Exercise Bulimia

Individuals that struggle with disordered eating will often engage in different compensatory behaviors to “earn” food or rid themselves of calories consumed. Many are aware that vomiting and using laxatives are some of these behaviors. What many do not know, and what is more difficult to identify as concerning, is that exercise is also often used as a compensatory behavior.

When Exercise is No Longer Healthy

Movement is a positive aspect of humanity that can allow us to cope effectively with our emotions, engage with the world around us, and experience connection with our bodies. When utilized for these reasons, it is often a fulfilling part of a person’s life.

Sadly, movement has culturally become more connected with worth, pride, competition, and body image. Individuals are often not taught that movement can be a joyous and intuitive act and, instead, learn movement as a tool to alter the body to be socially acceptable. What could be a profound experience of existing in the amazing machines that are our bodies has become a chore that individuals are judged or shamed for.

This already ugly dynamic between movement and worth becomes dangerous when an individual engages in excessive and compulsive exercise to the degree that they cannot stop.

Related Reading

Exercise Bulimia

Exercise Bulimia is not an official mental health or medical diagnosis. It is more a description of excessive exercise behaviors through the lens of eating disorders. “Bulimia” refers to “Bulimia Nervosa,” an eating disorder characterized by individuals engaging in binge-eating episodes and then utilizing compensatory behaviors to rid their bodies of the calories consumed.

As such, the phrase “exercise bulimia” refers to using exercise as one of those compensatory behaviors. Individuals engage in excessive and compulsive exercise for many reasons, however, “exercise bulimia” specifically refers to those that engage in excessive or compulsive exercise to counteract their nourishment. Individuals might engage in exercise before a meal to “earn” their meal or after in an attempt to burn the calories they had just eaten.

Stretching

How to Identify Over-Exercise

Identifying over-exercise is challenging because many of the warning signs are also behaviors that are glorified in our society. Individuals that exercise regardless of inappropriate weather, fatigue, injury, or insufficient daily nourishment are validated for their commitment when, in reality, all of these are red flags that this person’s relationship with exercise is disordered.

The Journal of Eating Disorders published suggested criteria for identifying and defining compulsive exercise in 2018, specifying the following:

  1. Compulsive exercise as defined by 1 and 2:
  1. Excessive exercise that the patient feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
  2. The exercise is aimed at preventing some dreaded consequence or at preventing or reducing distress, often based on distorted beliefs about exercise.
  1. The compulsive exercise is time-consuming (takes more than one-hour a day), significantly interferes with the person’s daily routine, occupational functioning or social relationships, or is continued despite medical injuries, illness, or lack of enjoyment.
  2. At some point during the course of the disorder, the patient has recognized that the compulsive exercising is excessive or unreasonable [1].

Some key aspects of this criteria include the concept that excessive exercise is motivated by avoidance of a dreaded consequence. For those with eating disorder beliefs and ideologies, this consequence is often weight gain. There can be many reasons for this fear including, but not solely limited to, achieving a certain physical body.

Another important aspect of identifying someone that struggles with excessive exercise is considering their emotional and cognitive reaction if they cannot engage in their planned movement. If they react with overwhelming shame or guilt and talk about what they have eaten or will now eat, or not eat, based on not being able to exercise, this can indicate that they are engaging in exercise bulimia behaviors.

Exercising Can Still be a Part of Recovery

Many that use excessive and compulsive exercise as a compensatory eating disorder behavior begin with a healthy relationship to exercise and movement. With disordered eating and body image beliefs, this devolves into something concerning.

When these individuals begin to seek treatment for their disordered eating and exercise, they are concerned that they will never be able to engage in it as they once did – with joy and intuition.

While reintegrating movement into recovery is a slow and very mindful process, it is something that is considered a key part of eating disorder treatment. The body is a wonderful machine and many treatment centers want their patients to believe this and engage with their machine and its amazing capabilities.

This process begins with engaging mindfully and intuitively with the body as it is still to learn how to be attuned to the body’s signals, sensations, and needs. As one becomes more experienced and comfortable with this, slow and thoughtful movement such as stretching, restorative yoga, and mindful walks can be incorporated into treatment, with the help of therapeutic, dietary, and medical support of a treatment team, of course.

Running

It may take a year or more for an individual to even consider approaching the most gentle version of their preferred method of movement, however, it will eventually be possible.

The important thing is to listen to the body in this process so that movement can be joyful while still allowing the body to heal.

Resources:

[1] Dittmer, N., Jacobi, C., Voderholtzer, U. (2018). Compulsive exercise in eating disorders: a proposal for a definition and clinical assessment. Journal of Eating Disorders, 6:42.

Author: Margot Rittenhouse, MS, NCC

Reviewed & Approved on July 27, 2022, by Jacquelyn Ekern MS, LPC
Published 7.28.22 on EatingDisorderHope.com