Exercise during an eating disorder recovery
The issue of exercise can cause a lot of worry and uncertainty when an individual is recovering from an eating disorder. Over-exercising is often a feature of anorexia, carried out compulsively as a tool in weight loss and maintenance of the disorder.
Eating disorder inpatient units provide an environment where exercise is very precisely managed. Zero exercise will be allowed at low weight and further into treatment when exercise is slowly introduced, it will be gentle and carefully managed activity. At Newbridge, young people join Leisure Group, which enables them to do yoga, moving on to badminton and finally swimming (undertaken in conjunction with body image work).
However, once a young person leaves the inpatient unit and returns home, it isn’t possible to control exercise in the same way. So how should reintroduction to exercise be managed?
“This is something parents are very concerned about as they prepare for discharge,” explains Gill Williams, Newbridge nurse who runs the Programme for Parents. “We advise it is much better for young people to take up organised activities and team sports, because these are structured activities within specific time frames and there are social benefits in being part of a team or group.” The structure nature of team practices and organised activities make it more feasible to plan and agree additional snacks to compensate for energy used and to ensure exercise is contained within clear limits.
“We would be much more concerned about a young person in recovery going running alone,” explains Gill. “There is the risk of runs getting longer and more frequent and no benefits of socialising with others.” If a young person prefers going to the gym to team sports, see if you can join them at the gym so their exercise is not a lone activity without time limits.
Normally, it is the compulsive approach to exercise which may still need to be considered and after discharge. “Think about the motivation an individual has for exercising,” explains Sue Taylor, HCA, who also works on the Programme for Parents. “Your daughter or son might say – ‘It makes me feel better’. This is exactly the role of sports and exercise for many, many people. But if the individual feels bad and guilty and bad if they don’t exercise, that is an indication they still have a problematic relationship with exercise.”
All sports and activities are not the same in terms of risk for individuals in recovery from an eating disorder. Endurance sports such as long distance running and triathlons present a raised risk because of the very high levels of energy and dedication they demand (and how this can be expressed in a person predisposed to eating disorders). Aesthetic sports such as dancing and ice skating are higher risk for young people in recovery because of their potential to maintain body image anxiety.
But it is widely agreed that even though exercise presents challenges for the recovering anorexic, it isn’t possible or advisable for individuals to permanently avoid exercise. “Often, sport and exercise is a big part of young people’s lives before they became ill,” explains Sue. “Sport and exercise became a tool of anorexia while they were ill, but in recovery, young people are often very keen to enjoy exercising again.”