We all know exercise is good for our bodies, but did you know that for some people, exercise becomes an unhealthy obsession? Studies show that at least three in every 100 Americans have an exercise dependence, with that number sharply rising among gym-goers and athletes. Obsessive exercise is also a huge problem among individuals with eating disorders, causing long-term health problems and a negative relationship with movement. In this article, we examine the relationship between exercise and eating disorders, while also looking at what exercise dependence really is, the problems with exercise resistance, and how to find joy and balance in exercise during eating disorder recovery.
Exercise Dependence
While exercise is unarguably good for our bodies – both physically and mentally – there can come a point when it is no longer healthful and becomes an obsession. But what separates the regular exercise enthusiast who loves to hit the gym every day after work or is training hard for a marathon from someone with an exercise disorder? In other words, how can you tell when exercise crosses over the line from healthy and enjoyable to being harmful?
There are seven main criteria used to identify an exercise dependence. These seven characteristics are laid out by Dr. Heather Hausenblas and Danielle Symons Downs, Ph.D. in their article, “How Much is Too Much? The Development and Validation of the Exercise Dependence Scale.”
- Withdrawal: if the person can’t exercise, they experience negative effects like irritability, anxiety, sleep problems, and restlessness;
- Lack of control: unable to successfully reduce exercise levels or cease exercising for a period of time;
- Intention effects: inability to stick to an intended routine, instead, going beyond the amount of exercise originally intended;
- Time: spending great amounts of time on exercise;
- A decline in other activities: due to excessive amounts of time spent on exercise, other occupational and social activities occur less often or are even stopped;
- Continuance: continuing to exercise even when the activity is causing physical, psychological, or relational problems.
- Tolerance: the individual increases the amount of exercise to feel a specific effect, usually a sense of accomplishment or a “buzz.”
Put simply, exercise dependence is a harmful obsession with exercise and physical fitness. There are multiple causes and motivators behind an exercise dependence, including eating disorders like bulimia nervosa and anorexia nervosa as well as body image disorders like body dysmorphic disorder.
HOW PREVALENT IS EXERCISE DEPENDENCE IN TODAY’S CULTURE?
As many as three in every 100 people within the general western population are dependent on exercise, and among certain groups like athletes and sport science students, the prevalence is even higher. Among gym-goers, the numbers rise even more, with one study finding that 42 percent of the members at a Parisian fitness club met the criteria for exercise dependence.
IS EXERCISE DEPENDENCE DANGEROUS?
While you may be thinking an obsession with working out doesn’t sound like the worst thing in the world, it can actually cause devastating health issues – both physically and psychologically. Often, exercise compulsion leads to extreme weight loss and a whole host of other health problems related to unhealthy weight loss. Unfortunately, in today’s diet- and exercise-obsessed culture, individuals with an exercise dependence often fail to see a problem with their excessive regime and usually blend right in with the gym-junkie and fitness-obsessed world around them.
Now that we know what an exercise dependence looks like, let’s examine the role excessive exercise plays in eating disorders…
Exercise and Eating Disorders
Excessive exercise and exercise dependence are often one of the accompanying components in an eating disorder. In fact, among restrictive eating disorders like anorexia nervosa, some research indicates that people with a restrictive eating disorder may experience a biological drive to obsessively exercise.
ANOREXIA AND EXERCISE
In a famous study done on rats, scientists restricted the rat’s food intake (stimulating anorexia) and gave them unlimited access to a wheel. They were shocked to find that the rats started running excessively, even skipping the few meals offered to them so they could keep on running. While one would assume the starving rats would decrease their levels of energy output, they instead became more active.
The same phenomenon has been observed in young children with anorexia. Often children with anorexia refuse to sit still, fidget constantly, and run around without purpose. While these youngsters don’t yet express the conscious attempt to burn off calories like adults or older adolescents do, they still can’t seem to stop moving.
Further, adult patients with anorexia often report a compulsive need to move, as this individual in a study about exercise said:
“Before I attended treatment, I only sat down during meal times, or else I felt I did not deserve to sit still. I was incredibly restless, so it was difficult to relax…I feel like I am being compelled to exercise…”
OTHER EATING DISORDERS AND EXERCISE
Anorexia Nervosa is not the only eating disorder in which sufferers engage in obsessive exercise. Individuals with Bulimia Nervosa commonly engage in excessive amounts of exercise as a form of purging (or compensatory behavior) for their binges. One study found that 20 to 24 percent of patients with bulimia nervosa engaged in excessive exercise.
Muscle Dysmorphia is another eating disorder that drives individuals to exercise obsessively. Muscle Dysmorphia is grouped within Body Dysmorphic Disorder, and commonly affects bodybuilders. People with muscle dysmorphia believe they are not muscular enough and often this leads to obsessive workout regimes, gym going, and other harmful behaviors. Approximately 71 percent of men with muscle dysmorphia lift weights and 64 percent of men with the disorder exercise excessively.
