Two hundred more, I thought to myself as I huffed and puffed on the arc trainer, salty sweat dripping down my face. Two hundred more calories. I was more than an hour into my second workout of the day, and it was all I could do to keep my arms and legs pushing and pulling, over and over, taking me nowhere. My eyes repeatedly flitted back to the calorie count on the screen. Two hundred more until I get to 1,000 — 1,000 calories to cancel out the two cheeseburgers and the ice-cream sundae I had at lunch.
Calories in, calories out — that's what weight is, right? This is what the experts tell us over and over again. It's no surprise, really, that many people are developing distorted relationships with exercise — why wouldn’t it be okay to eat a whole pizza, as long as we burn it all off afterward? But, a growing amount of evidence has shown that this mindset can quickly become a slippery slope, and exercise can turn into something far more dangerous. Experts have coined the term “exercise bulimia,” or compulsive exercise, to describe the phenomenon of obsessively burning off the calories you consume.
What makes someone an "exercise bulimic"? Kristina Saffran, co-founder of Project HEAL, a nonprofit that helps provide treatment for teen girls suffering from eating disorders, says, "They will find time to exercise at any cost, often skipping out on social events or extracurricular activities to get in their daily run. They feel anxious or guilty if they are unable to exercise or if a routine is unexpectedly cut short." The key here, though, is the motivation behind it: As Saffran says, "They exercise primarily to control their weight or 'make up' for calories they have already eaten or are about to eat.”
Even as a child, I had always had a dysfunctional relationship with food, one that could best be described as compulsive. I didn't really know what it was to be hungry or full. I ate as much as I felt like eating, whenever I felt like it, until I couldn't eat any more. Looking back, it was because eating was one of the few things that made me feel good. I became addicted to the way pizza or bread or biscuits lit up my brain, making me forget, for just a moment, how unhappy I was growing up as the fattest kid in my class.
When I discovered exercise at 17, I thought I had found God. I had just come out as gay and was faced with the task of really looking at myself through the eyes of potential boyfriends and sexual partners. Needless to say, I was horrified by what I saw.
Determined to transform myself into something that someone might actually want to date, I decided it was time to lose weight. For me, who even then realised I had a big, scary, overwhelming problem with the way I interacted with food, going to the gym every day was a rational alternative to facing my real problem. So, I started working out. A lot.
Miraculously, once I got over the initial hump of being embarrassingly out of shape, I genuinely grew to love exercise. I found that keeping to a routine and pushing myself each day made me feel good about myself. As I chugged away on the elliptical and the pounds melted off, I basked in the glory of accomplishing something I never thought I could, of finally finding something in my life that I could be proud of. Working out was a source of constant empowerment that never let me down. Whenever I felt depressed or stressed out, I went to the gym, desperate for a hit of endorphins and some fresh self-respect. And, it made me feel better. Every time. It was like magic. In less than a year, I lost 60 pounds.
Of course, looking back, I can see that the compulsive part of me had found the perfect outlet. My beloved cardio machines, with their prominent displays telling me just how many slices of pizza my workout was worth, became a game, a way for me to push myself further and further every time. And, as my weight stopped being the issue, my eating habits got even more out of control. At some point, working out stopped being about making me feel good — instead, I went to the gym so I would be able to eat whatever I wanted. Unsurprisingly, I became prone to bingeing. Somewhere along the way, working out became a very real way of purging myself of the sins I'd committed the night before. Two hundred more calories on the arc trainer, I thought, until I got to 2,000 for the day. Huff, puff. Sweat. Repeat.
Awareness surrounding eating disorders has soared in recent years, but exercise bulimia has received only modest attention. While it's not yet considered its own category in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, as Dana Schmitt, a social worker specialising in eating disorders, notes: "I've seen it in patients suffering from bulimia, anorexia, and binge-eating disorders." In fact, she says, "many of my anorexic clients have stated that they exercise, rather than purge, because of an extreme disgust for the purge behaviour itself." As Saffran points out, “Numerous research studies have found a significant connection between compulsive exercise and eating disorders, with some studies suggesting that up to 38% of patients engage in compulsive exercise.”
Spending even a few minutes on any pro-ana forum makes this connection abundantly clear. One user recounts her experience: "I used to have bulimia and I would puke and workout and use laxatives and ugh....I hated it. So I stopped eating, stopped puking, stopped the laxatives....but I can't stop the exercise. I just have to do it every day. I had to cut back because I was working out eight hours a day and I was passing out a lot...and I haven't gone to the gym for more than six hours since then, but even still, it's an abnormal day if I don't go for at least 2 hours. I just never saw it as bulimia, you know? I mean, I'm just working out."
The problem, Saffran says, is that we're programmed to see exercise as a universally positive thing. "From a public-health standpoint, exercise is great and something that the majority of our population should engage in much more. Compulsive exercisers hear this same messaging about exercise being the great panacea for all evils, which makes it harder to question when their exercise becomes compulsive and out of hand."