Eating Disorders and Exercise

Every day, we are exposed to messages from medical professionals, the wellness community and even the media that exercise is a thing we need to do, should be doing and is always a good thing — even if it is extensive or excessive in nature.

However, we need to keep in mind that this is not the best messaging for everyone.

For those with eating disorders, there is often a much more complicated relationship with exercise — one that might exacerbate existing problems.

Compulsive Exercise and Exercise Addiction

Exercise can have a positive impact on both physical and mental health. Unfortunately, it can also be compulsive, disruptive and fuel an eating disorder.

Compulsive Exercise or Exercise Addiction are terms frequently used to describe an unhealthy relationship with exercise. While exercise addition is not a diagnosable condition, as a symptom, it is often the focus of treatment as part of a diagnosable eating disorder. If a friend, loved one, patient or client is living with an eating disorder, being aware of the risks associated with compulsive exercise can be important.

What is Compulsive Exercise?

  • Feeling that exercise is obligatory rather than motivated by enjoyment
  • Can be referred to or experienced by some as addictive
  • In Bulimia Nervosa, exercise may be a compensatory behavior, excessive in nature, to prevent weight gain
  • Motivated by a fixation on weight loss goals/changing shape or size, or disproportionately relied on for regulation of affect/difficult emotions
  • Exercising past the point of injury, when ill or causing one to miss out on important social events
  • Rigid in quality, not flexible or able to change routine or time of day
  • Shares some common characteristics with OCD

Special Populations and Compulsive Exercise

Just like an eating disorder, Compulsive Exercise appears differently depending on the individual. Here are a few special populations and how compulsive exercise affects them:

  • Athletes:
    • Triggers can include frequent weigh-ins, the misconception that weight loss leads one to be be faster or better. Dieting is often encouraged
    • Over-training, increased injuries and athletic performance decreases
    • Female Athlete Triad or Relative Energy Deficiency in Sport (RED-S); the combination of disordered eating, amenorrhea (for Female Athlete Triad) and bone loss
    • Rest and appropriate nourishment/adequate energy intake are important
  • Military service members:
    • Physical fitness tests and height and weight standards
    • Can be particularly challenging for people with eating disorders who also need to maintain a certain level of fitness for their job

What Does Compulsive Exercise Treatment Include?

  • Pausing exercise may be medically necessary to focus on fuel, nourishment, rest and recovery. Time can be spent examining motives and learning alternative coping skills for aversive emotions. Reintroduction of exercise may happen once it is medically safe to do so.
  • Personalized exercise exposures can be incorporated into treatment for some individuals. Starting with an exploration around the relationship to exercise and mindset around movement, establishing a hierarchy of activities to practice with clinical supervision. Exposure work around movement always involves discussing what comes up during the session; how the patient feels, what negative thoughts arise, and identifying urges to “do more”. It is also important to note that implementing exercise exposures must be paired with education on fueling one’s body properly to support the movement and what that looks like in the meal plan.
  • Any treatment plan for disordered eating coupled with compulsive exercise should include a participation and monitoring by a medical doctor, registered dietitian, therapist, and potentially a psychiatrist. For athletes, treatment teams may include a coach or physical trainer, and supports can include teammates.
  • A reframing of thoughts and shift in language from exercise to movement or activity can be helpful for many individuals, along with examining the purpose behind and enjoyment of certain types of movement. An important clinical consideration is the shame and other associated negative feelings that come along with pressures to lose weight, and via restrictive diets and excessive exercise for those in larger bodies.

Treatment may incorporate movement that is not necessarily exercise based, but can help people connect to their bodies and work on body image related concerns or shame-based thoughts and feelings through restorative practices such as yoga, somatic awareness groups, or dance/movement therapies.

Contact Us Today

If you suspect you may have a problem with Compulsive Exercise, Reasons Eating Disorder Center is here to help you. Contact us right now to get started.