If you have an eating disorder or have chronically dieted, your relationship with exercise may be complicated. Most folks would agree that exercise is a good thing, but in our thin-obsessed world, a well-intended trip to the gym can wreak havoc on one’s mental and physical health.

The following are warning signs that your relationship with exercise may be problematic:

1.Exercise is used exclusively to change your body weight or shape.

Exercise can start out harmless enough. Maybe you were working out to improve heart health or to be a better athlete. In any case, your intentions for exercise were good.

We are bombarded with messages about how, when, and why we should exercise. Exercise gurus are selling programs that try to guarantee we will look a certain way upon completion.  With these types of messages, our relationship with exercise can start to change.

Exercise becomes more about how you look rather than the enjoyment of exercise itself. The truth is that body size and shape are determined mainly by genetics. Furthermore, our bodies are constantly changing because of the aging process.

2.  Exercise is used to “make-up” for eating “mistakes”. 

Many public health campaigns promote messages like “If you eat a donut it will take this many minutes of exercise to burn the donut off.”  This line of thinking disconnects us from both the eating and the exercise experience.

It is hard to enjoy what you are eating if all you are thinking about is how many laps around the track you will need to run in order to compensate for it.  These types of messages often lead to feelings of guilt if a workout is missed.  They make us mindless, not mindful, eaters and exercisers.

The bottom line is: food is needed in order to survive.  It is not a privilege earned.

3. Exercise is initiated when a new dieting or “lifestyle” is also started. 

Contrary to popular belief, exercise is not an effective method for weight loss, but it is a positive influencer of health.

Many diets come along with a plan for movement. The problem is that once you go off the diet (which isn’t your fault, by the way, diets fail, not the people on them) then movement stops too. This leads to a habitual pattern of exclusively exercising when dieting, reinforcing the use of exercise to change the size or look of our bodies.

Unfortunately, many diet programs, so-called health experts, and public health campaigns promote these problematic thought patterns which can lead to the misuse of and disconnection from physical activity.

A troublesome relationship with exercise can lead to:

1.Over-exercising.

Over-exercising is often associated with eating disorders.  It entails rigidity around movement (including intensity, type, and amount), exercising in order to give yourself permission to eat, and missing other obligations because of your exercise regimen.  Over-exercising can lead heart problems, dehydration, stress fractures, loss of menstrual cycle in females, and muscular-skeletal problems.

2. Avoidance of exercise. 

There are several reasons why you may not exercise.  Trust me, if you have chronically dieted, laziness is not one of them.

Maybe you subscribe to the belief that movement dramatically changes your body size.  However, studies show that exercise is not an effective weight loss method. Therefore, you may feel fed-up with exercise and stop as it fails to provide the intended weight loss.

Unfortunately, weight stigma is alive and well in our society.  Weight stigma is associated with a decrease in exercise. So if you live in a larger body (vs. the culturally prescribed thin ideal), most likely you have experienced weight stigma.

Being physically uncomfortable, not feeling like you are good at exercise, or having had a traumatic experience around exercise are frequent reasons why people avoid exercise.

Whether you avoid exercise, over-exercise, or fall somewhere in between there are things that you can do to improve your relationship with exercise.  

Before starting an exercise routine make sure that you have had a physical exam.  If you are in treatment for an eating disorder talk with your treatment team first before starting exercise.  If you have experienced trauma, bullying, or humiliation around physical activity it may be helpful to explore past experiences with a therapist.

I love to use the word “reconnect” when talking about exercise.  In the same way dieting or an eating disorder disconnects us from our experience with food, rigid exercise patterns or avoidance of movement also disconnects us from the possible joy and benefits of physical activity.

Tips to reconnect with exercise:

1.  Experiment with different types of movement.  Ask yourself: Do I like to be outside?  Are classes something I enjoy?  Do I like to sweat?  Is listening to music something I enjoy?  Do I like to be social during movement? Do I like to play sports instead of going to the gym or hiking? Answering these questions may give you clues about what types of movement you may find most enjoyable.
2. Notice how movement makes you feel.  Ask yourself, “Do my body and mind like this type of movement?” Different types of movement may feel different to different people.  Notice if the movement makes you feel less stressed, anxious, or uncomfortable.
3. Be flexible.  Don’t impose rules on the amount, type, and frequency of exercise you do. Go by how you feel.  For example, if you have been sitting all day it may feel good to get up and do some movement.  If you have been on your feet all day, it may feel better to do some gentle stretching or to put your feet up and relax.
4. Give yourself permission to rest.  Sometimes your body and mind won’t feel like exercising.  That’s more than okay.  Give yourself permission to rest when your body needs it.
5. Be patient.  If you have struggled with food, body image, and exercise issues for a while, it may take time and practice to build a more connected relationship with movement.

