Health At Every Size, Exercise & Eating Disorder Recovery: Answering A Reader’s Question
Last week, a reader asked some important questions that I wanted to highlight today, switching gears a bit from our regular Monday posts on body image. In a post on Health At Every Size (HAES), where I interviewed professor and author Jon Robison, Ph.D, reader Erylin asked:
Any helpful advice for a recovering bulimic discovering HAES? Any tips for exercise without it turning into purging?
For insight, I turned to HAES experts. I think their answers are relevant for everyone, and provide an excellent way of looking at exercise, and health as a whole. Remember that HAES is a weight-neutral approach that focuses on developing healthy habits and self-acceptance, regardless of a person’s weight.
Thanks to shows like The Biggest Loser and various magazines regularly advocating rigorous, almost-daily exercise, it’s tough to know what’s healthy and what’s unhealthy exercise. There seems to be this great pressure to exercise all the time, which in my humble opinion can breed an all-or-nothing attitude toward physical activity and muddle up our motives (i.e. I’m exercising for weight loss, not health).
And, interestingly, as a society, we admire people who exercise all the time. How often have you heard someone talk about exercising five days a week, and felt an intense pang of envy? I know I have. Or heard someone say that they’re addicted to exercise, and wondered how great that would be for you? Maybe you’ve even said, “I wish I had that problem.”
Most of us think these thoughts, because exercise, like sticking to a restrictive diet, is praised and viewed as virtuous. I can imagine that for individuals trying to recover from an eating disorder, these views of exercise can make matters worse. And, like other purging behaviors, compulsive exercise has serious health consequences.
So I’m grateful to Erylin for bringing this up, and to the below individuals for generously contributing their insight.
According to psychologist and eating disorders specialist Deb Burgard, Ph.D:
It’s an important issue — in the context of an eating disorder, food and exercise get hijacked by the agenda to be a certain weight, and then the person’s experience of them is drenched in fear and guilt. In our book, Great Shape, (back in the day!) Pat Lyons and I talked about physical activity as a right, not an obligation. We included a guided relaxation to figure out the movement you might feel hungry for, exactly the same as you would do with intuitive eating (now on my website).
Basically, the antidote to the ED-driven exercise is playfulness — think recess, not boot camp. Movement motivated by curiosity, mastery, whimsy, fidgety-ness — the reasons kids move. No fear.
Eating disorder specialist Susan Schulherr, LSW, wrote:
The idea that guides all my interventions with people with eating disorders is that the ED is an attempt to protect oneself from experiences that threaten emotional overwhelm. The person flips into ED behavior (including dieting) automatically to avoid the overwhelm. The opposite of automatic behavior is awareness. So change is a constant two-step process of bringing increased awareness to moments when the automatic behavior is getting triggered (e.g. Can she notice distinctions between how healthy exercise feels compared to “purging” exercise? Can she notice what’s going on when she flips from one to the other?) and developing more constructive options for dealing with the triggering experiences (e.g. self-soothing, problem-solving, reaching out for support, etc.).
People with bulimia tend to live with a lot of internal emotional chaos and shame and have tremendous fears of surrendering the dieting, bingeing and purging. It’s really important to offer reassurance that moving toward healthy eating patterns will help their efforts to diminish the chaos and shame. Most people need (and deserve!) some kind of outside support and guidance to make these shifts.
Dee Miller, another HAES advocate, said:
This advice is just based on common sense and on being sensitive (in a negative way) to any type of exercise that feels weight loss focused. I’ve never had an eating disorder, nor am I a mental health professional.
I’d strongly advise her to stay away from exercise machines that track calories burned. It might also be best to avoid types of activity that lend themselves to quantitative measurement, like running or swimming laps. Things like team sports, dance, and hiking are harder to think of primarily as calorie burning mechanisms.
In addition, Nancy Hieber, R.D. and Michael E. Berrett, Ph.D, have written an article on “intuitive exercise” here, which they say is crucial for anyone recovering from compulsive exercise, an eating disorder or other addictions. The authors caution against creating exercise-related rules for yourself. The below are guidelines for healthy exercise:
- Exercise because you want to – not because you feel that you have to.
- Do exercise activities that you enjoy – not exercises that you dislike.
- Include a variety of exercise activities – don’t get in the rut of doing only one or two things.
- Include leisure recreation activities such as bike riding or hiking in the canyon as part of your exercise.
- Stop if it hurts! Do not exercise when your body is in pain, or when fatigued.
- Never exercise with an injury.
- When your body is telling you something – listen!
- Get some physical activity every day, even if it is just walking around the block.
- Drink plenty of water during exercise and afterwards.
- Eat enough to properly fuel your body for the rigors of daily life and exercise.
Here’s where the intuitive part comes in, according to the authors:
- Spend some quiet and quality time listening to your mind, heart, and body.
- Respond to that self-understanding and approach exercise accordingly.
- Respect your inner needs and consequent internal messages.
- Respect and respond to your body, especially those messages of pain and fatigue.
- Examine your motives for exercise.
- Adjust your exercise as needed and develop the healthiest motives.
- Reserve and make sacred the time you need to take care of yourself.
- Find exercise and physical activities which are enjoyable.
- Remove concepts of fat, calories, and size from your exercise thoughts and language.
- Feed your body what it needs to assure nourishment and adequate fuel to burn.
In a future post, I plan on exploring healthy exercise in more detail.
In the meantime, do you see exercise as a fun activity or as a necessary evil for weight loss? If you used to use exercise as a purging behavior, how were you able to start exercising healthfully? What topics regarding healthy physical activity would you like to see covered in an upcoming post?
And the winner is…So last Friday, I reviewed It’s Not About the Food: A Woman’s Guide to Making Peace With Food and Our Bodies by Esther Kane, MSW, who generously offered to send a free copy of her book to one Weightless reader. I greatly appreciate everyone’s comments, and I wish I could give the book to every reader! But I hope to offer many book giveaways throughout the year.
OK, without further ado, the winner is … Sarah! Please email me at email@example.com with your mailing address, so Esther can send you a copy. Thanks again everyone for your thoughtful comments!!
Tartakovsky, M. (2010). Health At Every Size, Exercise & Eating Disorder Recovery: Answering A Reader’s Question. Psych Central. Retrieved on September 29, 2016, from http://blogs.psychcentral.com/weightless/2010/03/health-at-every-size-exercise-ed-recovery-answering-a-readers-question/