Exercise and Eating Disorders (Part 1)
Exercise is often promoted as something we should do to improve our physical health, boost our mood and feel good in our bodies. Movement can be enjoyable, social and an important part of everyday life.
However, when exercise becomes driven by guilt, anxiety, body dissatisfaction or a need to compensate for food, it can become part of an eating disorder.
For some people, exercise starts as something they enjoy but gradually becomes something they feel they have to do. Rest days can feel uncomfortable, eating certain foods creates pressure to exercise, and missing a workout can lead to feelings of failure or distress.
In my work as a dietitian, I often hear about how exhausting this can be. Exercise might look like a positive habit from the outside, but internally, the pressure to exercise can feel relentless.
So, how do you know when exercise has become unhealthy? And how can you support your body with adequate nutrition if you enjoy being active?
At The Nourish Club, we believe movement should be something that supports your wellbeing, not something you use to punish your body or earn your food.
What Is Compulsive Exercise?
Compulsive exercise is when physical activity becomes rigid, excessive or difficult to control, even when it negatively affects your physical health, mental wellbeing or everyday life.
It can occur alongside eating disorders, but you do not need to have a diagnosed eating disorder for your relationship with exercise to be concerning.
Compulsive exercise is not defined by how many hours you spend at the gym or how far you run. Someone can exercise for relatively short periods and still experience significant distress, guilt or anxiety around movement.
The important question is not simply how much are you exercising? but also why are you exercising, and how do you feel when you cannot?
Red Flags: When Does Exercise Become Obsessive or Compulsive?
It can be difficult to recognise when exercise has become unhealthy, particularly when our culture often celebrates discipline, consistency and pushing through discomfort.
Here are some signs that your relationship with exercise may need attention.
1. You feel you have to exercise, even when you don't want to
You might find yourself exercising because you feel you have no choice, rather than because you genuinely want to.
You may feel anxious, irritable, guilty or restless when you cannot complete your planned workout. You might also struggle to take rest days, even when you are exhausted, injured or unwell.
I often hear in clinic that the “head noise” can become incredibly loud, harsh and uncomfortable when someone considers skipping exercise. Thoughts about being lazy, losing control or changing their body can become difficult to switch off.
When this happens, exercising may feel less like a choice and more like the only way to quieten those thoughts or relieve the anxiety. While exercise might temporarily reduce this distress, it can also reinforce the cycle, making it even harder to rest the next time.
2. You exercise to compensate for food
One of the most significant warning signs is feeling that you need to burn off calories after eating.
This might look like:
Going for a run after eating a meal or snack you consider 'unhealthy'.
Increasing your workout after eating takeaway, dessert or other foods you feel guilty about.
Skipping social events because you have not been able to exercise.
Feeling that you need to earn your dinner by completing a workout.
Restricting food if you cannot exercise to compensate for what you have eaten.
Food does not need to be earned, and exercise is not a requirement for deserving to eat. Your body needs nourishment every day, regardless of whether you exercise.
In clinic, I often explore the thoughts that come up after eating certain foods. For some people, eating a takeaway meal or dessert can trigger an overwhelming urge to exercise, even if they are tired or have already completed a workout that day.
The distress is not necessarily about the food itself, but the meaning attached to it and the fear of what might happen if they do not compensate. Over time, this can reinforce a cycle of food guilt, exercise and increasing rigidity around eating.
3. You struggle to rest
Rest is an essential part of physical recovery. However, if you experience an eating disorder or compulsive exercise, rest can feel frightening or undeserved.
You might tell yourself that you can only rest when you are sick or injured, or feel compelled to replace a missed workout with extra activity the following day.
You may also find yourself exercising secretly, adding extra sessions or feeling unable to reduce your activity despite advice from your healthcare team.
I often hear people describe feeling as though they have to “make up for” a rest day. Rather than enjoying the opportunity to slow down, they spend the day feeling guilty, planning their next workout or worrying about how their body might change.
Rest can feel particularly challenging when exercise has become closely tied to self-worth or a sense of control. Learning to rest without responding to every uncomfortable thought can be an important part of recovery, and it is something you can work towards with the right support.
4. Exercise takes priority over other parts of your life
Exercise may be becoming compulsive if it regularly interferes with your relationships, work, study or social life.
For example, you might:
Cancel plans because they conflict with your workout schedule.
Feel unable to go on holidays without access to a gym.
Spend significant time planning exercise or worrying about missed sessions.
Avoid eating out because you cannot predict how much exercise you will need afterwards.
Continue exercising despite injuries, illness or significant fatigue.
Sometimes, people do not initially recognise how much exercise is affecting their lives because it has gradually become part of their routine.
A helpful question to ask yourself is whether exercise is adding to your life or whether other parts of your life are increasingly having to fit around exercise.
5. Your self-worth depends on exercise
Consider whether completing a workout determines how you feel about yourself that day.
Do you feel productive, worthy or successful after exercising, but lazy, guilty or disappointed when you rest?
Exercise can become particularly problematic when it is tied to body image, weight control or the belief that you must constantly change your body to be acceptable.
In my experience, these patterns can be difficult to untangle because exercise is often praised by others. You might receive compliments for being disciplined or consistent, while nobody sees the anxiety, guilt or self-criticism happening behind the scenes.
You can enjoy being active without needing to prove your worth through it. Your value as a person does not change depending on whether you complete a workout.
6. You ignore physical warning signs
Exercising through dizziness, weakness, persistent fatigue, pain or injury can place your body at risk.
