Do I have an Activity Disorder?

I get really nervous to talk about exercise, specifically over-exercise/compulsive exercise. I think it can be more difficult to pick up on, can be met with extreme resistance when challenged, and even harder to overcome than disordered eating behaviors. As a nutrition professional with additional trainings in anatomy, movement, Pilates, and Eating Disorders, I whole-heartedly believe that exercise behaviors must be addressed when unpacking eating behaviors.

I often see individuals who claim to be Intuitive Eaters, who embrace the “all foods fit mentality” only because they find safety in over-exercise. Whether they are aware of it or not, many people feel the need to compensate for unconditional permission to eat by making sure to always “get their workout in’’. I see a lot of red flags that are concerning to me because they keep a person stuck in their eating disorder. While they may seem disciplined, these behaviors do not foster whole-person health:

• When a client comes to me stating that they can’t function without running 6-7 miles each day, that’s a red flag.

• When a client sacrifices sleep to exercise over and over, that’s a red flag.

• When a client exercises through illness or injury, that’s a red flag.

• When a client can’t imagine vacationing without scheduled exercise, that’s a red flag (I’ll bring this up later.)

• When a client feels the urge to exercise harder because of something they ate or want to eat later, that’s a red flag.

I shouldn’t feel nervous to talk about this subject because I unpack it with clients, continue to learn about it, discuss it with my peers, and have my own less-intense experience with it. Even though it is a tricky and sensitive topic, it is incredibly important to be aware of because it causes harm. Let’s dive in!

I’m currently reading The Eating Disorder Sourcebook by Carolyn Costin with a peer supervision group. In the book, she addresses over-exercise or compulsive exercise as an “activity disorder’. This term might be outdated but I love it, so that’s the name I’ll be using here. It just makes sense.

“If dieting taken to the extreme becomes an eating disorder, exercise taken to the extreme may become an ‘activity disorder’.” (Yates 1991)

I first fell in love with exercise when I was a junior in high school. Even though I danced, I started attending group fitness classes at my local gym. I would often do 2 classes and go to dance practice. I lost weight my senior year and received a lot of attention for it. In college when I was studying nutrition, I started exercising for 1-2 hours every day – this is disordered. During fall semester of my junior year, I lost my period. I knew I was doing too much and cut back. You can read more about that here.

When I had babies and toddlers I was an avid, 6am exerciser. So many mornings I’d nurse a baby and head to the gym, run, burpee it up even when I was exhausted. I put a ton of pressure on myself because I believed that I wouldn’t be taken seriously as a nutrition professional if my body didn’t look a certain way. I also felt the need to “get it over with” and “get it in” while I used it as an escape. As someone who deals with ADHD, depression, and anxiety - I thought I needed a specific amount to stay sane. Turns out I don’t need as much as I thought I did.

I want you to understand that you don’t need as much as you think you do either.

Yes, exercise is a very good thing. I will get countless DM’s and messages telling me, “But exercise is so good for us!” Absolutely, there are so many benefits to exercise. We know them very well because they have been drilled into our heads. For that reason, I am not going to mention them here.

(the human body is meant to move)

We’ve been told that we need to spend X amount of time doing cardio with X amount of that time being “vigorous”. Plus, X amount of time strength training. We have watches, monitors, and trainers telling us what we have to do to be fit or to reach our goals. It’s too much and it takes away from our ability to listen, trust, and respect our bodies.

How much time you spend moving your body is up to you. Although, I’ll just say that you definitely don’t need over an hour. And mostly 30 minutes is just enough. In fact, that’s the time frame in which we see all the benefits that exercise gives us. You can also just aim to move your body throughout the day.

What movement you choose to do is up to you too. But there is a point when a good thing, a positive form of self-care becomes disordered.

