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What is Exercise Bulimia?

written by: Dr. Kristie Leong • edited by: Elizabeth Wistrom • updated: 11/7/2010

Exercise bulimia is a less commonly recognized form of bulimia. Find out what causes people to exercise compulsively - and whether this condition can be treated.

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    Most people envision a bulimic as a person who forces themselves to vomit after a meal - to control their weight. There is another type of bulimia, however, that is just as mentally and physically damaging. It is called exercise bulimia. People with exercise bulimia exercise compulsively - to the point where it’s no longer healthy, but harmful. They do this as a means of controlling their weight and their emotions.

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    The Characteristics of an Exercise Bulimic

    Exercise bulimia shares similarities with eating disorders such as anorexia and bulimia. With exercise bulimia, a person becomes so focused on working out that it takes over their life, and work. Family, and social obligations become secondary to the constant and overwhelming need to work out.

    People with exercise bulimia exercise even when they’re sick or injured and feel a deep sense of guilt when they’re forced to take a day off. They often exercise alone so no one will know they're working out four or five hours at a time. For some exercise bulimics, the goal is to burn calories and prevent weight gain, while for others it’s a way to deal with negative feelings such as anxiety or depression.

    Unfortunately, exercise bulimics soon find themselves with physical problems as a result of their overzealous exercise program. People who exercise compulsively are more prone to osteoporosis, fertility problems, infections, overuse injuries, and excessive fatigue. The constant pressure to exercise combined with exercise-induced exhaustion can lead to depression and anxiety. It can even bring on or aggravate an existing eating disorder since an exercise bulimic may stop eating or purge to avoid weight gain when they’re too exhausted to exercise.

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    What are the Causes?

    No one knows exactly what causes exercise bulimia, but the majority of people who suffer from it have low self-esteem, are perfectionists, and may wrestle with anxiety or depression. They turn to exercise in an attempt to control their body and their emotions, sometimes with tragic consequences as they experience the health repercussions of this disorder. Some studies show that people with eating disorders and exercise bulimia have imbalances of serotonin in their brain, which may contribute to their symptoms. It’s not clear whether this imbalance actually causes the compulsive need to exercise or whether it occurs as a result of it. Most likely, both biochemical and environmental influences contribute to the problem of exercise bulimia.

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    Can it be Treated?

    Exercise bulimia can be successfully treated once a person suffering from this disorder admits they have a problem and is willing to seek help for it. At this point, it’s best to enlist the help of a therapist who specializes in exercise bulimia and eating disorders. Both cognitive and behavioral therapy can be effective for reducing the compulsive need to exercise, but it may take months or even years to see a full recovery. Since people with eating disorders and exercise bulimia may have imbalances in serotonin levels, they may also respond to anti-depressants that increase serotonin levels.

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    The Bottom Line?

    Exercise bulimia can have serious health repercussions. Fortunately, once the problem is recognized and acknowledged, most can be helped with counseling and, possibly, short-term use of medications.

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    References

    WebMd.com. “Compulsive Exercise: Are You Overdoing It?"

    Merck Manual. Eighteenth edition. 2006.

    Psychiatry Res. 2009 Jan 30;165(1-2):154-62.