Eating disorder recovery and exercise
Disordered behavior around exercise is very common in people with eating disorders, occurring in as many as 80% of cases, according to some estimates.1 Often, this behavior was connected to more severe psychological and physical symptoms of an eating disorder.1
Even in recovery, someone may experience additional complications related to exercise. Health issues connected to their eating disorder, including damage to internal systems or the effects of prolonged malnutrition, can all impact the effect of exercise and should be taken into consideration when developing a workout plan.1
Whether or not you can exercise in eating disorder recovery is a very personal question, best answered by you and your treatment team. However, there are some general thoughts on how people who struggle with specific eating disorders should go about incorporating more movement into their recovery journey.
Anorexia and working out
Exercise in
anorexia recovery has been studied more commonly than exercise during treatment for other eating disorders. While limited food intake is the primary symptom of anorexia nervosa (AN), many people also
utilize excessive exercise as a way to lose or control weight.
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Still, one comprehensive study on anorexia and exercise found that, overall, nutritionally-supported exercise during eating disorder treatment did not interfere with
weight restoration. In fact, it enhanced patients’ quality of life, psychological well-being, and willingness to honor treatment recommendations.
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But people who’ve struggled with severe cases of anorexia nervosa still need to be cautious. The
malnutrition that often results from the condition can lead to a number of complications, which certain types of exercise may exacerbate.
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Binge eating and exercise
Not nearly as much research has been done on binge eating and exercise as anorexia recovery and exercise. That said, one large study found that participating in a structured exercise program improved eating disorder symptoms in female participants with binge eating disorder.
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People who struggle with
binge eating disorder (BED) should still make sure to consult with their treatment team about the best way to go about incorporating physical activity into their recovery plan.
BED can lead to high cholesterol, high blood pressure, and an increased risk for heart disease, among other issues.
4 All of these conditions can be improved with regular physical activity, but it’s worth consulting with a doctor to discuss the type and amount of exercise that’s best for both eating disorder recovery and heart health.
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Exercise and bulimia recovery
Similar to BED,
bulimia nervosa (BN) has not received as much attention as anorexia and exercise dangers. However, people recovering from this condition may also have specific complications to remember if/when incorporating movement into their recovery plan.
Bulimia nervosa can lead to a number of cardiovascular complications and electrolyte abnormalities, which can both be incredibly dangerous during exercise.
5 Many people with BN also utilize excessive exercise as a
compensatory behavior for binging, so adopting a workout routine may be particularly triggering for these people. Getting more specific recommendations from a treatment team is essential in these cases.
Eating disorder recovery and exercise: Mindful movement
One approach to exercise during eating disorder recovery, which may be more universal, is an overall perspective shift on physical activity. It can be helpful to think of physical movement not as punishment for eating or a tool to sculpt a particular shape into or carve pounds out of the body but as a healthy expression of the body and something that can even be joyful.
Mindful movement is a common method used to help patients adopt this point of view. The philosophy focuses on being present in one's body and listening for internal cues about how much and what kind of movement the body wants. It then asks patients to honor these requests as a way to treat their bodies with more compassion.6
This concept can apply to more typical exercises like jogging, walking, or yoga, but any kind of movement can be mindful. Gardening, cleaning, dancing, playing with your kids, or hanging out with friends can be part of a mindful movement experience.
Switching to these less quantifiable forms of movement may even be the most mindful, self-affirming thing someone in eating disorder recovery can do. The idea is to focus on how the movement makes your body feel rather than how it changes your body’s weight or appearance.
Tips for engaging in exercise during eating disorder recovery
Exercise during eating disorder recovery is not simply about the movement itself; it is about how you approach your exercise. The hope is to embrace physical activity in eating disorder recovery from a place of self-compassion, self-care, and radical acceptance of your body.
Some tips that may help you approach exercise from a place of healthy intentions include:
- Recognizing—and honoring—when you need to rest and recover
- Cultivating gratitude for your body’s ability to move
- Fostering a flexible relationship with exercise (feeling comfortable with skipping a workout or taking several days off from working out)
- Finding a community or support network of people in eating disorder recovery who prioritize mindful movement
- Understanding that every body is unique and resisting the urge to compare your workout routine to others
Remember, recovery is a process and often comes with ups and downs. It's okay to not feel this way about movement right away or struggle with exercise later in the journey.
The important thing is to extend yourself patience and forgiveness in the process, knowing that every day is a new chance to make a difference.
Eating disorder recovery and exercise: When to know if there's a problem
If you are in recovery from an eating disorder and have begun an exercise routine, even if you follow the directions of your clinician, you should periodically check in with yourself to gauge how the routine is working for you.
Some potential concerns to look out for include:
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- Exercising to "make up for" what you ate
- Exercising specifically to lose weight or fat
- Being preoccupied by thoughts of working out
- Feeling anxious or upset when you can't work out
- Exercising even while injured, sick, or tired
- Keeping a rigid exercise routine
- Feeling ashamed or guilty for skipping a workout
- Feeling uncomfortable with or unable to take rest days
- Forfeiting social experiences due to intense fear of not exercising
- Overlooking medical advice to rest vs exercise
- A return of disordered eating behaviors or thoughts
Remember, there is no shame in experiencing challenges in recovery or relapsing. The journey toward a healthier future is hardly ever straightforward. If you are experiencing these types of thoughts and behaviors, it's important to be honest with your therapist, nutritionist, or another trusted member of your treatment team.
With help from your support system, you can get back to extending yourself grace, forgiveness, and compassion along your healing journey.
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