Other warning signs can include feeling unusually cold, recurrent injuries, changes to your menstrual cycle, reduced libido, difficulty concentrating or taking longer to recover between sessions.
These symptoms are not always caused by exercise or inadequate nutrition, but they warrant medical assessment, particularly when combined with high exercise levels or restrictive eating.
It can be difficult to recognise these signs when eating disorder thoughts are encouraging you to keep going or dismiss what your body is telling you. Feeling exhausted does not mean you need to become fitter or more disciplined. It may mean your body needs more nourishment, recovery or medical support.
You do not need to experience every warning sign for your relationship with exercise to deserve support. If exercise is causing distress or interfering with your ability to nourish and care for yourself, it is worth exploring.
Exploring Your Motivation: Why Are You Exercising?
Not all exercise motivated by health, fitness or appearance is automatically problematic. Motivation can be complex, and it is possible to have several reasons for wanting to move your body.
However, understanding your motivation can help you recognise when exercise is being influenced by eating disorder thoughts.
Try asking yourself the following questions:
Would I still want to do this activity if it did not change my weight or appearance?
How do I feel when I need to cancel a workout?
Do I feel I need to exercise after eating a particular food?
Can I adjust my plans if I am tired, injured or unwell?
Am I choosing to exercise, or do I feel compelled to do it?
Does exercise add enjoyment to my life, or is it taking me away from things I value?
There are no perfect answers to these questions, and you do not need to feel positively about every workout. The aim is to notice patterns without judging yourself.
For some people, exercise provides community, enjoyment, stress relief or a sense of connection with their bodies. For others, it may have become a way to manage anxiety, cope with difficult emotions or feel in control when other parts of life feel uncertain.
In clinic, I encourage people to look beyond the behaviour itself and explore what exercise is doing for them emotionally. Is it helping them connect with others, enjoy an activity or feel present in their body? Or is it helping them escape feelings of guilt, anxiety or fear about food and weight?
Sometimes, exercise can serve both purposes. The goal is not to judge yourself for your motivations, but to understand them and gradually build more flexibility.
If exercise has become your main way of coping with distress, working with a psychologist and dietitian can help you develop additional strategies that do not depend on physical activity.
Why Is Over-Exercising Without Adequate Nutrition Dangerous?
Your body requires energy not only to move, but also to keep your heart beating, regulate temperature, support brain function, maintain bones and muscles, produce hormones and repair tissues.
When you exercise regularly but do not eat enough to meet your body's needs, there may not be sufficient energy available to support all these functions.
This is known as low energy availability. When it becomes prolonged or problematic, it can contribute to Relative Energy Deficiency in Sport (RED-S), which affects people of all genders and activity levels.
Importantly, you do not have to be an elite athlete or have a low body weight to experience the effects of inadequate fuelling.
Potential consequences include:
Bone health: Reduced bone formation, lower bone density and increased risk of stress fractures.
Hormonal health: Menstrual changes, missed periods and reduced reproductive hormone function.
Muscle recovery: Reduced muscle repair, persistent soreness and impaired training adaptations.
Energy and concentration: Fatigue, dizziness, difficulty concentrating and reduced day-to-day functioning.
Immune function: Greater susceptibility to illness and slower recovery.
Cardiovascular health: Changes in heart rate, blood pressure and other cardiovascular functions, particularly when malnutrition is severe.
Mental wellbeing: Increased irritability, anxiety, low mood and difficulty managing emotions.
Under-fuelling can also reduce exercise performance. You may find that your usual workout feels harder, your strength or endurance declines, or you struggle to recover between sessions.
This can create a difficult cycle: you feel tired and your performance declines, so you try to exercise harder or more often, while continuing to eat too little to meet your needs.
I often discuss with clients how difficult it can be to recognise under-fuelling when the focus is on completing workouts or maintaining a particular routine. You might feel proud of pushing through fatigue, but your body may actually be struggling to meet the demands being placed on it.
Adequate nutrition and appropriate rest are essential for recovery, health and performance.
If you are experiencing fainting, chest pain, significant palpitations or severe weakness, seek urgent medical assessment. Stop exercising while awaiting assessment if you are experiencing concerning symptoms.
How The Nourish Club Can Help
At The Nourish Club, we understand that eating disorders can affect far more than what you eat. They can influence how you move, how you feel about your body and how much control you feel you need over your everyday life.
You do not have to wait until exercise feels completely out of control to ask for support.
As an eating disorder and neurodiversity-affirming dietetic practice, we provide individualised nutrition support for children, teenagers and adults experiencing eating disorders, disordered eating and difficulties with food and body image.
We can work alongside your existing healthcare team to help you:
Develop a more consistent and flexible approach to eating.
Understand your nutritional needs and learn how to fuel your body adequately.
Explore food rules, exercise-related guilt and compensatory behaviours.
Support recovery from under-fuelling and the physical effects of inadequate nutrition.
Build a relationship with food and movement that prioritises your wellbeing rather than punishment or control.
Our approach is weight-inclusive, non-judgemental and tailored to your individual circumstances.
You deserve to eat without having to earn it, rest without feeling guilty and move your body without fear.
If you would like support with your relationship with food, exercise or body image, we would love to help.
Book an appointment with The Nourish Club
Visit The Nourish Club to learn more about our services and book an appointment, with clinic appointments in Newcastle and telehealth appointments available Australia-wide.
You do not have to navigate recovery alone.