Eating disorder treatment is a challenging endeavor. It pushes individuals to face many of their greatest fears while refraining from using eating disorder behaviors that are often used to cope with related stress and anxiety. For many patients, such as recreational and competitive athletes, the healing process can also include confronting complicated mindsets, beliefs and habits regarding exercise. Practitioners treating this population may often feel confused about the role of exercise within eating disorder treatment and may disallow the activity altogether. Although exercise restriction is appropriate and medically necessary for some, it can lead many individuals to feel dissatisfied with the recovery process.
Luckily, emerging research, observations, and practice at programs such as the Walden GOALS Program and the Victory Program at McCallum Place, offer interventions specifically designed to help individuals recover from eating disorders while healing their relationship with physical activity.
While exercise restriction can temporarily decrease overall immediate risk factors, for many clients, this generates new problems. For instance, how does an athlete or avid exerciser understand the appropriate use of exercise for health benefits while recognizing when exercise is becoming a problem? How does one develop healthy attitudes and exercise behaviors? How does one develop body awareness and best understand various physiological states, injury, and pain? How does one develop an enjoyment of exercise and exercise for fun as opposed to a tool for maintaining an eating disorder? Lastly, how does one understand their exercise identity and identify factors related to overtraining and burnout? For many patients, failure to address these issues during treatment can increase dissatisfaction and risk of relapse after discharge.
Fortunately, research from McCallum Place and programs at Walden Behavioral Care present viable solutions to this conundrum. To accomplish these tasks, Walden and McCallum employ teams trained in specific knowledge related to eating disorders, exercise, nutrition, psychology and physiology to help develop exercise programs that synergize with eating disorder treatment. Research and experience indicate these programs are safe as long as nutritional needs are met and the team employs a thoughtful evidence-based approach. Utilizing guidelines, such as those outlined by Ron Thompson’s team’s research for the American College of Sports Medicine, individuals can experience a wide range of benefits including decreased obligatory exercise attitudes and behaviors, reduced drive for thinness and bulimic symptoms, decreased body dissatisfaction, increased weight gain in individuals with anorexia nervosa, increased strength, reversed cardiac abnormalities in individuals with severe anorexia, and improved overall quality of life. When implemented correctly, engaging in evidence-based exercise programs during treatment exhibits the possibility of transforming physical activity from a tool for the eating disorder to a possible form of medicine.
If you or someone you know is concerned about problematic exercise or are interested in introducing or reintroducing exercise in eating disorder recovery, do not despair. There is hope. Walden and the athlete specific GOALS program offers a wide range of services that can help you or someone you know understand the role exercise can play in your recovery. To learn more be sure to check out our Walden GOALS Program.
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
Matt Stranberg is a licensed registered dietitian nutritionist and certified strength and conditioning specialist. He is a nutritionist and exercise science advisor for the Walden GOALS program. Matt devoted the early part of his career to refining the art of training elite collegiate and professional athletes. In graduate school, he developed expertise in nutrition, behavior change and eating disorders. Matt now devotes his practice to translating nutrition and exercise science into practical solutions. As a lead member of the GOALS team, Matt is known for his dedication to educating and empowering athletes of all backgrounds to facilitate a full and meaningful recovery from disordered eating. Matt holds a B.S. degree in Kinesiology from the Honors College at The University of Massachusetts Amherst, a master’s degree in Applied Exercise Physiology and Nutrition from Columbia University and was a dietetic intern at Boston’s Brigham and Women’s Hospital.