The Basics of Disordered Exercise

Reprinted from Bulimia: A Guide to Recovery
By Lindsey Hall and Leigh Cohn

There’s a fine line between exercising for health and overdoing it, and you can tell the difference by looking at your motivation and degree of obsession. If you exercise primarily as a way to control your weight or to compensate for food you’ve eaten—especially binges—then you are approaching it in a harmful way. That’s also true if you feel compelled to work out when you are injured or sick, and if your routine interferes with relationships or other important activities, or puts you in dangerous situations. It is also unhealthy to always exercise to the point of near exhaustion, not take days off, or devote hours a day—on average—unless you are in supervised training.

Studies have shown that between 33% and 80% of anorexics and bulimics engage in excessive exercise—the wide range probably due to inconsistencies in defining the term "excessive".  However, regardless of the statistics, a strong connection between eating disorders and overexercise exists, resulting in serious psychological, emotional, and physical consequences (in addition to those previously described for food-related behaviors). Exercise also has an addictive component because of neurochemical changes in the brain, which make recovery more difficult.

People who overexercise, and isolate themselves by escaping into their routines, can suffer from fatigue, sleep disturbances, and depression. Common medical problems include decreased sex hormones, reduced immune function, potentially fatal cardiovascular complications, strained or torn muscles and ligaments, and bone loss (osteopenia or osteoporosis) that can lead to fractures. Many women athletes suffer from the "Female  Athlete Triad" (amenorrhea, osteoporosis, and an eating disorder), and men can suffer from the "Male Athlete Triad" (with lowered testosterone as the hormonal component). Furthermore, eating disorder sufferers who excessively exercise usually have more severe levels of body dissatisfaction, preoccupation with weight, and hyperactivity; and, they often have poorer outcomes in treatment (Power's 2008).  

It’s not surprising that elite athletes are at high-risk for eating disorders. In one study among females, 46% who participated in lean  sports (requiring a lean body: gymnastics, diving, long-distance running, etc.) and 20% in non-lean sports (requiring a more muscular body: ball games, speed skating, sprints, etc.) met the clinical criteria for an eating disorder. Other studies with men have shown that weight-class sports (wrestling, martial arts, and jockeys) have particularly high rates of bulimia. The reasons are fairly obvious. Athletes commonly, but mistakenly, think that less weight is an advantage both physically and aesthetically. But the truth is that an eating disorder is actually a hindrance to competition: an athlete can lose his or her edge when they are focused on food and how they look rather than performance; player confidence can be eroded by insecurities and low self-esteem; and eating disorders cause a decrease in strength, power, and endurance (Thompson, 2010).

Changing the goal from thin to healthy means creating balance both in eating and exercise. While you uncover the mental, emotional, and spiritual issues that drive your eating disorder, also look at how they influence your choices about exercise.