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Exercise Bulimia: When working out becomes an obsession

Posted July 11, 2007 at 06:30 PM by Katie Drummond

Section: Her Fitness, Athletics, Her Health, Body Image, Eating Disorders, Injury & Rehab, Her Nutrition, Diet Myths, Special Features

exercise-bulimia For many busy women, it can be a struggle just to fit in that recommended thirty-minute daily dose of physical activity. But for a growing number, an effort to get regular exercise has been replaced by an obsession with burning calories and fulfilling rigid workout quotas - to the point of skipped work, depression, and potentially fatal harms to physical health.

While a fit body needs activity, exercise bulimia – an obsessive illness with serious consequences for the body and the emotional psyche - is becoming increasingly common. Experts estimate that at least 4% of Americans struggle with excessive exercising, but the diagnosis of exercise bulimia is rare in a culture that celebrates trim physiques and a disciplined dedication to workouts. In fact, most sufferers from exercise bulimia aren’t diagnosed with any medical problem until symptoms of more common eating disorders, namely anorexia and bulimia, rear their heads. And unfortunately, they often do, as most of those who struggle with one of the three will battle the others at some point in their lives.

It can be easy for exercise bulimia to go on for years under the radar – physical evidence like the emaciation and hair loss of anorexia or the swollen face and scarred fingers of bulimia aren’t present in a compulsive exerciser. Furthermore, there isn’t any “cut off” amount of exercise necessary to make a diagnosis – a woman who runs and lifts weights for an hour and a half every day might simply seem dedicated to her workouts – but looking more closely at her behavior may reveal that she actually suffers from the psychological and physical consequences that accompany a serious disease.

So what are the signs and symptoms of exercise bulimia? The key word when it comes to its psychological impact is obsession. Much like other eating disorders are characterized by fixation on food, exercise bulimics are obsessed with working out, specifically aiming to work off the calories they take in. Think of it as an “alternative” to the vomiting or laxative use that occurs with standard bulimia – exercise has nothing to do with physical fitness or that euphoric endorphin high, and everything to do with burning off that extra dab of peanut butter or bite of dessert.

Much like any obsession, daily exercise can quickly take over from other routine activities and priorities. Exercise bulimics will do everything from miss social engagements and appointments to skip work if it means hitting a certain “number” of necessary workout hours or a specific calorie-burn target. And if their goal isn’t met, even for one day? Sadness, anxiety, depression, and under-eating are all par for the course when an exercise bulimic misses a workout or doesn’t hit a designated quota.

The psychological unwillingness to take rest days or ease up when muscles get tired means that exercise bulimia is characterized by a number of serious physical symptoms as well. Because exercising through illness or aches and pains is common, more serious injuries like stress fractures and muscle sprains will eventually sideline workouts, and can have life long repercussions or require intensive treatment.

Even more serious is the low body weight, and accompanying amenorrhea, of many exercise bulimics. Women missing periods are at a much higher risk for arthritis, osteoporosis, and heart failure - three surefire ways to make workouts permanently off limits. Because exercise bulimia often occurs as an attempt to “burn” off consumed calories, sufferers are usually cardio buffs, running for miles or sweating it out on a stationary bike. Without a balanced approach that includes rest days and strength training – and with under eating likely occurring simultaneously – women often lose muscle mass as well, putting their bodies under even more strain than low weight alone.

Diagnosing exercise bulimia is difficult, and treating the disorder is even harder. Because of the powerful psychological grip that eating disorders have on sufferers, counseling is almost always necessary to see a patient through to recovery. Many in-patient centers have specific programs geared towards athletes, whose highly competitive, self-disciplined personalities are particularly suited to disorders like exercise bulimia.

Even if you don’t obsess about your workouts, it can be easy for any motivated athlete to forget the importance of rest in a training regime, and while overtraining might not be a psychological disorder, it can lead to similar physical repercussions. The next time you contemplate skipping a much-needed rest day, consider the potential consequences – and get those overworked legs back into bed - sometimes an extra hour of sleep is the best training you can do.

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