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November 19, 2017

Is Exercise Possible in ED Treatment and Recovery

Woman in the sunset enjoying exercise

In most eating disorder treatment settings, exercise is often discussed. Being able to learn how to maintain healthy exercise, while practicing recovery can be challenging.

Often many cognitive and emotional struggles still exist as the client is learning how to incorporate working out into their recovery goals.

Exercise is a Tool

Often, exercise can be used as a tool, and it can be challenging to help a person understand that physical exercise is similar to therapy for the mind. The use of it in a structured setting allows for check-in’s prior to exercise, that focuses on a person’s awareness and feelings going into the session [1].

Programs may also use various local settings such as swimming pools, or workout facilities to be able to expose and acclimate individuals to thoughts and emotions around being active around others.

A check-in or process hour can be scheduled for after the workout to assess client’s well-being. It is helping a person understand the benefits of healthy exercise.

In post-workout follow-ups, individuals in treatment are able to journal and process outside of the workout session. Through the use of writing assignments, experiential projects, and talking, can help individuals see the differences in healthy versus unhealthy exercise.

Some clinicians and nutritionists tend to focus on themes around their client’s perception of how exercise can be an addiction or a part of their eating disorder.

Evaluating what thoughts and feelings feed into the exercise can help with the recovery and treatment process.

Other focuses are on the relationship between the body, body-image, and exercise as a whole.

These themes can be explored with the person’s therapist to help understand and objectively look at their eating disorder. Patients are often given individual assignments that may help them come to understand how they came to be in treatment in the first place.

Assignments can help the patient become more well-informed about how they may have applied exercise in an unhealthy manner.

Stop, Don’t Pass Go

For athletes having to cease their sport or physical activity can be mentally painful. Many athletes want to be able to continue their sport while receiving eating disorder treatment. For some that might be possible or reduced, for others due to medical necessity, they may not be able to continue until they are medically stable [2].

Woman relaxing with exercise

A person may not be ready to return to exercise when there is difficulty achieving treatment goals with weight restoration or reduction in symptoms. Some individuals may be unwilling to try the recommended treatment nutrition plan or exhibit unhealthy thinking around exercise and food.

Often education on the effects of compulsive and overuse exercise on the body while in an eating disorder can help challenge eating disorder thoughts.

Weight restoration is also helpful for the body and mind to be running at 100% capacity for exercise to resume.

Ready, Set, Go

When individuals are ready to resume exercise or their sport, they are able to show positive physical and emotional progress with treatment recommendations.

They are medically stable and are recovered from any physical or overuse injuries, and are not resisting the meal plan or extra nutrition. Easing back into exercise is essential and not allowing the person to go straight back into a rigorous scheduled.

While in treatment for the eating disorder it is imperative that the individual is under the supervision of the treatment team while resuming or continued exercise. This includes therapist, nutritionist, physician, sports psychologist and nutritionist.

Developing a written contract that states the extent and type of exercise the person is allowed to start with as well as any meal plan changes.

The agreement needs to be revisited as any parts of the agreement are modified. Help the individual focus on the emotional and physical well-being of exercise.

Keep it fun and enjoyable. Many sufferers are used to exercising to the point of nausea, exhaustion, and feelings of passing out. Relearning how to have fun in exercise and moving the body is key to using exercise in eating disorder treatment.

Helping clients remember that activities such as gardening, walking their pet, taking a hike in nature, yoga, are all physical activities.

How is this Important for All Treatment Levels

Being able to talk about exercise, its benefits, its challenges within the eating disorder treatment setting at all levels is essential. It can be scary for both clinician and client to start the conversation around exercise, but it is a tool for recovery that can be misunderstood. Each person can incorporate some level of body movement into their day.

Woman thinking and struggling with anxietyWhether it is a walk around the neighborhood or park with their dog, a yoga class, a nature hike with friends, or visiting the local zoo and leisurely walking is all considered activity. It is being aware of your body and how it moves in a specific way.

Using mindfulness within the process of exercise is pulling in from Dialectical Behavioral Therapy (DBT) that used mindfulness as one of its tenants to emotional tolerance and distress. By teaching awareness, many individuals can focus on the activity versus counting calories or weight loss. It is about being in sync with their body signals and needs in each moment.

Incorporating programs that include exercise within treatment is imperative. Many centers offer yoga classes, nature hikes, workout sessions at local community centers, swimming fitness and much more. Being able to connect the significant benefits of healthy exercise into eating disorder treatment adds a fuller holistic healing process to the recovery journey.


Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


References:

[1] Steffes, D. (n.d.). Addressing exercise issues in eating disorders treatment. Retrieved October 03, 2017, from https://rogersbh.org/about-us/Newsroom/Blog/addressing-exercise-issues-eating-disorders-treatment
[2] Athletes & Eating Disorders – When Can I Exercise, Again? (n.d.). Retrieved October 03, 2017, from https://www.waldeneatingdisorders.com/athletes-eating-disorders-when-can-i-exercise-again/


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer 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 November 19, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on November 19, 2017.
Published on EatingDisorderHope.com

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