Eating Disorders and Compulsive Exercise

Although compulsive exercise is not an official psychiatric diagnosis, it is widely recognized as a companion behavior to eating disorders.  Disordered eaters exercise excessively for various reasons.  Usually compulsive exercise functions as a self-imposed chore or penance for individuals with eating disorders—a mechanism, like food avoidance or purging, for making them feel better.  Compulsive exercisers exceed healthy levels of physical activity.  A compulsive exerciser will jeopardize their employment, education, relationships, health, and safety to keep exercising. 

Current federal guidelines for healthy exercise recommend 20-30 minutes of activity on most days, and strength training two days per week, for the average person.  Exercising for more than one hour per day, more than five days per week is considered extreme for most people. Compulsive exercise involves working out for longer or more strenuously than what is considered normal or healthy, exercising three, four, five, or more hours per day.  They may exercise more than once per day, and will work out even when ill or injured. 

Compulsive exercisers obsess over exercise so much that they will take time away from other important activities (school, work), break or refuse social engagements, and hide from others in order to exercise.  Many compulsive exercisers become secretive about their behavior, as they sense rising concern or criticism from others.  As a result, they may begin working out in odd places or at odd times, such as in the shower, in bed, in a closet, or in the middle of the night.  Not being able to exercise, or not exercising enough, causes them extreme feelings of anxiety and guilt.

Individuals whose occupations are body-focused, such as athletes, dancers, and models, routinely exceed established guidelines for physical activity.  These individuals are prone to developing compulsive exercise problems because of immense external pressures to remain fit and competitive.  While some only engage in unhealthy behaviors for short periods of time and with set goals, others develop full-blown problems with compulsive exercise that they cannot address without help.

Individuals with eating disorders exercise compulsively for various reasons: to alleviate feelings of anxiety and guilt (related and unrelated to eating); to give themselves permission to eat; to make up for bingeing or eating when they think they should not have; to garner feelings of power and control over their bodies; to achieve a certain body type; to meet an athletic or fitness goal.  Compulsive exercisers do not exercise for fun or pleasure.  Usually, their exercise is accompanied by a careful tally of calories consumed or to be consumed and the amount of exercise required to neutralize them.

Like other behaviors associated with eating disorders, compulsive exercise carries great physical risk.  Compulsive exercisers are prone to heart problems, severe dehydration, stress fractures, osteoporosis, degenerative arthritis, and reproductive issues.  Compulsive exercisers also risk permanent damage to muscles, tendon, ligaments, and joints.  Because they exercise almost every day, if not every day or more, their bodies are deprived of time to heal and rejuvenate between workouts.  Because compulsive exercise is basically a purging activity (like vomiting or laxative use), it deprives the body of needed nourishment, and leads to malnutrition and associated conditions.  Compulsive exercisers are prone to infections, fatigue, and worse.

References

A Healthier You.  Department of Health and Human Services, Office of Disease Prevention and Health Promotion, 2005.  Retrieved June 30, 2008 from
http://www.health.gov/dietaryguidelines/dga2005/healthieryou/html/chapter10.html

Eating Disorders.  Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Mental Health Information Center, 2003.  Retrieved June 29, 2008 from http://mentalhealth.samhsa.gov/publications/allpubs/ken98-0047/default.asp

Compulsive Exercise.  Something Fishy – Website on Eating Disorders. 2008. Retrieved on June 29, 2008 from http://www.something-fishy.org/whatarethey/exercise.php.

Scholten, Amy, MPH.  Risk Factors for Eating Disorders. Aurora Health Care. 2007. Retrieved June 29, 2008 from http://www.aurorahealthcare.org.