Eating Disorders & Exercise: How to Strike a Healthy Balance

Woman working with Eating Disorders and Exercise

Contributed by Canopy Cove

Exercise is a crucial component of good health, but when exercise is taken to an extreme, it can negatively impact one’s health and well-being. This is often the case when considering the role of exercise in eating disorders (EDs).

Exercise is defined as any physical activity undertaken with a specific objective such as the improvement of fitness, health, or physical performance. For individuals who have a healthy relationship with exercise, exercising is a source of fun, pleasure, and connection. They “want to” exercise for these internal, joy-based motivating factors. [1, 4]

On the other hand, those who exercise as a part of an ED experience a much different relationship with exercise. In these individuals struggling with an ED, exercise is often seen as obligatory or feeling like they “have to” exercise for reasons such as physical appearance, weight loss, or self-worth.

For these individuals, exercise is characterized by extreme concerns about the perceived negative consequences of stopping or reducing exercise, dysregulation of affect (that is, they may experience emotional distress if they do not engage in exercise), and inflexible exercise routines. [1, 3, 5]

Striking a healthy balance

Addressing exercise behaviors in those who struggle with an ED is essential in seeking full recovery. More and more research is exploring how important it is to target exercise behaviors in ED recovery. More specifically, research has been exploring how reconnecting with exercise in a healthy way is vital in seeking long-term recovery. [1, 2, 3, 6]

Here are some key treatment components that address striking a healthy balance with exercise: [1, 2, 3, 6]

  • Maintaining stable and adequate nutrition to support exercise
  • Close medical monitoring
  • Addressing unhealthy thoughts and relationships with exercise
  • Attunement and connection to the body during exercise. For example, awareness of how one’s body feels during exercise; recognizing feelings of muscular exertion from pain and/or injury; recognizing safe heart and breathing rates; appreciation of recovery, rest, and body acceptance.
  • A slow, progressive exercise program that begins with extremely small amounts of low-intensity exercise and slowly increases intensity, duration, and frequency over an extended period of time
  • Education on how to do exercise, the appropriate use of exercise for health benefits, and how to recognize when exercise is becoming problematic
  • Woman compulsively exercisingUtilization of a multidisciplinary team approach in recovery that includes providers who specialize in eating disorder and exercise recovery, such as:
    • therapists
    • physicians
    • athletic trainers
    • dietitians

Full recovery from an ED is possible. With the most recent research guiding us, it seems that incorporating how to strike a healthy balance with exercise is an essential treatment component.


  1. Cook, B. (2018, May). Recommendations for the progression of exercise in eating disorders treatment. Presentation at the Central Texas Eating Disorder Conference, Austin, TX.
  2. Cook, B. (2017, Feb). A Brief Review of Exercise in Eating Disorders Treatment. National Eating Disorder Information Centre Bulletin. 31(1), ISSN 08366845.
  3. Cook, B., Hausenblas, H., & Freimuth, M. (2014). Exercise Addiction and Compulsive Exercising: Relationship to Eating Disorders, Substance Use Disorders, and Addictive Disorders. In T. Brewerton, & A.B. (Eds.), Eating Disorders, Addictions and Substance Use Disorders: Research, Clinical and Treatment Perspectives. (pp. 127-144). New York, NY: Springer.
  4. Garber, C.E., Blissmer, B., Deschenes, M.R., Franklin, B.A., Lamonte, M.J., Lee, I., Nieman, D., & Swain, D.P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidelines for prescribing exercise. Medicine and Science in Sports and Exercise, 43(7), 1334–1359.
  5. Young, S., Touyz, S., Meyer, C., Arcelus, J., Rhodes, P., Madden, S., Pike, K., Attia, E., Crosby, R., Hay, P. (2018). Relationships between compulsive exercise, quality of life, psychological distress and motivation to change in adults with anorexia nervosa. Journal of Eating Disorders, 6(1), 2. DOI 10.1186/s40337-018-0188-0
  6. Mathisen, T.F., Bratland-Sanda, S., Rosenvinge, J.H. et al. (2018) Treatment effects on compulsive exercise and physical activity in eating disorders. Journal of Eating Disorders, 6: 43. DOI 10.1186/s40337-018-0215-1

About Our Sponsor:

Canopy Cove Eating Disorder Treatment Center is a leading residential Eating Disorder Treatment Center with 25 years of experience treating adults and teens who are seeking lasting recovery from Anorexia, Bulimia, Binge Eating Disorder and other related eating disorders.

About the Author:

Chelsea Fielder-JenksChelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.

She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope but an effort to offer a discussion of various issues by different concerned individuals.

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.

Published on December 20, 2018.
Reviewed & Approved on April 12, 2024, by Baxter Ekern, MBA

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