The bottom line is that through listening to your body, patience, and practice you can find the type of movement that is right for you to promote both your mental and physical health.

Would you like to receive helpful tips for eating disorder or diet recovery?  Click here!

I am sure you have heard the African proverb “It takes a village to raise a child”.   The same can be said for treating an eating disorder.  It takes a village.  When it comes to treating & recovering from an eating disorder the village looks like medical professionals, friends, and family.

Having the support system in place when seeking treatment can make all the difference. All too often I have clients who have been struggling for years with an eating disorder who haven’t ever had a true treatment team in place. Without one, the likelihood of a full recovery is often greatly reduced.

Who should you look toward to build your treatment team?

If you’re struggling with anorexia nervosa, bulimia nervosa or binge eating disorder, it’s crucial to build up your support system. The types of people you should look toward when creating your treatment team are:

A Medical Doctor

Establishing good medical care is a must in the treatment of an eating disorder.  Unlike, many psychological disorders, eating disorders can have serious medical consequences–in some cases resulting in death.   Eating disorders can cause severe medical problems such as heart conditions, hypoglycemia, kidney failure, poor bone health and even death. Medical care for an eating disorder can include a physical assessment, laboratory tests such as blood work, EKG, etc.

While you may have an established care provider whom you see for routine care, it is important that you find a doctor that has experience treating eating disorders. Doctors not trained in treating eating disorders may overlook symptoms or not know what to assess for and may miss or minimizes symptoms that the sufferer is experiencing. A good place to start is the Medical Guide for Eating Disorders.

Psychotherapist

At first glance, an eating disorder may appear to be about food.  But if you suffer from an eating disorder or have a loved one with an eating disorder you may have already begun to realize that eating disorders are not really about food. Rather, eating disorders emerge as a way to cope with life.  People develop eating disorders for many different reasons and the role of the psychotherapist is help the sufferer find healthier ways to cope with life instead of using eating disorder behaviors.

Most folks with eating disorders also have a co-occuring mental health condition such as anxiety and/or depression.  The psychotherapist also helps the sufferer with co-occurring conditions.

Psychotherapist, therapist for short, is a general term for clinicians trained in psychotherapy.  A therapist could by a psychologist (has a Ph.D. in psychology), a licensed clinical social worker, a marriage family therapist or a licensed professional counselor (the later hold at minimum a master’s degree).  Lastly, a psychiatrist is a physician who can provide therapy and prescribed medications for mental health conditions.

Not all therapists have a lot of training in the treatment of eating disorders, just like when selecting a physician, be sure to select one that has experience with treating an eating disorder.

Psychiatrist

A psychiatrist is a medical doctor who is specifically trained in the diagnosis and treatment of mental health conditions. They are trained in psychotherapy, like a therapist, but also can assess the need for medication in treating mental health conditions. A psychiatrist, due to their training as doctors, can also rule out any underlying medical or medications that may be contributing to mental health problems.  Some psychiatrists focus on prescribing and managing medications while others will manage medication and do psychotherapy.

On your team, you may have a psychiatrist that provides both psychotherapy and medication management or see a psychiatrist for medication management and a therapist for psychotherapy.

A Registered Dietitian

If you have an eating disorder, you probably already know a lot about food.  You probably know how many calories, how much fat and how many grams of sugar are in different foods.  You’re probably an expert on the latest diets. So you may be asking yourself, “Why do I need to see a dietitian for my recovery if I already know so much about food?”.

But remember, eating disorders are not really about food.  Food and eating disorder behaviors are used to cope with stress, relationship struggles, worry, and other uncomfortable feelings.

With this in mind, we know that knowledge about food is not the issue, but rather how you relate to food.  A registered dietitian can support you in your recovery. They will help to ensure that you’re eating enough food consistently throughout the day and help untangle food facts from food myths.

One final note:

It’s important to make sure that all or the majority of the members of the treatment team have experience treating eating disorders.  Here are some questions to ask when interviewing clinicians for your treatment team:

1.  What are your credentials?  For example, do you hold a license to practice therapy or nutritional services?
2. Do you belong to any professional eating disorder groups where you receive on-going education to stay-up-to-date on the treatment of eating disorders?
3. How long have you been treating clients with eating disorders?
4. What is your philosophy for treating eating disorders?
5. Do you have other clinicians that you can refer me to in order to help me with my recovery?
6. How often will you communicate with other clinicians on my treatment team?
7. How often can I expect to see you?
8. When do you typically see clients (day, evening, weekends, for example)?
9. How will you assess my progress?
10. What is the typical length of treatment for my type of eating disorder?
11. Will you bill my health insurance carrier or will I need to do that?