What is Exercise Bulimia & Is There A Treatment For It?

What is Exercise Bulimia?

All over the world, exercise is typically viewed as a virtue. This is why many people wonder how it can possibly be bad for you. This is because, for most people, exercise provides many health and mental health benefits. However, for people with eating disorders, excessive exercise can be a common symptom of their disorder, and it can play a big role in the aggravation of the disorder.(1, 2, 3)

Exercise bulimia is an extreme form of over-exercising behavior. The disorder has many features that are similar to bulimia nervosa, which is an eating disorder that involves binge eating followed by purging. Purging behavior involves getting rid of the ingested food and calories by self-induced vomiting, laxatives, diuretics, or extreme fasting. A person with exercise bulimia, though, does not engage in purging behavior. They tend to over-exercise to burn calories and fat. Exercise bulimia was once classified as a subtype of bulimia nervosa itself. However, today it is not classified as a type of bulimia anymore. Even then, this condition remains difficult to classify as it may fall into several other categories as well, including OCD-spectrum disorder, body dysmorphic disorders, or a combination of these, and others.(4, 5, 6, 7)

What are the Symptoms of Exercise Bulimia?

Exercising is a healthy routine for most people. This is what makes it challenging to spot over-exercising. One of the first signs is usually excessive worrying about exercise and weight loss. Missing important events in one’s life due to exercise is another warning sign. Some of the other symptoms of exercise bulimia include:

  • Becoming angry or anxious or feeling incredibly guilty when you miss a scheduled workout.
  • Closely monitoring how many calories you burn when exercising.
  • Measuring yourself frequently to see how thin you are.
  • Feeling the need to work out even more to reach your desired weight.
  • Seeing your body differently and more unsightly than others do.
  • Getting defensive or angry if someone points out that you are exercising too much.

Women with exercise bulimia may also experience amenorrhea, a condition marked by the absence of menstruation. This happens due to over-exercise. If chronic, amenorrhea can cause reproductive challenges in women of childbearing age.(8)

Are There Any Complications Linked With Exercise Bulimia?

Exercise bulimia and excessive exercising can cause several adverse effects on the body. A study carried out in 2012 found that excessive endurance exercise can lead to an abnormal remodeling of the heart.(9) Excessive endurance exercise can also put patients at a higher risk for arrhythmias or irregular heart rhythm. While there is a need for more in-depth research, this study pointed out that pathological amounts of exercise can bring about many negative impacts on the body.

Similarly, too much of exercise puts a lot of stress on your joints and bones. This can cause stress fractures, chronic joint pain, or even arthritis over a period of time.
A person with exercise bulimia may find that they fall sick more often than usual as an excessive amount of exercise starts to weaken the immune system. This also makes you prone to respiratory and other infections. In such cases, your weary body begins to struggle to overcome and battle against any type of infection.

Furthermore, women who do not have a sufficient amount of body fat can experience a shutdown of their reproductive system, a condition known as amenorrhea. This can cause infertility and many other types of reproductive issues.

Is There A Treatment For Exercise Bulimia?

The first step in treating exercise bulimia is to admit that you may have a problem with over-exercise. Talk to your doctor about your excessive exercising and eating habits if you are worried about your behavior. Your doctor will be able to direct you towards the right kind of help that you need.

A psychiatrist or therapist is able to treat the psychological aspects of exercise bulimia. Your mental health professional will be able to help you with your body image issues and also suggest ways in which you can overcome the negative views of yourself. They are also likely to use methods like cognitive behavioral therapy to help you adjust and accept your self-image and attitudes.

Your therapist or doctor will also ask you to monitor your exercise habits closely, including how much time you spend exercising. This is because it can be very easy to fall back into your over-exercising habits. However, discussing a healthy workout routine with your doctor and therapist will help you stay fit and healthy without risking your overall health due to excessive exercising.(10)

Conclusion

Exercise bulimia should not be taken lightly. It is a serious condition, but recovery is possible with the right treatment. A good doctor, therapist, or psychiatrist can help you develop the skills you need to cope with this condition. It is important to remember that extreme exercise does not have to take over your life. It is possible to take control of exercise bulimia through therapy and make a commitment to have a healthy workout routine. Again, the first step towards getting better is to admit that you have a problem with over-exercising and seek help.

References:

  1. Ruby, M.B., Dunn, E.W., Perrino, A., Gillis, R. and Viel, S., 2011. The invisible benefits of exercise. Health Psychology, 30(1), p.67.
  2. Vina, J., Sanchis‐Gomar, F., Martinez‐Bello, V. and Gomez‐Cabrera, M.C., 2012. Exercise acts as a drug; the pharmacological benefits of exercise. British journal of pharmacology, 167(1), pp.1-12.
  3. Dittmer, N., Jacobi, C. and Voderholzer, U., 2018. Compulsive exercise in eating disorders: proposal for a definition and a clinical assessment. Journal of eating disorders, 6(1), pp.1-9.
  4. Keel, P.K. and Mitchell, J.E., 1997. Outcome in bulimia nervosa. The American journal of psychiatry.
  5. Russell, G., 1979. Bulimia nervosa: an ominous variant of anorexia nervosa. Psychological medicine, 9(3), pp.429-448.
  6. Fairburn, C.G. and Beglin, S.J., 1990. Studies of the epidemiology of bulimia nervosa. The American journal of psychiatry.
  7. Adkins, E.C. and Keel, P.K., 2005. Does “excessive” or “compulsive” best describe exercise as a symptom of bulimia nervosa?. International Journal of Eating Disorders, 38(1), pp.24-29.
  8. Warren, M.P. and Chua, A.T., 2008. Exercise‐induced amenorrhea and bone health in the adolescent athlete. Annals of the New York Academy of Sciences, 1135(1), pp.244-252.
  9. O’Keefe, J.H., Patil, H.R., Lavie, C.J., Magalski, A., Vogel, R.A. and McCullough, P.A., 2012, June. Potential adverse cardiovascular effects from excessive endurance exercise. In Mayo Clinic Proceedings (Vol. 87, No. 6, pp. 587-595). Elsevier.
  10. Fairburn, C.G., 2008. Cognitive behavior therapy and eating disorders. Guilford Press.

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