When does exercise become Unhealthy? Signs and Treatment of Compulsive Exercise
Written by Eating Disorder & OCD Therapy Founder, Allyson Inez Ford, MA, LPCC
It can be really confusing when you start eating disorder recovery and you are asked to stop exercising. You might be thinking “Wait- I though this was healthy for me, why should I stop?!” And I get it. As a society, we are constantly fed messages about exercise being the best thing for our health. We receive messages like “No rest days!” “No excuses!” “No pain no gain!”
But, just how ‘healthy’ is this? Do we really need 10,000 steps a day? Are there benefits to taking extended breaks from exercise? And what is the difference between exercise that is healthy vs. harmful?
Let’s unpack this:
While it’s true that exercise can be a healthy choice- like any health promoting behavior it is dependent on the person and the context. There is no universal version of health. What is healthy for you may not be healthy for the next person. If you ate Kale all day every day (another seemingly ‘healthy’ behavior) you would actually get thallium poisoning. If you are malnourished, which can happen at any size, exercise is not the healthy choice for you. If you have rigid and obsessive habits around exercise, taking a break is actually ‘healthier’ for you. Health also encompasses the mind- your mental health. So if the thought of missing a workout floods you with anxiety, you miss out on important social events to exercise or you continue to exercise even though your body has physical ailments (illness, injury), exercise is in fact, hurting you, not helping you.
The other thing that people don’t often realize, is that when you are exercising, your body is releasing the stress hormone cortisol. This means that no matter how stress-relieving your work out feels, it is actually cueing your body to be in a stressful state. Another reason why taking a break and having rest days is actually very good for you. This especially becomes a problem for women (or AFAB folks) who have lost their menstrual periods (and again, this can happen at any size). Often what I see is that as someone is waiting for their period to return after disordered eating or an eating disorder, they have to give up intense exercise for some time to allow their period to return. We know that stress (cortisol production) is a major trigger for amenorrhea (loss of your menstrual cycle) and so to get it back, many often have to minimize ALL triggers for stress- including exercise. When your body is chronically malnourished, from consuming less energy than you are “burning”- it shuts off certain body systems deemed not needed for survival, such as sex hormone production.
Here are some signs your relationship with movement has become disordered and compulsive:
You feel anxious or guilty at the thought of missing a workout
You consistently choose exercise over time with family and friends
You develop rigid rules around time, type and frequency of exercise
You are hyper focused on numbers (calories burned, time lapsed) instead of how the movement feels to your body
You continue exercising despite illness, injury or extreme weather
You feel preoccupied with thoughts about how and when to exercise
Seem to base self worth off of workouts completed
You’ve lost your menstrual cycle (does not happen to everyone- and if it hasn't happened to you, it doesn’t mean you aren’t sick enough!)
How is compulsive exercise treated?
The way I treat compulsive exercise is individualized, however I generally use a combination of exposure therapy (ERP) and Acceptance and Commitment Therapy (ACT). With ERP, I help you gradually challenge your exercise rules, to the point where you have less anxiety, distress and increased flexibility around when and how you move your body. With ACT, I help you look at what your true values are vs. what your eating disorder’s values are. We then work together to help you cultivate a life that is reflective of your true self. Plenty of research shows that when we live our lives according to our true values (not society’s, not your parents, not your eating disorder’s), anxiety, depression and other mental health challenges naturally decrease. You start to feel more connected to yourself, your relationships, you feel happier and more at peace. I’ve never met anyone whose true values are based on appearance or exercise. We will also look at how compulsive exercise was serving you, and some alternative ways to get those needs met. Finally, after we have worked on all of these goals and if you are not malnourished, we may talk about ways to incorporate movement for joy in your life vs. movement for punishment. The goal is not to give up exercise forever, it’s to establish a truly healthy relationship with it; including your mental health.
Recovery from compulsive exercise is 1000% possible and from someone who has been there myself, I can tell you I’m so much happier with joyful movement and flexibility with when and how I move my body. Often, I go weeks without any formal kind of workout and I feel zero anxiety and guilt. I know I can trust my body and I can help you trust yours too. Book a free consultation today and let’s work together on your goals for more freedom and joy in your life–free from your eating disorder.
At Eating Disorder OCD Therapy, we offer compassionate, relational, and evidence based care, rooted in the belief that healing is not one-size-fits-all. Honoring client autonomy, collaboration, and anti-oppressive, neurodivergent-affirming practices, we walk alongside you as the expert in your own life. We provide therapy for Eating Disorders, OCD, Body Image, Trauma, Maternal Mental Health, and offer Ketamine Assisted Psychotherapy (KAP), Group Therapy (globally), Recovery Coaching (globally), and Clinical Consultation and Supervision for clinicians.
We are currently accepting new clients for in-person therapy in San Diego and virtual services in California, Washington, Utah, and Florida.
