Exercise Series, Part 3: Developing a Healthy Relationship with Exercise

Now that we’ve talked about figuring out whether you relationship with exercise is toxic and about the role of exercise in eating disorder recovery, let’s take a look at how you can develop a healthy relationship with exercise.

If You Are in Active Eating Disorder Recovery

First and foremost, I need to state that if you are actively struggling with an eating disorder, especially if you are potentially under-nourishing your body, please do not undertake extra physical activity without the guidance of trusted professionals. As discussed on my previous post, exercising while malnourished can be very dangerous. Also, know that people of all sizes can be under-nourished so don’t assume that you are not even if you’re in a larger body!

If you’re not currently seeing a therapist or dietitian—or both—that is a good place to start. Just make sure they specialize in eating disorders because unfortunately, professionals who do not can unintentionally cause harm for eating disorder clients. (Please contact me if you need help finding an eating disorder therapist or dietitian.) Other members of your treatment team might include a medical doctor, a psychiatrist, and an occupational therapist. If you think you might need more treatment than outpatient can provide, check out this post about the levels of care available for eating disorder treatment.

Tips for Exercising In a Mentally and Physically Health Way

Even as you are renourishing (also called weight restoring), there could be a place for movement in your treatment. What your current relationship with exercise is like and your physical condition are critical considerations in developing a plan for exercise, which is why you should ultimately work with your treatment team on creating a plan since they know your specific challenges and needs.

Dr. Jennifer Gaudiani, author of Sick Enough: A Guide to the Medical Complications of Eating Disorders and Medical Director of the Gaudiani Clinic eating disorder treatment facility, recommends a slow increase in movement, making sure to have rest days in between. She also emphasizes the importance of adding more nutrition if needed. I want to mentioned that although exercise during this stage can result in some bone density loss in some patients, Dr. Gaudiani feels this is offset by the fact that a plan involving movement can lead to earlier eating disorder recovery, which can in turn have a better long-term effect on bone health.

What’s the Goal?

If I had to give a name to what a healthy relationship with exercise looks like, I would call it intuitive exercise (or intuitive movement if the word exercise has negative connotations for you). In the Intuitive Eating book, the authors call it joyful movement, so you can use that too if you like it better. 

I personally like having “intuitive” in there because I think that better personifies what it’s all about. Like intuitive eating, intuitive exercise involves tuning into the body and respecting the body’s cues, which means removing the obstacles to attunement—the disordered rules, beliefs, and thoughts that previously surrounded exercise. In other words, it is guided by internal cues rather than external ones. Again, like with intuitive eating, it can be quite a process getting there, but it’s so freeing once you do.

Tips for Learning Intuitive Exercise

In addition to taking a slow-increase approach recommended by Dr. Gaudiani and other experts, here are some other general principles to help you incorporate movement in a healthy way and to heal your relationship with exercise.

Tip #1 – Take a break

For many people who’ve had issues with exercise, taking a break from it can be a necessary step in healing. Yes, this can be very distressing, and that gives you an opportunity to deal with all the things that come up when you don’t exercise. It’s hard but important to learn other coping skills besides just exercise. Plus, taking a break gives you time to do a mental “reset” with the other tips here.

Tip #2 – Change your motivation for exercise

Just like the first step in developing a healthy relationship with food is challenging the diet mentality, it’s also an important starting point for changing your relationship with exercise. Sadly, in our current culture, movement is usually associated with trying to lose or maintain weight. Untangling exercise from those goals is difficult for most people, let alone people with an eating disorder. Yet there are so many benefits to our physical and mental health! Take some time to identify reasons to exercise that matter to you besides staying thin or losing weight. Here are a few that might be important to you:

• Relieve stress
• Improve learning and memory
• Strengthen your heart
• Build stronger muscles and bones
• Promote better sleep
• Improve mood
• Decrease depression and anxiety
• Improve digestion to help relieve constipation and help those with digestive disorders like inflammatory bowel disease and liver disease
• Strengthen immune system
• Reduces risk for disease like stroke, cardiovascular disease, and some forms of cancer
• Improve sex life

Tip #3 – Rethink what defines “exercise”

Exercise does not have to be running X miles or doing X minutes on the elliptical. Resist the toxic thinking about exercise having to look a certain way. Often, we think it only “counts” if it’s a certain type, intensity, or amount of time. Not true! We can get a lot of benefits from a variety of movements, and they don’t have to be intense or high-impact. Dr. Jennifer Gaudiani recommends (and I agree) that it’s good to start by incorporating a variety of gentle activities such as yoga, walking, and free weights.

Over time, get creative and think about trying other types of movement like:

• Walks with your pet or family
• Hiking
• Roller skating or ice skating
• A dance party at home or try a dance class
• Riding a bike
• Martial arts
• Wrestling or playing tag with your kids
• Play a rec league sport
• Play laser tag
• Hula-hoop
• Jump rope
• Swimming or water aerobics
• Think about what you enjoyed as a kid and do that!

In my eating disorder days, I was a compulsive runner. I gave that up when I went into recovery and years later, I’m still exploring what types of movement I enjoy. Watch the video at the end of this post to hear more about my recent journey with intuitive exercise!

Tip #4 – Listen to your body

Since the basis of intuitive exercise is tuning into your body, you need to work on practicing mindfulness, which you’re likely doing with intuitive eating already. Listening to your body means noticing when you feel the urge to move, and then honoring that by moving. It also means noticing when you’re feeling fatigued or sick and need to rest instead of exercising. 

As you’re exercising, respect your body’s cues. It’s okay for exercise to be a bit challenging and uncomfortable at times, but it should not be painful or miserable. The idea that we have to beat up our bodies for a workout to be beneficial is toxic fitness thinking and is just plain false.

A Warning About Starting to Exercise Again

As you get more stable physically and are consistently nourishing yourself, you can increase your intensity… but only if you want to—and want to for the right reasons. Emotions to watch out for are guilt, shame, stress or pressure. If it feels more like “I should” or “I need to” to increase workout intensity or times, that is a red flag that you’re slipping into compulsive exercise again.

Be aware of your thoughts too. If you start thinking about things like how many calories you burned, step back and challenge the diet mentality. Recognize those thoughts and feelings are a slippery slope back into disordered eating… and don’t give into them. With self-compassion, remind yourself of the healthy reasons you are exercising and that there are no rules for how it has to be. The point is for you to enjoy it both physically and mentally, and for it to add to the quality of your life. Scale back, try a different form of exercise, or take a break again if you need to. Like with food, healing our relationship with movement is not a linear process!

(If you missed the first two posts in this exercise series, check them out at Part 1: Is Your Relationship with Exercise Toxic? and Part 2: The Role of Exercise in Eating Disorder Recovery.)

Sources:

Cook, B., Wonderlich, S. A., Mitchell, J., Thompson, R., Sherman, R., & McCallum, K. (2016). Exercise in Eating Disorders Treatment: Systematic Review and Proposal of Guidelines. Medicine and Science in Sports and Exercise, 48(7), 1408–1414. http://doi.org/10.1249/MSS.0000000000000912

Definition of Intuitive Eating