Your Guide to Exercise in Eating Disorder Recovery
As someone recovers from an eating disorder, it's common to wonder how and when it’s safe to resume exercise.
“Many patients can absolutely safely implement exercise—if done intentionally, with multidisciplinary support, and taking the various complex factors of eating disorder recovery into consideration,” says Adee Levinstein, MS, RD, LD, CEDS-C (she/her/hers), clinical dietitian training specialist at Eating Recovery Center (ERC).
If you are in recovery from bulimia, anorexia or another eating disorder, we encourage you to speak with your treatment team before you begin any exercise routine. While the type and frequency of exercise will vary based on your unique circumstances, a mindful and gradual approach is often recommended. Here’s what that might look like.
![Friends exercise together in eating disorder recovery.](/sites/default/files/styles/small_hq/public/image/2024-06/exercise-eating-disorder-recovery.jpg?itok=YWVHU4T1)
Tip 1: Make a plan
The first step to starting exercise in eating disorder recovery is to make a clear plan.
So, where do you start? Set clear parameters for exercise along with your treatment team and loved ones. It’s important to be intentional and communicate with your support system about challenges, progress and goals each step of the way.
Ideally, individuals in recovery should look for opportunities to exercise in a social or group setting, especially if you’ve exercised alone in the past. Joining others in exercise can build connection and encourage branching out from your usual routine and create a new mindset around exercise.
Tip 2: Let mindfulness guide your movement
When you first begin to exercise, focus on gentle movements. These may include:
- Gentle yoga in a group setting
- Tai chi
- Mindful nature walks in a group setting
- Short family walks around the neighborhood
- Unstructured activities like gardening and playing with pets
Use mindfulness as you move, focusing on your breath and being present in the moment. You might, for example, take time to notice your surroundings (birds, trees, clouds) while on a nature walk. These skills work to replace what you might have been focusing on in the past: the length of time you are exercising, the intensity of the exercise, the number of calories burned or even negative self-talk.
Mindful movement can also support our mental health in other ways: being present in the moment and giving us space to decide what to do with our feelings or thoughts.
Tip 3: Know what to avoid
Our experts recommend that you avoid the following in early recovery:
1. Avoid focusing on numbers
We try not to use numbers as we re-introduce exercise into someone’s routine. Any focus on numbers can be triggering. Instead, we use more general language, encouraging people to begin by walking “at a gentle, slow pace” for “a short amount of time.”
2. Avoid using fitness trackers and other technology
We also educate our patients about the concerns of using fitness trackers and similar technologies during exercise. Using these devices can trigger excessive exercise patterns, especially for someone who has a perfectionistic or overachieving personality. We recommend people avoid Fitbits and turn off any health tracking settings on their iPhones or watches. Family members should also avoid these devices and be mindful of what they say around their loved one in recovery.
3. Avoid extreme forms of exercise
Instead, we encourage people to start in a non-competitive environment that is not focused on strength-building, calorie-burning or weight loss. We encourage patients to start with gentle walks with family and friends.
Learn how to view exercise differently in recovery
Physical movement is meant to be enjoyable and energizing. It shouldn’t make you feel worn out or depleted. When starting exercise after treatment for an eating disorder, seek balance and moderation.
At ERC, our experts ask individuals to look at movement as something to be enjoyed, asking several questions to help them through this process. Try it now. Ask yourself:
- What type of movement did I enjoy as a child?
- Did I enjoy being out in nature or in classes with others?
- Did I enjoy biking in the neighborhood with friends?
- Do I find pleasure in exercise?
- Can I make exercise a social event?
![Friends make exercise a social event in eating disorder recovery.](/sites/default/files/styles/small_hq/public/image/2024-06/friends-exercise-eating-disorder-recovery.jpg?itok=8DfIF694)
Exercise can have powerful effects on both your physical and emotional well-being, boosting mood, improving self-image and self-esteem, and reducing stress. This is why it is so important to create a positive relationship with movement, to reap the benefits while reducing chances for harm. Focus on self-compassion and self-care rather than achievement or perfectionism.
FAQs: Exercising in recovery
Here, we answer some commonly asked questions to help you identify ways to integrate movement back into your life in recovery.
When can I exercise in eating disorder recovery?
In the early stages of recovery, we recommend that you take a break from exercise for a while, to allow your body to heal. Instead, spend this time establishing a more mindful, stable relationship with food and prioritizing nutrition. As you progress in recovery, develop positive coping strategies and improve your relationship with food and your body, your treatment team may recommend reintroducing exercise.
What goals should I set for exercise in recovery?
At ERC, our experts recommend that you establish exercise goals with feedback from your treatment team (e.g., therapist, dietitian). Your goals for movement will be unique to you, based on multiple factors and treatment progress.
Overall, individuals recovering from eating disorders can create a more positive mindset toward exercise by focusing on self-compassion and self-care rather than achievement. It’s essential to avoid rigid exercise schedules, calorie tracking or negative self-talk about missed workouts.
