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The essentials of exercise bulimia recovery

Exercise bulimia is not as frequently talked about or as well understood as other eating disorders. But that doesn't mean the condition isn't just as dangerous or draining on mental, physical, and emotional health.

Thankfully, exercise bulimia treatment is possible, with different therapies available to help heal your relationship with exercise, food, and yourself so you can take back control of your life.

 minutes read
Last updated on 
January 25, 2024
April 5, 2024
Exercise bulimia treatment
In this article

What is exercise bulimia? 

Exercise bulimia is a subset of bulimia nervosa (BN), an eating disorder characterized by cycles of binging and purging. Those with BN utilize various unhelpful behaviors as a way to "compensate" for the amount of food eaten during a binging episode.

With exercise bulimia, excessive and compulsive exercise is the primary compensatory behavior, with working out used as a means to "purge" calories.1

Warning signs of exercise bulimia
Dangers of exercise bulimia

How to get help for exercise bulimia

The good news about exercise bulimia is that exercise bulimia treatment does exist.

If you’re concerned about your behaviors surrounding exercise and food, it’s important you seek professional help. The longer you allow these behaviors to rule your life, the worse the potential impact on your physical and mental health.

Treatment for exercise bulimia typically requires a multi-pronged approach, which includes implementing coping strategies, developing healthy eating habits, maintaining healthy self-esteem and body image, and redirecting exercise goals with the gradual incorporation of moderate physical activity. (9)

Treatment for exercise bulimia will depend upon your individual needs, symptomatology, and co-occurring conditions like other eating disorders or mental health conditions.

A biopsychosocial approach

A quality eating disorder treatment program will use a biopsychosocial approach to care—this model understands and aims to address the various biological, psychological, and social factors that influence a person’s body image, exercise, disordered eating, and mental health. When you first enter a program, a treatment provider will perform a biopsychosocial assessment, which evaluates:

  • The patient’s perception of their exercise bulimia and how it’s affected them and those around them
  • Description of exercise bulimia and any other disordered eating symptoms and triggers
  • The duration of their exercise bulimia
  • Current patterns of exercise and eating
  • Body image dissatisfaction and distortion
  • Family history of mental health conditions or eating disorders
  • History of trauma
  • Effects of exercise bulimia on their life
  • Occupational and educational history
  • Living situation
  • Community relationships
  • A sensitive physical assessment of weight, pulse, blood pressure, etc.
  • Motivation for change

Treatment modalities

Research has indicated that some people with exercise bulimia or compulsive exercise may need motivational interviewing, a short-term therapeutic modality aimed at resolving ambivalence related to change and entering treatment. (10)

Once someone is ready to enter treatment and heal their relationship with exercise, their individualized treatment plan may include several therapies, such as:

  • Cognitive Behavioral Therapy (CBT): Examines the connection between your thoughts, feelings, and behaviors so you can understand how the three influence one another, aiming to change behaviors, emotions, and thought patterns. Also examines and challenges core beliefs that aren’t helpful and influence compulsive exercise.
  • Acceptance and Commitment Therapy (ACT): Aims to increase psychological flexibility and encourages you to make choices that align with your values.
  • Dialectical Behavior Therapy (DBT): Focuses on mindfulness, emotional regulation, distress tolerance, and communication with others. 
  • Exposure therapy: Exposes you to your fear, which over time can habituate the stimulus and lead to reduced anxiety. For someone with exercise bulimia, the exposure may include stopping exercise or movement.
  • Group therapy: Allows patients to share honestly while still being accepted by others, which can be very validating. Different groups may focus on different modalities, such as CBT groups or DBT groups.
  • Nutritional counseling: Debunks myths related to food and your food beliefs. May also involve meal support and planning.

One of the main goals of treatment for exercise bulimia is to restore a healthy relationship with exercise and movement. This may involve movement groups in which you learn to enjoy movement again, focusing on physical activity that brings you joy as opposed to choosing exercise based on how many calories it can burn or how much muscle it can build. Mindful movement can help strengthen your mind-body connection and help you appreciate and care for your body.

While at times it may seem impossible, exercise bulimia recovery is possible. Contact someone you trust who can help you find the support and treatment you need.
Get help

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. Compulsive exercise. (2018, February 22). National Eating Disorders Association. Accessed May 2023
  2. Exercise bulimia. (2017, February 20). Bodywhys. Accessed May 2023
  3. O'Keefe, J. H., Patil, H. R., Lavie, C. J., Magalski, A., Vogel, R. A., & McCullough, P. A. (2012). Potential adverse cardiovascular effects from excessive endurance exercise. Mayo Clinic Proceedings, 87(6), 587–595. 
  4. Smith, A. R., Fink, E. L., Anestis, M. D., Ribeiro, J. D., Gordon, K. H., Davis, H., Keel, P. K., Bardone-Cone, A. M., Peterson, C. B., Klein, M. H., Crow, S., Mitchell, J. E., Crosby, R. D., Wonderlich, S. A., le Grange, D., & Joiner, T. E., Jr (2013). Exercise caution: over-exercise is associated with suicidality among individuals with disordered eating. Psychiatry research, 206(2-3), 246–255.
  5. Lichtenstein, M. B., Hinze, C. J., Emborg, B., Thomsen, F., & Hemmingsen, S. D. (2017). Compulsive exercise: links, risks and challenges faced. Psychology research and behavior management, 85-95. 
  6. Bulik, C. M., Sullivan, P. F., & Kendler, K. S. (2002). Medical and psychiatric morbidity in obese women with and without binge eating. The International journal of eating disorders, 32(1), 72–78.
  7. Sunder, A., Mohanty, B., Singh, A., & Yadav, P. (2019). Rhabdomyolysis - Exercise induced nightmare. Journal of Family Medicine and Primary Care, 8(1), 305–307. 
  8. Jee, Y. S. (2016). Exercise addiction and rehabilitation. Journal of Exercise Rehabilitation, 12(2), 67–68.
  9.  Lichtenstein, M. B., Hinze, C. J., Emborg, B., Thomsen, F., & Hemmingsen, S. D. (2017). Compulsive exercise: links, risks and challenges faced. Psychology research and behavior management, 10, 85–95.


What is exercise bulimia?

Exercise bulimia, also known as compulsive exercise or exercise addiction, is a disorder where a person exercises excessively to compensate for calories consumed through regular or binge eating. 

Do I have exercise bulimia?

If you feel compelled to exercise excessively to control your weight or to give you permission to eat, you may be suffering from exercise bulimia. Further signs that you’re living with exercise bulimia include feeling anxious when you can’t exercise, continuing to exercise even when injured, neglecting other commitments to exercise, and constant body checking.

Where can I find help for exercise bulimia?

If you’re worried about your behaviors around exercise, reach out to a trusted loved one or health care professional for health.

The experienced care team at Within Health will be able to recommend a personalized treatment plan that addresses the underlying cause of your disordered behaviors. This will help you to regain a healthy relationship with your body, movement, and food.

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Further reading

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