Ken Weiner, MD, FAED, CEDS
Founding Partner, Chief Medical Officer and Chief Executive Officer
Eating Recovery Center

 

Exercise is good for us. This shouldn’t come as shocking news to anyone—the risks of a sedentary lifestyle are abundant and well-reported, particularly as the country faces a public health crisis in which one-third of adults are obese. Regular exercise can be a particularly beneficial activity as part of the college lifestyle. Not only does it improve mood and combat serious health conditions and diseases, but exercise also boosts energy, giving students the endurance to effectively manage their academic, professional and social commitments.

However, like most things in life, we can get too much of a good thing when it comes to exercise. Compulsive over-exercise is characterized by frequent episodes of excessive physical activity. Individuals will go to great lengths to fit exercise regimens into their schedules, even if it means cutting school, skipping work and avoiding social events with friends, or exercising in secret. Instead of supporting health, excessive exercise and inadequate rest and recovery time between physical activities can damage a person’s body and overall health, causing joint injuries, tendonitis, stress fractures, muscle tears, exhaustion, fainting and dehydration.

Compulsive exercise often occurs alongside eating disorders, as the motivations underlying the excessive physical activity often stem from food-, body- or weight-related issues. Many over-exercisers will do so as a result of guilt or shame from just having eaten or binged, or to give themselves "permission" to eat. (The latter was recently the target of much scrutiny from the eating disorders awareness community when the idea was used humorously in a Yoplait commercial.) In fact, exercise bulimia is a subset of bulimia in which an individual is compelled to exercise at an overly excessive level in an effort to burn calories and fat. Just as individuals with bulimia purge calories through vomiting or laxative use, exercise bulimics use physical activity as their compensatory behavior. Over-exercising behaviors can also accompany anorexia when used in conjunction with severe food and calorie restriction.

In addition to the aforementioned health risks of compulsive over-exercising, when paired with the insufficient nutrition that generally accompanies anorexia and bulimia, intensive exercise behaviors can result in medical complications such as bone disease, cardiac distress and organ failure.

Because exercise is common and encouraged in a healthy college lifestyle, and because the negative outcomes of this compulsive behavior can be subtle, easily hidden or downplayed by students themselves, it can be difficult to determine whether an individual’s level of physical activity is worrisome. The best way to gauge if behaviors are out of control or symptomatic of an eating disorder is to understand the warning signs of exercise bulimia, as well as those indicative of anorexia and bulimia, since compulsive over-exercising can occur with these illnesses as well.

Warning Signs of Exercise Bulimia

• Missing social events, appointments and even work in order to exercise.
• Straying from normal activities or social events because they don’t support a “more physically active lifestyle.”
• Refusing to adjust or halt an exercise schedule despite physical or muscle exhaustion and injuries.

Warning Signs of Anorexia Nervosa

• Dramatic weight loss; a preoccupation with weight, food, calories, fat grams and dieting; denying hunger.
• Frequent comments about feeling “fat” or overweight despite weight loss and withdrawal from usual friends and activities.
• Development of food rituals and excuses to avoid mealtimes or situations involving food. An excessive, rigid exercise regimen–despite weather, fatigue, illness or injury.

Warning Signs of Bulimia Nervosa

• Evidence of binge-eating, including disappearance of large amounts of food in short periods of time and evidence of purging behaviors. Frequent trips to the bathroom after meals, signs and/or smells of vomiting and presence of laxatives or diuretics.
• Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions and/or an excessive, rigid exercise regimen – despite weather, fatigue, illness or injury.
• Unusual swelling of the cheeks or jaw area, tooth decay, and/or calluses on the back of the hands and knuckles from self-induced vomiting.

Treatment for an eating disorder can range from outpatient appointments as necessary to inpatient, hospital-based care for those individuals who are medically compromised from their unhealthy exercise and eating patterns. Assistance from trained eating disorders professionals can help guide students into the right level of care at a treatment center that meets their recovery needs, helping them to interrupt unhealthy behaviors, re-engage in college life in a healthy manner, and benefit from this formative stage in their adult development.