A powerlifter trained two hours a day. A runner ran up to 15 miles a day but always ran a minimum of 6 daily. A group exercise instructor taught Bootcamp and Spin five days a week.
Sounds like a routine schedule for those three individuals.
What if I told you it's not three individuals but a 21 year old girl. She did all of these activities on a bag of popcorn, an apple, and a bowl of oatmeal daily. She used exercise as a means to "purge" her body of the calories consumed.
No one said anything to her because she was just doing what an active girl did.
Even when bald spots began forming on her young, feminine head.
Or when she cried on the scale at powerlifting competition weigh ins.
Not even when she refused to eat in public after running a race and avoided all public mirrors and pictures.
In fact, no one said anything to her until she was injured in a bicycle accident. A bicycle accident that shouldn't have happened. The girl had already lifted for hours, ran for miles, and taught classes on a near empty stomach. Thinking she was fat and needed to burn off the calories of her daily apple and oatmeal, she mounted her mountain bike for a road ride. She was clipped by a purple van, flung over it's hood, and thrown across the pavement.
It wasn't the fractured hip and cheekbone, busted blood vessels in her eyes, or missing fingernails that caused anyone to notice her disease. It was being witnessed immediately after diagnosis of her injuries trying to do sit ups in the hospital. She was convinced her 117 pound frame was going to gain weight because she hadn't exercised in two hours (since the accident).
That Girl Was Me
I was diagnosed with exercise bulimia and was included in the statistic that 13.5% of elite athletes suffer from some form of an eating disorder.
I can hear you now, "Wait, what eating disorder? You just exercised a lot."
Unfortunately exercise isn't always good for you. I'll wait for you to lower your eyebrows and close your mouths at that metaphorical bombshell.
In my pursuit of a perfect body I ruined my own. By training excessively, improperly fueling my body, and never taking rest days, I had done irreparable damage. My L3, L4, L5, and S1 vertebras in my back (pretty much the entire lower half of my back) were permanently bulged and I am now prohibited from performing high impact movements and sitting for long periods of time.
So what happens when exercise becomes such an obsession that it derails training and causes more harm than good? How do you know when you, or someone you love, crosses that line and suffers from exercise bulimia?
Bulimia can affect 4.7 million women and 1.5 million men during their lifetime but it's rarely mentioned in the fitness community. Most individuals, especially athletes, want to be stronger, faster, and look better naked. Usually no one bats an eye at how often someone exercises; that can't be considered a disorder can it?
Learn the warning signs and symptoms of exercise bulimia (or excessive exercise), effective approaches of tactful intervention, and how to seek appropriate treatment for yourself or your friends so you don't have to suffer as long as I did.
Exercise bulimia is a subset of bulimia, a disorder characterized by the inflicted individual's need to "purge" calories consumed. Rather than the "traditional" vomiting or use of laxatives, exercise bulimics use excessive exercise as their purging outlet. A majority of individuals suffering from this disease have underlying depression or anxiety.
Warning Signs & Symptoms
Not every symptom or warning sign will be as extreme as some of mine.
Exercise bulimia can be a subtle and sneaky disease manifesting in behavioral and physical conditions. Most individuals suffering from it will "appear to be normal bodyweight" so it's important to notice any behavioral changes.
Below are some common warning signs and symptoms to look for if you think you or a friend may be suffering from exercise bulimia:
Behavioral Signs & Symptoms
· Excessive exercising regardless of health, injury, and weather
· Attending the gym three or more times a day
· Refusing rest days
· Skipping class, work, or social functions if they did not exercise that day
· Avoiding social functions where food is involved
· Hyper focusing on calorie intake and output
· Reducing caloric intake drastically if unable to exercise that day
· Fearful of gaining weight if they do not exercise that day
· Feeling extreme guilt or anger if unable to exercise that day
· Being uncharacteristically defensive if someone suggests they exercise too much
Physical Signs & Symptoms
Regardless of whether the warning signs and symptoms are behavioral or physical, perfectionism remains at the core of exercise bulimics' need to purge through exercise so their actions and thoughts will mirror that.
If you are reading this article and have even the slightest concern for yourself or someone you love, then something isn't right. You need to address the issue before it escalates any further. However, what you say to someone who may be suffering can either push them to relapse or recovery.
· Carefully evaluate how often you have been training, why you've been training, and how you've been feeling using the checklist above.
· Confide in a trusted friend about your concerns. A support system is vital in your recovery.
· Seek out a general practitioner, therapist, or psychiatrist to talk to and work through your recovery. I know from experience this is the hardest thing to do but I promise you it is worth it.
· Approach a nutritionist or professional with any questions you have before talking to your friend to ensure you handle the situation tactfully. I recommend Constance Shelby of Perfect Fit Nutrition.
· When you talk to your friend, do so in private. Keep your tone comforting and conversational. Do not judge, berate, or make fun of your friend. This can cause them to be defensive and spiral further into their disease.
· Do not ask them to keep a food log. If someone has an eating disorder this is the worst thing you can do.
· Do not talk about their body weight or appearance (good or bad); focus on their behavioral patterns.
Typical treatment options may include therapy sessions with a trained professional. Since exercise bulimia is typically associated with depression, anxiety, or trauma, those underlying issues need to be addressed so the individual can recover. The severity of the disease within the individual will dictate whether they will receive in patient or outpatient therapy. If caught early, most individuals will receive outpatient treatment in a therapist's office. Individual or group therapy sessions are typically available.
Individuals with exercise bulimia have an unhealthy relationship with food and calories. Working with a licensed nutritionist or dietician to help improve their relationship with food is crucial in creating long term success and recovery. Learning about food and why your body needs certain nutrients goes a long way in that journey.
Medication may be prescribed if necessary but typically would be used to treat the underlying diseases that contributed to exercise bulimia (depression, anxiety, PTSD).
Monitoring of exercise habits may also occur. Seeking the advice of recommended personal trainers or professionals with experience in eating disorder is beneficial to instilling a healthy relationship with exercise. Learning how to balance healthy exercise regimes and having that progress monitored and can help form safe and long lasting recovery.
I spent years in recovery, found a nutritionist, and activities that didn't require me to obsess with my weight. For years I had to avoid Fitness magazines and things that made me feel inferior.
Working in a fitness facility hindered my recovery but that took me years to figure out. If you look on my Facebook timeline you'll notice an absence of photographs from certain time periods. That's because I was in relapse; I was injured or had gained weight (easy to do once you stop restricting) and was ashamed of how I looked.
Luckily I've been able to find balance in the last few years. The thoughts to purge my body of calories are very few and far between. I just don't act on those thoughts anymore. Instead I take my experiences and use them to work with my own athletes and those struggling with eating disorders and exercise bulimia.
Exercise bulimia is a silent disease undetectable by the uninformed eye. Yet society does not have to be silent about fighting it. Dialogue not only opens doors but can save lives.
If you feel like you or someone you know is suffering from this disease, in any form or fashion, then please speak up and say something.