Exercise in Eating Disorder Recovery

What to consider when re-introducing movement 

*Trigger warning – discussion of eating disorders and exercise. 

**Disclaimer – this is from the perspective of an Eating Disorder Dietitian who works with many athletes and active individuals. Not a medical doctor or exercise specialist.  

For some individuals who have an eating disorder, exercise can be very problematic and may need to be reduced or even stopped completely in different stages of recovery. In my experience, the re-introduction of exercise can be a slippery slope for the continued and maintenance of progress in recovery.  

In some cases, exercise has accidentally been used as a way to make food and the body feel easier. This is not uncommon as in the world of sport or the general culture we live in exercise has been inappropriately linked to our body and our worth. Part of this is because we understand exercise to be a healthful thing for individuals in general and it is often encouraged or praised when done regularly. However, there are times when exercise is not a healthful option and can be harmful, so this relationship does need to be assessed.  

Regardless of body size or weight, working on the relationship with exercise can be just as important as the relationship with body and food to achieve recovery.  

The reason this can be so messy is because joyful movement and exercise can actually soothe the brain in a positive way too. It can help with emotion regulation, stress management, cardiovascular health, bone health, and more. For those reasons, we want to find ways to re-introduce exercise, when it has been taken away during recovery, for those individuals who desire to return to it.  

8 Tips to Consider When Exploring Exercise Re-introduction in Eating Disorder Recovery

1. Medical clearance

This is the first hurdle, without medical clearance your recovery team will not want you to re-introduce exercise

2. Build a monitored re-introduction plan  

Not unlike having a meal plan at first, having an exercise plan helps to reduce the decision-making around movement in the moment and allows the return to movement to be completed in a controlled manner. 

This also allows the treatment team to make adjustments as needed alongside this systematic approach 

3. It will likely be slower than you would like and maybe even slower than what your body “could” handle  

This is to help you practice tolerating the discomfort of a potentially changing body yes, and also, different eating patterns in recovery without relying on something like movement to make the food feel “okay”  

4. Social movement or exercise with others is recommended first 

I believe that the kindest thing we can do is not leave you alone with your eating disorder thoughts and exercise as they can become an internal battle Very quickly. So, to help support you with this, we encourage walks with a friend, going to the gym together with a support person, easing your way back into team training, or playing frisbee in the yard with a sibling. This way you have supports in place and the distraction of others to help keep you out of the internal battle.  

Typically, I encourage my clients to avoid solo activities in the beginning. 

5. Keep everything out in the open, especially with solo activities when they are allowed  

Once you are cleared to start doing some solo activity, such as a run by yourself or an exercise class without your support people around, we still want to make sure that you are open about the amount of activity you are doing.  

Anything that feels “hidden” from others, provides the opportunity for the ED thoughts to get louder and for the amounts to become more of an internal negotiation  

And anything hidden, provides the opportunity for shame to show up which is absolutely something we don’t want to be adding to in the recovery process.  

6. Make sure you are fuelling appropriately (What you thought I would forget about food?)  

Depending on your phase of recovery, your body’s needs and your level of activity, you do need to ensure that you are adequately fuelling to be able to continue to include exercise into your weekly routine.  

Remember, we eat enough to allow for exercise, we do not use exercise to earn our food.  

7. Explore the reasons “why” 

• Are you moving “so that you can eat?” Or because you feel like you have to?  
• Are you moving because you enjoy being with others in this way or how capable it makes you feel in your body?  
• If it doesn’t feel good or you feel too tired, can you stop the workout? Or can you choose rest over activity in those times of fatigue?  

8. Keep checking in on your relationship with activity  

Well into recovery, it is a good idea to keep coming back to your whys of activity. This may be a monthly discussion with your therapist or a quarterly check-in with your spouse, no matter how you do it, don’t let it slip from your awareness.  

If you’re curious about how exercise plays into your recovery journey and want to explore this further, consider discussing it with a clinician, such as an ED-trained dietitian.  

Learn more about exercise and eating disorders: