Exercise is almost exclusively considered a positive activity, but one exception is exercise that takes place within the context of eating disorders. When done excessively or compulsively, exercise is detrimental to a person’s physical and mental wellbeing. Excessive exercise has been identified as an unhealthy outlet for people with numerous different eating disorders. Exercise addiction is not included in the fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5), so it is not currently recognized as a clinical diagnosis. Still, multiple studies in recent years have identified exercise addiction as a habit of people with eating disorders.
What are the commonalities between compulsive exercise and eating disorders?
According to a 2020 study on eating and weight disorders, exercise addiction occurs more than three and a half times in people with an eating disorder than it does in people without one. The DSM-5 identifies excessive exercise as a compensatory behavior among people with the following types of eating disorders:
People with anorexia tend to limit the number of calories and types of food they eat. They eventually lose weight or cannot maintain the appropriate body weight that correlates with their height, age, and physical health. Excessive physical activity prior to the onset of these sort of restrictive eating habits is symptomatic of anorexia. Bulimia is defined as a potentially life-threatening eating disorder in which people eat large amounts of food before trying to prevent weight gain by eliminating the extra calories in an unhealthy way. Purging, fasting, and excessively exercising are considered the unhealthy measures used to compensate for overeating in people with bulimia. Excessive exercise is also associated with body dysmorphic disorder, which is characterized as a preoccupation with a person’s perceived flaws in their physical appearance. The DSM-5 states that body dysmorphic disorder and eating disorders can co-occur in an individual.
Are there overlapping symptoms?
The National Eating Disorders Association (NEDA) defines compulsive exercise as exercise that significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings. Here are some of the behavioral and emotional warning signs, according to the NEDA:
- Exercising as a means of purging calories
- Exercising as permission to eat
- Exercising secretively
- Feelings of discomfort while resting or inactive
- Maintaining an excessive, rigid exercise regimen despite weather, fatigue, illness, or injury
- Overtraining because you feel weak or slow
- Using exercise to manage emotions
- Withdrawing from friends and family
Conversely, many eating disorder behavioral and emotional warning signs are similar:
- Appearing uncomfortable eating around others
- Extreme concern with body size and shape
- Extreme mood swings
- Frequent checking in the mirror for perceived flaws in appearance
- Frequent dieting
- Preoccupation with weight, food, calories, carbohydrates, and dieting
- Skipping meals or taking small portions of food at regular meals
- Withdrawal from friends and activities
What is anorexia athletica?
Anorexia athletica – or athlete's anorexia – is a type of eating disorder that affects athletes or people who play a lot of sports. People with anorexia athletica restrict calorie intake and exercise to an extreme level to maintain a lean or thin appearance associated with athleticism, according to WebMD. Women generally experience anorexia athletica more than men. As with other eating disorders, people with anorexia athletica may have a distorted sense of body image and fear of gaining weight. The health consequences of anorexia athletica and general compulsive exercise are similar. They include:
- Altered resting heart rate
- Bone density loss (Osteoporosis)
- Chronic bone and joint pain
- Increased risk of injury
- Irregular menstrual cycles
- Weakened immunity
Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) can help members find an in-network mental health professional by calling behavioral health access lines listed below: PPO: Behavioral Health Access Line | 1-800-762-2382
- A free and confidential resource that’s just a call away when you need immediate support. Behavioral health professionals answer, 24/7.
HMO: Behavioral Health Access Line | 1-800-482-5982
- Connect with a behavioral health clinician if you need help finding a mental health or substance use provider.
- Behavioral health clinicians are available for routine assistance from 8 a.m. to 5 p.m., Monday through Friday. For urgent concerns after hours, clinicians are also available 24 hours a day, seven days a week.
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