How long will it take before I resume regular activity?
In the long term, with specialized treatment, patience and a gradual progression back, you may be able to resume regular activity. You may even be able to compete in sports or visit a gym again. It may take time to get to this place, and it really depends on the individual. With a positive mindset and support from your treatment team, many things are possible.
Special consideration for athletes with eating disorders
For athletes, exercise isn’t just a part of their sport. It’s also a significant part of their identity and daily routine. That’s why athletes resuming exercise in eating disorder recovery face unique challenges.
“Often, athletes have a strong connection to their team, and their identity as an athlete is an important part of their own self-worth,” Levinstein says. “Additionally, college and professional athletes may rush returning to athletic pursuits due to considerations related to scholarships or salaries.”
When resuming competitive activities, athletes in eating disorder recovery can follow a structured plan created with their eating disorder treatment team, sports medicine and sports performance staff. In some cases, we recommend athletes first return to their sport as a team manager or non-physically active participant.
Also, coaches, athletic trainers and team doctors should be educated about any history of excessive exercise and eating disorders. Those close to the athlete should know how to identify the warning signs of eating disorder relapse.
Learn more about eating disorders in athletes here.
How to help someone in eating disorder recovery
Family members and loved ones play a critical role in eating disorder recovery and can help by supporting the individual at home. Sometimes monitoring is needed (e.g., some people will hide their exercise behaviors by waking up early to run or secretly exercising in their bedroom or bathroom).
The following five tips from the experts at ERC can help you support your loved one as they resume activity.
1. Do not talk about exercise
Do not invite your loved one to go to the gym, take part in a 5K or attend an exercise class other than gentle yoga. Store in-house exercise machines out of sight. Families that focus on physical activity often – such as those that run marathons or play soccer together – can try to connect through other activities, such as attending a festival, dining out, or seeing a play or a movie.
2. Avoid discussing nutrition, supplements, food or weight
We recommend people in recovery avoid certain situations that are known to be triggering, and loved ones can help them identify what this means to them. For example, we recommend avoiding classes in locations that promote weight loss or use of nutritional supplements, or places where scales are easily accessible. Be mindful when attending health or gym classes in schools or universities that promote calorie counting, weighing and exercise tracking.
3. Watch out for social media
Unfollow exercise- and weight-focused accounts. Remove or unfollow friends or accounts that could trigger eating disorder thoughts and behaviors. Help your loved one adjust social media settings so these types of post aren’t being suggested.
4. Stay in touch with the treatment team
As movement is added back in, loved ones can encourage patients to remain in outpatient therapy.
“Family members can help make sure the prescribed exercise plan is being followed,” Levinstein says. “They can also help communicate a patient’s challenges, progress and goals to everyone on the team—primary care doctor, dietitian and therapist—as long as they have the consent to do so.”
When to stop exercise in recovery
Often people with eating disorders can struggle with black-and-white thinking that leads to all-or-nothing behavior, making it difficult for them to achieve a balanced relationship with exercise. Family members can help make exercise helpful and reduce the chance of harm by watching for signs of relapse.
“Just like everything else in life, there is beauty in the grey space,” Levinstein says. “Different types of movement can serve different functions. But if disordered thoughts and urges are motivating the exercise behavior, activity that would often be considered ‘good’ can quickly turn into ‘bad’ or unsupportive behavior."
If exercise starts to feel overwhelming or triggering for your loved one, encourage them to talk with their treatment team and adjust their exercise plan accordingly.
Exercising during eating disorder treatment
During treatment at ERC, individuals often receive a structured amount of moderate activity during the day – if they do not have a history of excessive exercise and have been cleared by their treatment team. We monitor this closely during and after treatment for any significant changes in someone’s exercise-related attitudes and behaviors, such as exercising to compensate for food intake or exercising to cope with anxiety about changes in their body.
Make an exercise plan
We give individuals with a history of excessive exercise a detailed exercise plan during treatment. For these patients, the return to exercise is highly individualized and depends on several factors, including:
- Progress in recovery
- Medical status
- Exercise history
- Attitudes, thoughts and feelings about exercise
- Rationale behind the decision to return to exercise
During this process, the treatment team works closely with the individual, their loved ones and outpatient providers to develop a reasonable, sustainable plan that can be maintained after treatment ends. The individual can and should be involved in this decision making process. Exercise physiologists and recreation therapists can also be helpful in developing this plan.
Find help today
If you or your loved one has a complicated relationship with exercise, you can connect with one of our mental health professionals today or call us at (866) 622-5914 to get matched with the exact support you need.
Related Resources
Student Athlete Mental Health: Behind the Applause
Compulsive Exercise and Eating Disorders in Athletes
Anorexia in Males: What It’s Like to Have an Eating Disorder
Anorexia in Teens: A Guide for Parents & Caregivers
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Written by
Written by
Written by
Adee Levinstein, MS, RD, LD, CEDS-C