because of chronic conditions, they should exercise as much as their abilities and conditions allow.

Key Guidelines for Adults with Disabilities

If possible, adults with chronic conditions or disabilities should follow the exact same guidelines as adults without disabilities. If adults with chronic conditions or disabilities are unable to meet the guidelines for adults, they should engage in regular physical activity according to their abilities and avoid inactivity.

Key Guidelines for Safe Physical Activity

To exercise and safely and reduce risk of injury, people should:

• Understand the risks but know that physical activity and exercise can be safe and fun for almost everyone.
• Choose types of physical activity that match their current fitness level and health goals
• Increase physical activity gradually over time to meet their health and fitness goals. Inactive people should start easy and go slow, meaning they should begin with lower intensity activities and gradually increase their frequency, length, and intensity over time.

People with chronic conditions or symptoms should consult a health care or exercise professional to come up with a list of exercise types or activity options that are safe, appropriate, and do not exacerbate their chronic condition or symptoms.

The New Guidelines: Takeaways for People in Recovery

A constant refrain in the new CDC report is that something is better than nothing. Another is start where you are and build on that.

Since addiction often leads people away from exercise, toward a sedentary, inactive lifestyle, this advice is perfect for people seeking sobriety and/or people in treatment for alcohol or substance use disorder (AUD/SUD).

People in recovery should start slow, do what they can, and go from there.

When you start from a place of emotional or psychological imbalance or impaired physical health – both of which are common to people with AUD or SUD – your emotional/psychological balance and physical health won’t return magically overnight.

It takes time and consistent effort – but starting small and building gradually works.

And whether you’re already in great shape or know you have some work to do – I recommend finishing this sentence, then putting down the phone or stepping away from the computer and going out for a walk.

The evidence shows you can’t go wrong: even a relaxed, easy, ten-minute walk can start you on the path to a healthy lifestyle – and sustained recovery.