The Role of Exercise in Eating Disorder Recovery

For people with depression, anxiety, or really any form of mental illness, a common refrain from well-meaning friends and acquaintances is often “well just exercise. That will help you feel better”. It’s true that there is good evidence that regular exercise can improve mental health (although there are many problems with simply prescribing exercise). However trying to incorporate exercise into a recovery and treatment regime becomes infinitely more complex in the context of an eating disorder. Over exercise is often a symptom of eating disorders, and for many people trying to recover it’s also a trigger for other self-destructive behaviors.

Because exercise is an important element both in healthy weight maintenance and improving mental health, but is also a triggering and potentially dangerous activity for someone with a history of overexercise, people in treatment for eating disorders must walk a delicate tight rope when it comes to their exercise regimes. This has been a particular struggle for me, and I’ve been looking for ways to bring exercise into my treatment in a positive fashion.

There are a few techniques that I’ve had some success with, but if anyone has more suggestions, please share in the comments. The first way that I’ve found to improve my relationship with exercise is to stop using the word exercise to refer to movement. This opens the way for all kinds of “exercise” that don’t involve going to the gym and using equipment that loudly announces your calories burned to you every time you look down. I swing dance and I rock climb and sometimes I just throw dance parties in my room and sometimes I try to just go for walks or have squirt gun fights with my friends. The more that I can find things that I enjoy which also happen peripherally to involve movement, the better.

The reason I try to use this technique is because the moment my brain is convinced that I am “exercising”, it becomes convinced that I need to hit certain markers of acceptability: burn a certain number of calories, exercise for a certain period of time, stick to a certain regime. If I don’t use the label “exercise” to describe what I’m doing, but rather focus on “fun activity, preferably with friends”, I get a lot more mileage out of the activity and don’t fall into a negative spiral that tells me I am not acceptably fit. Looking for activities that fit this mold also lets me double dip on my activities: not only do I exercise but I also find some depression fighting positive activities, and potentially social time as well.

Something else that has worked well for me is to accept that sometimes a complete break from exercise is necessary. I find exercise extremely helpful with anxiety and don’t like leaving it entirely behind (especially as I’ve been pretty active my whole life). However when I’m compulsively exercising every day, it can be much harder to try to slowly lower the amount of exercise that I’m doing while still doing some. In many ways it’s easier to simply say that I can’t be responsible about my exercising at this moment in time and I need to take some time off. This has the added benefit of giving me LOTS of extra time to do other positive things with my day.

There are a lot of ways that cutting exercise out of  your life for a time can backfire. How do you deal with all the anxiety you worked off before? How do you accept loss of muscle mass or increase in fat? How and when do you begin to add exercise back in without swinging immediately into over exercise mode again? Especially if you’re doing this while you’re trying to increase your caloric intake, it can take a serious toll on your emotions and your motivation to continue treatment. Unfortunately, this is one of those places I don’t have the answers: I’m struggling to find ways to begin incorporating exercise again without it becoming unhealthy.

One helpful way to deal with feeling guilty about not exercising or feeling extremely compelled to started exercising again is to find some friends who aren’t big on exercise. This doesn’t mean you have to dump your friends who are extremely fit, but there are people out there who aren’t particularly interested in physical fitness and are perfectly happy with their lives. I am a big proponent of distract until you’re in a healthier place, and finding people who will encourage you to do other types of fun and interesting things, model other versions of healthiness and happiness, and generally not bring up exercise as something you have to do is a great way to build a life that doesn’t circulate around exercise.

The final, and perhaps most difficult thing to do if you’re working on overexercise is to make sure that you’re not paying any money for exercise. What I mean by that is if you’re paying for a gym membership or classes or a personal trainer: stop. I’ve found that when I’m shelling out money I feel obligated to “get my money’s worth”. You can always go to the local rec center and swim some laps or go for a run or a bike ride. But those ongoing expenses are a constant pressure to get to the gym and make it worth it and I’ve found that pressure nearly unbearable.

Of course all of these are just suggestions that I have found helpful, and won’t work for everyone. I’d love to hear other suggestions in comments, especially from those who have found an exercise regime that works for them.