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Anorexia/Eating Disorders/Recovering from anorexia and exercise addiction

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QUESTION: Hi I am a 42 year old female in the midst of recovering from anorexia and exercise addicttion.  The exercise addiction started about 10 years ago and the anorexia (restricting) started probably four years ago.  I am 5'3" and the lowest weight I went to was 92 pounds.  I have been recovering for several months now (with three relapses) and eating more each meal and have had to cut back on my exercise due to loss of period, hip problems, osteopenia, etc.  I now weigh 113 pounds and eating more normally at each meal.  My psychiatrist and doctor have been after me to cut back even more on the exercise.  My main question for you is what your opinion is of my exercise schedule.  I walk for approximately a total of an hour and a half with approximately and hour and a half of toning (a half hour of weight lifting and an hour of abdominals, leg and butt exercises).  I did get my period back last month but it lasted only a day.  Am I still doing too much.  I used to do tons of high energy aerobics for years so at least I don't do that anymore because of my bad hip.  Sorry this is such a long rant!!  Thank you for your help.

ANSWER: If you are still not having a period, you need to get your metabolism back on track.  That means no more restricting calories and you'll need to lay off heavy training.  It may not seem like heavy training to you because it always seems like others are doing more, but that's just how we are as athletes.  Walking, swimming yoga...the focus should be on health and not fitness goals or training.  I never like to recommend people stop exercise unless they are being treated medically and are too sick from their disorder to exercise.  It should be part of a healthy lifestyle.  But, the focus HAS to be on health, not calories burned, time in a training zone, heart rate zone, etc.  Many women's bodies are very sensitive to training load, slight changes in diet or emotional stress, while other women are able to train very heavily or intensely and continue to menstruate or even conceive during this time.  You can't compare yourself to others, you have to listen to your body.

---------- FOLLOW-UP ----------

QUESTION: How much exercise would you recommend each day?  I know my doctor originally insisted a half hour of walking in the morning and another half hour in the evening, or at least exercising every other day.  But I am terrified if I cut back too much I will pack on the pounds. In fact, I find it hard to sit still when I am not exercising.  I feel I should keep busy and move around as much as possible to burn calorires.   I am finally on board so far of realizing I need to put weight on, and I am eating well now at each meal.  But I still fear putting on way too much.

Answer
Again, numbers aren't the thing to be fixated on, health is the goal.  Can you go walking with your kids, spouse, partner, neighbor, etc after work to just catch-up and do something active?  Can you do a 40 minute yoga class over your lunch break?  The key things I hear you saying are "terrified I will pack on the pounds," and that you move "as much as possible to burn calories."  Those things are something you need to talk about with a good therapist.  As long as those beliefs persist, you'll never be free from this.  How about moving to feel your body move?  What about activity for the sake of doing something enjoyable?  I understand that you have a very strained relationship with your body.  Moving for the sake of feeling movement and enjoying the activity aren't something you are used to feeling or maybe even ever felt.  It's that feeling of swinging on a swing-set at the playground when you were little, or riding your bike just because you liked to feel the Earth move underneath you.  

You need to work on the relationship you have with your body.  It's like any unhealthy relationship though...there are the relationships where even though both partners aren't good for each other, the couple still insists on keeping their dysfunctional relationship going.  It's almost like it's more comfortable to stay than to face the uncertainty of leaving.  It's the same thing with your relationship with your body or with food.  Even though you may say you want to change or believe you want to change, it's a scary thing to be asked to give up something you've been using to get by for so long, and you have been using it to get by haven't you?  Whether it's past abuse or trauma in your life, I'm betting there's something you are trying not to feel or experience...to the point you'd rather feel any other way than how you usually feel.  That's the relationship with yourself I am talking about.  A good therapist can help.  Already been to someone?  A good fit is key, find one that you can really connect with because it makes all the difference.

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Ryan Hale

Expertise

I can answer questions specifically geared towards athletes and their eating issues. I would be able to assist parents or coaches with questions or concerns about disordered eating practices often found in the exercise and sports settings. I also have experience in training and conditioning so I am in a position to discus how the two interrelate.

Experience

I have a bachelor's degree in sports medicine and master's degrees in sport psychology and clinical counseling. I have done counseling with individuals, couples, and families, with specialization in athletes. Past clients have included triathletes, dancers, college cyclists, and Pro Tour cyclists.

Organizations
National Athletic Trainer's Assoc. American Counseling Assoc

Education/Credentials
bachelor's degree sports medicine master's degree sport psychology master's degree clinical counseling Nationally Certified Athletic Trainer with NATABOC Nationally Certified Counselor with NBCC Colorado Registered Psychotherapist

Past/Present Clients
U.S. national team level female athletes High school athletes Semi-pro soccer Pro Tour cyclists Triathletes Dancers

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