Exercise Bulimia? Three Things You Might Not Know

Even before I started specializing in treating eating disorders, I heard the term 'exercise bulimia" frequently in the media. Here are three things you might not know about it:

1. Exercise Bulimia is no different than bulimia nervosa

Bulimia nervosa is an eating disorder characterized by cycles of binge eating (eating a large amount of food in a short amount of time in which the individual feels a loss of control over and feelings of shame and guilt after) and purging (efforts to rid the body of the calories just consumed). Most people associate bulimia nervosa with self-induced vomiting or sometimes laxative use. However, the DSM-V includes excessive exercise as a method of purging. "Exercise bulimia" is not a clinical term and has the same implications as a traditional diagnosis of bulimia nervosa.

2. Exercising is important, but so are other things

Individuals who utilize excessive exercising as a form of purging typically do not enjoy exercising. They view it as a chore or something that they have  to do in order to stay thin or to compensate for ingesting a large amount of calories. They may prioritize exercising over spending time with friends, family, or loved ones. They may also feel extreme guilt if they miss a workout. These are all characteristics of somebody who uses excessive exercise as a form of purging.

Working out and engaging in moderate exercise is healthy and adaptive. However, prioritizing exercising over nearly every aspect of your life is not adaptive and may be a sign that an individual is utilizing exercise compulsively. 

Because I'm a counselor and not a medical doctor, I always encourage my clients who struggle with disordered eating to consult with a medical doctor and, in some cases, a dietitian. A doctor can provide you with specific feedback about the amount of exercise that is appropriate for you. A doctor can also provide information about the physical consequences of bulimia nervosa.

3. There are options

Individuals who struggle with bulimia nervosa may feel overwhelmed by their compulsive desires to engage in binge eating and purging. Specifically, those who struggle with excessive exercise as a form of purging may feel overwhelmed with the amount of time they dedicate to exercising. It can be hard to make time for a therapy appointment if you're exercising several hours per day. 

However, seeking treatment from a therapist can serve to interrupt those cycles of binge eating and purging and can help to normalize exercising behaviors. When I work with individuals who struggle with binge eating and purging, I utilize cognitive behavioral therapy (CBT) techniques to examine the cycle of behavior and identify a point to interrupt that cycle. I then work with the client to explore underlying issues that reinforce disordered eating behaviors, such as body image concerns or a desire to exert control.



Emily Teegarden