I recently worked with a client who shared how a support person kept encouraging her to work out to help with body confidence. This is a common thought for people with eating disorders. Often clients share workout plans with me they hope will help them cope with their body dissatisfaction, but they’re just reinforcing and masking the eating disorder!

In and of itself, exercise is obviously, not bad, but it often can be a symptom of an eating disorder. It is often a symptom that can be “swapped” for another. For example, suppose someone with restrictive eating starts eating more. In that case, their eating disorder may encourage them to engage in more strenuous exercise to combat the negative self-talk the increase in consumption has caused or to mitigate weight gain, which may be necessary for their wellness. If you are numbing out eating disorder thoughts with exercise, substances, or other compulsive behaviors, you aren’t truly challenging the eating disorder. A way to think about this is if someone with alcoholism gets sober but smokes marijuana every time they think about alcohol, they aren’t truly dealing with the urges to use alcohol; they are numbing them out! This phenomenon happens when someone stops restricting or purging and starts exercising or exercising more intensely. We aren’t helping the person deal with their fears around weight gain or their body changing; we are just allowing them to find another way to control their body shape and weight.

Often people will point out how exercise is healthy and good for mental health, so it should be a part of someone’s life and is healthier than restricting or purging. This is true, but it is more important that we help clients with eating disorders learn to nourish and accept their bodies naturally. To fully recover, we have to give up controlling our bodies completely. We can only do this by eating regularly throughout the day, finding and maintaining our body’s natural set point, and eventually incorporating exercise into a healthy lifestyle. If we rush this process, clients may do better with their food intake but aren’t dealing with the underlying feelings and thoughts that caused the eating disorder.

People with eating disorders aren’t just obsessed with what they look like (and some aren’t at all!); their brains have created a universe where food and body are all that matter to help distract them from painful experiences and feelings. We need to help them re-learn how to take care of their bodies so they can tap into the underlying issues and learn to cope with them instead of masking them with food and body concerns.
This can be a confusing concept for supports, especially those who are avid exercisers. We must know that the client needs to re-learn how to care for and trust (not control) their body to recover fully. If you are struggling to understand someone’s relationship with exercise, I encourage you to ask to join a session with your loved ones’ care team; it can be helpful to understand that a healthy behavior for the average person may be causing obsessive thoughts, fear, anxiety and preventing full healing for someone with an eating disorder.