Exercise Resistance
While we’ve talked a lot about exercise dependence and obsessive exercise, this is not the only harmful response associated with exercise, especially when it comes to exercise and eating disorders. Resistance to (or avoidance of) exercise also commonly occurs both in the general population and among individuals with eating disorders. While this may not be as destructive or harmful (at least in the short-term) as exercise dependence, a resistance to exercise can cause problems later down the road, while also robbing an individual of the joys and health benefits of movement.
CAUSES OF EXERCISE RESISTANCE
Humans have an innate desire to move their bodies. From a very young age, we see children playing tag, jumping in puddles, and swinging at the park for the pure joy and fun of it. Tragically, many people no longer find joy in movement nor experience that biological desire to move their bodies. This resistance to movement can happen for several reasons.
Before we look at these reasons, let’s first be clear on what we do and do not mean by movement. Movement should not be mandated, rigid, stressful, or unenjoyable. You do not need to get on a strict exercise regime or start running on the treadmill for hours at a time to experience the benefits of exercise. Instead, movement should be enjoyable, should honor your body’s desires, energy levels, and capabilities, and should never feel forced or rigid. Remember, humans were made to move and we feel our best – both physically and mentally – when we reconnect with our bodies and honor their desire to move.
Movement can be anything from taking a gentle walk to tidying up the house, it could be a 2-hour bike ride on a Saturday with the family or a 10-minute breathing and stretching session on your mat. It could be walking to the coffee shop for a pastry and hot drink or even pushing your kids on the swing set.
MANDATED EXERCISE
One of the primary reasons people resist exercise and avoid movement is simply because they’ve been told to exercise, shares Francie White, M.S., R.D. She goes on to say that our diet- and fitness-obsessed culture bombards us with messages on how to exercise, when to exercise, and how much to exercise. Because of this, we no longer find joy or pleasure in moving our bodies. Instead, movement has been reduced to a scientific formula for burning calories or getting six-pack abs, and for many, the rigidity and rules associated with physical exercise keep them from even attempting it.
EXERCISE FOR WEIGHT LOSS
Another reason why many people experience exercise resistance is that for years, they have only thought of movement as a way to lose weight. Viewed in this way, physical exercise is no longer about enjoying an activity or listening to our body’s desire to move, but rather, it’s all about an outcome. And if, after years of exercise plans and rigid workouts, the outcome (weight loss or some other physical goal) still hasn’t been reached, the individual may give up on movement altogether.
Resistance to exercise because of a former (or current) goal of weight loss may also affect people with eating disorders, especially during recovery. If exercise was excessive or harmful and only focused on weight loss during the disorder, the individual may have a difficult time finding balance and joy in movement again both during recovery and beyond.
If you struggle with resistance to exercise, here are a few tips to help you find a healthy relationship with movement once again. These tips are laid out in a video by Ai Pono’s founder, Dr. Anita Johnston, and Francie White, M.S., R.D.
- Stop being critical of your efforts to move or your movement outcomes (weight loss, fitness level, etc.), and instead approach movement with a curious mindset.
- Notice the ways you resist movement and instead of fighting it, allow it. Honor those resistant feelings for now and consider why you might be experiencing them.
- Remind yourself that humans were made to not only move but to love moving. Figure out when moving your body went from being something fun and enjoyable to being obligatory and something to be avoided.
- Ask yourself what 3 movement activities you would like to try if you were at your ideal weight and fitness level (in other words, if you weren’t exercising for weight loss or body shape).
Exercise in Recovery
For many people in eating disorder recovery, exercise can be a trigger or can be physically counterproductive to weight gain goals. If this is where you are in your recovery process, listen to your treatment professionals, and only begin to exercise when they deem it wise and healthy. With that being said, exercise is good for humans both physically and mentally, and if you have abused exercise in the past during your eating disorder, it is important to learn how to approach movement in a healthy, balanced way. So if you’re further on in recovery and would like to heal your relationship with movement and incorporate physical exercise into your life once again, let your treatment professionals know, consult your doctor, and continue to work closely with them as you re-discover the joys and benefits of movement.
As you re-introduce movement into your life, follow these helpful guidelines:
- Reject old ideas about exercise.
- Listen to and honor your body.
- Get curious, have fun, and try a new form of exercise.
- Create a safety net of treatment professionals to support you on this journey back to mindful movement.
- Always be honest about your intentions for movement and if you catch yourself sliding into the old ways of thinking (weight loss, calorie-burning, etc.) tell your support group and consider ceasing the activity until you can approach with the right mindset.
If you or a loved one may be suffering from an exercise dependence or compulsion, or simply want to re-discover a healthy, balanced relationship with movement, consider seeking professional help at ‘Ai Pono Hawaii. We’ve helped countless people find life and happiness in recovery, and we want the same for you.
Take the next step today and talk to someone about recovery or simply learn more about the recovery programs we offer.
