How Eating Disorders And Exercise Intersect: What You Need To Know

Exercise is often celebrated as a cornerstone of a healthy lifestyle, but when exercise becomes compulsive or intertwined with eating disorders, serious physical and mental health challenges can arise. The line between healthy exercise and harmful behavior can be thin, particularly in environments that emphasize body image or performance. 

Understanding the signs of compulsive exercise and its connection to eating disorders may help individuals recognize when to seek help. Below, explore the concept of exercise addiction and how problematic exercise behaviors can manifest in individuals with eating disorders. In addition, explore ways to recognize unhealthy exercise behaviors and find support. 

Eating disorders and exercise: Binge eating disorder, anorexia, and bulimia 

While physical activity is often promoted as part of a healthy lifestyle, exercise can exacerbate the symptoms of eating disorders like anorexia nervosa and bulimia nervosa. In binge eating disorder, exercise may be sporadic, often used as a form of compensation. Understanding how exercise and other eating disorders intersect may help individuals recognize and address unhealthy exercise patterns.

Anorexia nervosa 

Individuals with anorexia nervosa may engage in excessive exercise to control or lose weight, often pushing themselves to dangerous limits despite severe malnutrition. Without sufficient nourishment, however, this exercise can lead to severe physical complications, including but not limited to muscle wasting, bone density loss, and cardiovascular issues. 

Bulimia nervosa

For those with bulimia nervosa, exercise can be a way of purging, as individuals may use exercise as a compensatory behavior to offset calories consumed during binge eating episodes. They may exercise to an extreme degree, resulting in physical exhaustion, dehydration, and a heightened risk of injury.

Binge eating disorder

While less commonly associated with compulsive exercise, individuals with binge eating disorder (BED) may engage in sporadic bouts of intense exercise as a form of compensation or to cope with feelings of guilt after a binge. Unlike with other eating disorders, regular exercise can help individuals manage both physical and mental symptoms of the eating disorder.

What is exercise addiction?

Exercise addiction is a behavioral addiction involving compulsive or excessive exercise. Individuals living with exercise addiction may be compelled to exercise to the point of physical pain and exhaustion, often resulting in injury and other health complications. This addiction frequently occurs alongside eating disorders, appearing 3.5 times more often in individuals with an eating disorder than in those without.

Exercise addiction is thought to result from a combination of psychological, social, and biological factors. Perfectionism, a desire for control, and internal or external pressures to maintain a certain physique can lead to compulsive exercise behaviors. The body's release of stress-relieving endorphins during exercise may further reinforce this cycle, making the behavior hard to stop, even when harm ensues. 

Eating disorders in athletes

While eating disorders affect around 9% of Americans, up to 19% of male athletes and 45% of female athletes live with eating disorders and disordered eating. EDs are most common among athletes in sports where leanness or weight control is emphasized, such as ballet, wrestling, and gymnastics. 

A focus on physical appearance in athletics can lead to restrictive eating, over-exercising, or purging. Additionally, the culture within some sports can normalize or encourage disordered eating behaviors, making recognizing symptoms and seeking help more difficult for athletes. The physical demands of their sport can further increase the toll on their bodies, leading to fatigue, increased injury risk, and long-term health complications.

Because of these unique challenges, treating athletes with eating disorders often involves a multidisciplinary approach with coaches, trainers, and administrators. In addition, temporary adjustments may be made to an athlete’s schedule, including resistance training, competition, team responsibilities, and, in the case of student-athletes, academics. 

Weight loss and compulsive behavior: Recognizing unhealthy exercise patterns

Unhealthy exercise patterns often emerge when the desire for weight loss becomes an obsession, leading to compulsive behaviors that can be harmful. Often, compulsive exercise behavior appears alongside restrictive eating behaviors. Recognizing these patterns may help individuals prevent physical and mental health deterioration.

Overemphasis on weight loss

While physical activity can contribute to maintaining a healthy body composition, an unhealthy attitude toward exercise often manifests as an overemphasis on using activity to control body weight. Whereas a balanced and mindful approach to fitness generally focuses on enjoyment and overall well-being, focusing on body weight and partaking in too much exercise may be a sign of a deeper issue.

Frequent, excessive, or compulsive exercise

Engaging in frequent or excessive exercise beyond what is considered healthy is another sign that a person may be struggling with an eating disorder or exercise addiction. Individuals might work out multiple times a day for hours, often focusing on high-intensity or cardio exercises. To learn more about their exercise habits, a person can take a compulsive exercise test. 

Exercising despite injury or illness

Continuing to exercise despite injury or illness is a dangerous sign of compulsive exercise. This relentless drive to maintain one’s exercise routine can prevent the body from healing correctly, which may exacerbate existing conditions. Ignoring the body’s need for rest and recovery can lead to worsening injuries, prolonged recovery times, and long-term health consequences.

Using exercise to compensate for food intake

Those living with EDs or exercise addiction may use exercise as a means to "earn" or compensate for food intake, often driven by guilt or fear of weight gain. This behavior may be significantly pronounced when combined with binge eating. Exercise can become part of a broader fixation on calorie counting and restriction, where the focus shifts from health to rigid control over food intake and energy expenditure.

Feeling anxious or guilty about missing a workout

Feeling emotional distress about missing a workout can indicate an unhealthy relationship with exercise. Eating disorders and exercise dependence can cause a person to feel anxious or guilty about losing progress or gaining weight, which may drive them to push themselves beyond healthy limits.

Is it safe to exercise during eating disorder treatment?

Whether it's safe to exercise during ED treatment depends on the individual’s health, the nature of their eating disorder, and the stage of their recovery. Often, exercise may be temporarily restricted or carefully monitored by one’s care team to ensure it supports recovery and does not exacerbate the eating disorder. 

Once significant progress in eating disorder recovery has been achieved, such as weight restoration, healthcare professionals can guide the client in safely reintroducing physical activity, emphasizing healing and joyful movement rather than weight control. This process generally occurs after the individual has reached a healthy body weight and compulsive urges to exercise have diminished. 

Target disordered eating behaviors in therapy

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Professional mental health support for eating disorders

If you’re struggling with an eating disorder or exercise addiction, consider seeking the guidance of a mental health professional. A licensed therapist or counselor can help you identify underlying issues, build healthier coping mechanisms, and develop a comprehensive treatment plan. 

If you’re concerned about not being able to attend sessions in your area, you might also try online therapy through a platform like BetterHelp, allowing you to connect with a qualified ED specialist for weekly therapy sessions from your home. Online therapy is as effective as in-person therapy and may be preferable for those in need of a convenient, flexible, low-cost alternative to traditional therapy. With additional tools and features like guided journaling, digital therapy worksheets, and group sessions, you can make meaningful progress toward long-term recovery in each session.