Treatment Options for Compulsive Exercise Among Eating Disorder Sufferers

Summer Flowers

Compulsive exercise (aka abusive exercise) is common in people with eating disorders. This behavior can be difficult to treat, but eating disorder treatment professionals have been developing ways to help people have a healthier relationship with exercise.

What Is Compulsive Exercise?

Compulsive exercise is when someone obsessively participates in physical activity. Other signs of abusive exercise are if someone feels unable to stop exercising and if they are forced to or try to stop, they may experience intense emotional distress.

Also, Someone who is struggling with this will continue to work out despite negative consequences, such as an injury. Compulsive exercise may also interfere with someone’s relationships or their ability to complete school or work responsibilities.

Why is Compulsive Exercise Harmful?

It might seem surprising to think that exercise can be harmful. Well, it can be if it’s compulsive. People in eating disorder treatment who also engage in compulsive exercise are less likely to receive the maximum benefit from treatment [1].

This behavior is also linked with poorer quality of life, increased risk of suicide, and increased risk of relapse [1]. Abusive exercise is also linked with the following emotional and physical risks:

  • Bone density loss
  • Loss of the menstrual period
  • Chronic joint and bone pain
  • Ongoing exhaustion
  • Weakened immune system
  • Anxiety and depression [3].

What Are The Current Treatments For Compulsive Exercise?

Historically, eating disorder treatment professionals have recommended complete abstinence from exercise during treatment and the early phases of recovery. However, this has changed.

There are a few different treatment approaches that aim to help people create a healthy relationship with movement. There are a few different treatment approaches for disordered exercise that have shown to be helpful.

Here is a brief overview of the different treatment options:

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a style of therapy that aims to help people change their behavior by changing the way they think. In a recent study looking at how effective CBT is for treating compulsive exercise, the study did not focus on exercise. Rather, the treatment focused on addressing the core eating disorder issues and then working on relapse prevention [2].

Physical Exercise & Dietary Therapy

Another approach is Physical Exercise & Dietary Therapy (PEDT) [2]. This approach combined supervised and unsupervised exercise sessions and dietary counseling.

Of the two approaches, both were found to be equally effective [2]! In fact, the study showed that the people who received these therapies made more progress compared to individuals who did not receive it [2]. This is promising considering how difficult it has been to treat this harmful behavior.

It’s also encouraging that there are treatment methods that are shown to be effective because approximately 42% of people who go to the gym have a disordered relationship with exercise [4]!

Butterfly and Pink Flowers

Is It Only People with Eating Disorders who Compulsively Exercise?

No! While the stereotype is that only people with eating disorders struggle with disordered exercise, it’s not true. People with body dysmorphia may also engage in abusive exercise [1].

Body dysmorphia is a mental illness where someone may obsess over a perceived physical flaw that is hardly noticeable or not a big deal to anyone else. This mental health condition could distort the way someone perceives their body shape or size.

This could drive them to continue exercising in an attempt to change their body. For example, a man struggling with body dysmorphia may view himself as lacking muscle definition. To everyone else, he is clearly built but when he looks in the mirror he doesn’t see that. This person may continue to lift weights despite suffering from an injury.

People with this condition may also benefit from the treatment approaches that were mentioned above [1].

If you or someone you know are struggling with compulsive exercise, there is hope. Use Eating Disorder Hope’s treatment finder to locate a treatment professional near you.


[1] Martenstyn, J.A. Touyz, S., Maguire, S. (2021). Treatment of compulsive exercise in eating disorders and muscle dysmorphia: Protocol for a systemic review. Journal of Eating Disorders, 9(19), 1-7.

[2] Mathisen, T.F., Bratland-Sanda, S., Rosenvinge, J.H., Friborg, O., Pettersen, G., Vrabel, K.A., Sundgot-Borgen, J. (2018). Treatment effects on compulsive exercise and physical activity in eating disorders. Journal of Eating Disorders, 6(43), 1-9.

[3] National Eating Disorders Association. (2018). Compulsive Exercise.

[4] National Eating Disorders Association. (2018). Statistics and Research on Eating Disorders.

About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.

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 July 8, 2021, on
Reviewed & Approved on July 8, 2021, by Jacquelyn Ekern MS, LPC