For most people, exercise is an important component of living a healthy, satisfying life. Being physically active can improve your brain health, reduce the risk for disease, and strengthen your muscles and bones.
For a person who is in recovery from an eating disorder, though, the relationship with exercise can be one that is fraught with tension, anxiety, and the potential for relapse.
In one study of patients who were struggling with anorexia, 37%-54% engaged in excessive exercise . That rate was lower for those who were living with bulimia (20%-24%), but when potentially a quarter to a half of patients who had the two most common types of eating disorders participated in excessive exercise, it’s clear that this is a common hang-up.
So, if you’re in recovery from an eating disorder, how can you safely return to exercise?
Understanding compulsive exercise
Compulsive exercise is not a recognized clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), but it’s a condition that can affect those who are already struggling with eating disorders — or spur the onset of a disorder.
Common signs and symptoms of compulsive exercise include:
- Intense anxiety, irritability, or feelings of distress if unable to exercise
- Discomfort with rest or inactivity
- Exercise used as a means of purging
- Exercise that is secretive
- Maintaining a rigid regimen despite obstacles such as weather, injury, and illness
Compulsive exercise can lead to a loss of a menstrual cycle in women, osteoporosis, chronic bone and joint pain, an altered resting heart rate, female athlete triad, and much more .
It can be difficult to determine how to appropriately return to physical activity while in recovery. Even if compulsive exercise is not something you’ve struggled with, defining healthy exercise parameters can be challenging as you move forward.
One of the benefits of exercise, for many people, is an ability to maintain a healthy weight. Naturally, for someone who is in recovery from an eating disorder, the subject of weight fluctuation can be a big stumbling block.
Taking It Slow at First
If you’re unwilling or unable to maintain a nutritious diet to match an increased level of activity, or if you’re viewing the reintroduction of exercise as a way to simply burn calories, it’s probably not time to be ramping up your physical fitness routine.
But if you are medically stable, have had positive physical and emotional responses to treatment, are not currently nursing a physical injury, and are able to fuel your body with good nutrition, odds are that you can begin to exercise again.
If that’s the case, you have to be cautious to ensure that you’re building (or rebuilding) a healthy relationship with exercise rather than ramping up too quickly and doing more harm than good. You can do this by:
- Developing a plan. Get in touch with your treatment team. Whether it’s medical or mental health professionals, physical therapists, psychologists, nutritionists, or any other experts, work with those who know you best to develop a plan that has guidelines for fueling your body and the types of exercise that can complement your nutrition.
- Starting gradually. Think of mild intensity and low frequency when you’re beginning to get back out there. A brief walk or jog, lifting with light weights, and a low volume of core exercises are ways to reintroduce your body to physical fitness.
- Making sure that it’s enjoyable. For a lot of people who struggle with compulsive exercise as part of an eating disorder, there is no pleasure in being physically active. Rather, it feels like a rigid requirement to continue what are often dangerous patterns of disordered eating. Find activities that bring you joy instead of exercising because you feel obligated.
- Avoiding potential triggers. Don’t do anything that may threaten your recovery. Perhaps that means staying away from a certain athletic activity or exercise routine — or even a group of people or a particular place. Let your journey back to exercise be a positive one, both physically and mentally.
Exercising while in recovery from an eating disorder has its challenges. For those who struggled with the dangers of excessive exercise prior to entering treatment, it may be even more of an uphill battle.
At the end of the day, though, it can be worth it. With the right level of support and the proper guidelines in place, easing back into an exercise routine can be rewarding physically, emotionally, and spiritually.
 Muhlheim, L. (2021, Oct. 20). Excessive exercise as an eating disorder symptom. Verywell Mind. https://www.verywellmind.com/excessive-exercise-eating-disorder-symptom-4062773.
 Compulsive exercise. (n.d.). National Eating Disorders Association. https://www.nationaleatingdisorders.org/learn/general-information/compulsive-exercise.
McCallum Place is an eating disorder treatment center with locations in St. Louis, Missouri, and Kansas City, Kansas. We provide comprehensive treatment for adolescents and adults. We also offer a specialty treatment program for athletes who are living with eating disorders. Our experienced treatment team works closely with each patient to ensure that they play a central role in their recovery process. We offer a full range of services to meet the unique needs of each patient and address all issues related to the treatment of eating disorders.
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 September 27, 2022 on EatingDisorderHope.com
Reviewed & Approved on September 27, 2022, by Jacquelyn Ekern MS, LPC