A Clinical Profile of Compulsive Exercise in Adolescent Inpatients with Anorexia Nervosa

Closeup of runner's shoes

Contributor: Maggie Geraci, RD, Director of Nutrition Services for Timberline Knolls.

Compulsive over-exercise is frequently linked with anorexia, and unfortunately, it is often the case that as calorie expenditure increases, food intake decreases.

Physical Consequences:

1. Emaciated state and fatigue
2. Obsessive compulsiveness
3. Low self esteem
4. Damage tendons, ligaments, bones, cartilage, joints and potential long-term injuries
5. Depleted muscles related to inadequate nutrition
6. For women: imbalance in hormones in their bodies can induce amenorrhea or increase the risk of osteoporosis
7. Elevated pressure on the heart that can be fatal
8. Increased depression and anxiety

Those who engage in compulsive exercise are often perfectionists and compulsive people who struggle with low self-esteem. Considering that adolescents, particularly female, are often the very definition of perfectionism and low self-esteem, it is no surprise that many become compulsive about exercise.

Whereas the average recommended amount of exercise for adolescents is 60 minutes a few times a week, these individuals far exceeded that recommendation, often spending hours running or working out each day. The problem is their bodies are not done growing yet, so this type of excessive exercise can prove quite harmful in the long run.

Clinical Indicators:

  • Low CBC: low iron indicating anemia, elevated inflammation and infection.
  • Hypoglycemia due to dehydration, malnutrition or over-exertion.
  • Ketoacidosis or ketones that accumulate in the blood due to the body breaking down fat for energy due to starvation.
  • Woman compulsively exercisingIrregular heart beat including shortness of breath or palpitations.
  • Low blood pressure due to the body slowing down to compensate for lack of energy provided.
  • Electrolyte imbalance.
  • Low potassium: muscle cramping, increased thirst, low blood pressure.
  • Low calcium: leg numbness, headaches, fragile bones, muscle cramps.
  • Low sodium: loss of appetite muscle cramps, fatigue, vomiting, confusion, and weakness.
  • Low phosphorous: loss of appetite, bone pain, fatigue, cardiac and renal complications.
  • Low magnesium: muscle cramping, anxiety, low blood pressure, low body temperature.

Healthy, enjoyable exercise is good; compulsive, excessive exercise is not. If you, or someone you know struggles with compulsive exercise, please get help.

Community Discussion – Share your thoughts here!

What do you do to maintain a healthy balance of activity in your recovery?



Maggie Geraci photoAbout the Author: Margaret Geraci, RD, LDN, is Director of Nutrition Services at Timberline Knolls Residential Treatment Center.

As Director of Nutrition Services, Maggie‘s job entails many duties. She oversees the dietitians and diet technicians, carries a caseload of adolescents, supervises the menu and meal planning stages and develops nutrition-related protocols. She also implements current nutrition recommendations, participates in community outreach and trains dietitians.

Prior to joining Timberline Knolls, Maggie was the Nutrition Manager at Revolution in Chicago. She started with Timberline Knolls as a diet technician and progressed to a Registered Dietitian.

Maggie attended Eastern Illinois University for her undergraduate degree in Dietetics and Nutrition and then completed her dietetic internship at Ingalls Memorial Hospital.

She is a member of the Academy of Nutrition and Dietetics, Behavioral Health DPG and South Suburban Academy of Nutrition and Dietetics.


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We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on June 7, 2016
Published on EatingDisorderHope.com

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