“Health and fitness go by the wayside, and exercise becomes all-important – even if the person is exhausted or injured, or when exercising means missing out or losing something else. [There] has been a rise in the number with exercise disorders. These are individuals who define themselves through their overinvolvement in exercise to the point where instead of choosing to participate in their activity, they become “addicted” to it – continuing to engage in it despite adverse consequences” – Carolyn Costin

As a side note, using the word “addiction” when talking about food and exercise doesn’t sit well with me. I believe that you can develop a dependence on exercise - using it to cope with difficult emotions and having withdrawal symptoms when you need to cut back. The behavior can be addictive-like. Which makes it so hard for the over-exerciser to rest.

Activity Disorder is rampant among athletes. A study done on female track runners at Stanford University, clear back in 1984 forced the researchers to go outside of the team for a control group as they couldn’t find a female on the team who was menstruating.

If a woman loses too much weight through intense physical activity and eating below their energy requirements, she will develop the Female Athlete Triad – she will stop menstruating and lose bone density, making her susceptible to stress fractures. To be clear, some women who have an activity disorder might still have a period, but they may not ovulate.

We tend to congratulate over-exercisers, deeming them disciplined and high achieving. In fact, the world thought Kara Goucher was incredible when she raced just 7 months after giving birth. She is incredible. But she admits her body wasn’t ready for it.

For those with Activity Disorder, they seem unable to NOT exercise. And is not limited to just exercise. Many have a hard time resting or sitting still, they go all day long

Signs of Activity Disorder:

-          They have a high level of activity and are uncomfortable with rest & relaxation

-          They depend on activity for self-definition and mood stabilization

-          They are intensely driven to activity and resistant to change

-          They overuse their body to produce the psychological effects of deprivation (may not be rigid with food)

-          They are highly functioning

-          They are extremely committed and pride themselves on putting mind over matter

-          They value self-discipline

-          They use activity to soothe, control, and maintain self-esteem

-          They have symptoms of overtraining syndrome and exercise anyway:

o   Fatigue

o   Reduction in performance

o   Decreased concentration

o   Inhibited lactic acid response

o   Loss of emotional vigor

o   Increased compulsivity

o   Soreness/stiffness

o   Decreased maximum oxygen uptake

o   Decreased blood lactate

o   Adrenal exhaustion

o   Decreased heart rate response to exercise

o   Hypothalamic dysfunction

o   Decreased anabolic (testosterone) response

o   Increased catabolic (cortisol) response (muscle wasting)

Many professionals recommend complete rest for several months when the activity disorder is severe. This is hard for a highly active person. I truly believe that when you are used to getting a certain level of endorphins from exercise, cutting back is hard. To this person, it can feel like they are going crazy or giving up on themselves. This challenges their identity. And because we live in a culture that idolizes these behaviors, it makes cutting back even harder.

We live in a society that places a high value on achievement, athleticism, thinness, and high volumes of physical activity. When an individual feels attached to these values, it’s difficult. I want to validate that. But rather than tying your whole identity into how hard you move your body, aim to discover who you are outside of this.

If you or someone you love fits the criteria for an Activity Disorder, please reach out for support. This is incredibly hard to combat on your own. Until you are ready, try shifting your language. Instead of saying, “exercise” or “workout”, try “movement”. Find gentle and enjoyable ways to move your body. If you need to take a complete break, do it. That could be the very thing that redefines movement for you. Rather than using it as a form of punishment, compensation, or competition - it can be enjoyable, pleasurable, and fun. Rather than feeling nervous about not having access to a gym on vacation or during a global pandemic, you can find new ways to move your body. Or better yet, embrace rest.

And speaking of vacations, a good way to check your relationship with exercise is to see if you can go on one without planning in a formal workout. I even dare you to not pack your running shoes. Could you do that? What feelings, thoughts, and emotions arise when I challenge you with this? Do you feel the need to argue back, “But what is wrong with exercising on vacation?” To that I say, “Nothing. But could you do it?” It doesn’t mean that you won’t move your body or try something like paddle boarding, hiking, or skiing. It means that your vacation isn’t planned around how you will fit in a workout. You can hit the gym when you get home…or not. Because you are not defined by how, how much, or how hard you move.