Episode 322: One of the most common questions I get from people is, "What are your thoughts on exercise in recovery?" In this episode, I answer this question by looking at the fears connected to changing exercise habits, why I believe it's essential to have a break from exercise and how and when to reintroduce it, is stopping exercise the first change you need to make, do you have to go cold turkey or can you reduce it over time, how to reframe this change and much more.
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Chris Sandel: Hey! If you want access to the transcripts and the show notes and the links talked about as part of this episode, you can go to www.seven-health.com/322.
Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist and a coach and an eating disorder expert, and I help people to fully recover.
Before we get started with today’s show, I just want to announce that I’m taking on new clients. If you have been living with an eating disorder, irrespective of how long this has been going on – whether it’s been a year, whether it’s been multiple decades – and you want to reach a place of full recovery and you want to get out of the state that you are currently in and the life that you’re currently leading, then I would love to help.
If you want to send an email to info@seven-health.com and just put ‘coaching’ in the subject line, then I can send over the details of how we can work together. I’ve been working with clients for 16+ years now and I’m very good at what I do. I very much understand eating disorders and what is required as part of recovery and how to support someone to get to that place. So if you want to reach a place of full recovery, even if you’re feeling ambivalent about that, even if it feels like “That’s just too big a thing, I don’t know if I could ever get there”, then please still reach out and we can have a conversation and figure out if the way that I work and the way that I think about recovery is appropriate for you.
So, on with today’s show. This one, I’m going to be talking about exercise and recovery. Over the last couple of weeks, I’ve had a number of people email in out of the blue saying, “Hey, have you got a podcast on this?” or “What are your thoughts around exercise and recovery?”, and I realised this isn’t a topic that I’ve covered in any great detail on a standalone podcast. It’s definitely come up in conversations I’ve had with people, but in terms of me just doing a real chunk of time on this topic, it’s not something that I’ve done.
So I wanted to do it, and this morning, as I’ve started to put together the notes for this, there’s the realisation of, there is a ton that I could talk about in this area. What I think will happen is that there’ll probably be a number of podcasts connected to exercise and recovery, and the way that I’m thinking about this one is this is an overview of lots of different areas. This is the bigger picture connected to this, and then I can go into a lot more detail on some of these topics in other podcasts.
I’m going to ask you, if there’s things that I miss, if there’s things that I say and you think “Hey, I want to know more about that area”, then please send an email to info@sevenhealth.com and just ask whatever it is, and I can then include it on the next episode or one of the episodes that I do on this topic, because I think it is a really big topic.
I also think it’s so common with so many of the people I work with. It’s more of a rarity that I’m working with someone now where exercise compulsion isn’t part of the eating disorder picture. I think it’s something that so many people are wanting to know about, so many people are struggling with, so this is the first of two or three or four podcasts on this topic. It won’t necessarily be over the next handful of weeks that they’ll come out, but over the next handful of months, I do want to focus on this topic because I think it’s something that I have a lot to say on and I think is really important as part of recovery.
00:03:43
What I will say as a starting point is, as I mentioned, I think this is a really common thing. Compulsive exercise is pretty prevalent with nearly everyone that I work with, and I think of this as being a problem irrespective of the total number of hours that someone is doing the exercise or the amount of days they’re doing each week. I think there can be this idea of, “Well, it’s only X number of hours or X number of minutes so it’s not really a problem” or “I used to be doing way more than I’m doing now. I’ve been able to pull it down, so it’s not a problem.”
Really, from my perspective, even if you’re doing what we think of as a small amount, it can still be a problem because there is this compulsion that is connected to that. It’s being able to break that compulsion and actually rest and do all of the repair work that is really important.
I’ll also say with this, we can think about this as not just what we think of as exercise. I think also, what often happens is people will use the thinking process of “I used to be doing high-intensity exercise and now I’m not really doing that anymore. I’m only doing walking.” Or “I’m not really doing that much, but yeah, I’m cleaning the house quite a lot each day.” When I’m thinking about this, even if I’m using the word ‘exercise’, I’m thinking about exercise, I’m thinking about movement. I could even be thinking about standing. If someone’s spending an inordinate amount of time standing each day, or even if it’s not a huge amount of time each day but there’s this inability to sit down, or “When I sit down, I feel so anxious and overwhelmed and I feel like I’m being lazy or unproductive” or any of these things that come up, then this is still something to be working on.
When we’re thinking about exercise compulsion or issues in this area, the spectrum goes from the stuff we all think about as exercise or high-intensity exercise through to the things we think of as fairly mundane low-level movement that we wouldn’t even put into the category of exercise.
00:05:49
I want to also say as we start this out that it’s very normal to feel scared or anxious about taking a break or making changes to your exercise. It’s one of the things that people fear the most when we’re talking about making changes. I think it’s actually one of the things that repairs the quickest in terms of people taking a break and then they’re able to get over that quickly in terms of the first week or two weeks is where it’s really hard, and then it starts to lessen. I think people’s ability to take a longer break is easier than they imagine it’s going to be, and it’s easier than other changes. But before making any of these changes and before doing anything, there’s so much fear and anxiety around it.
And when I think about where these things are coming from, one, it’s about the fear – the fear of weight again or the fear of losing fitness or the fear that “If I stop, I’ll never start up again” or the fear that “When I do stop, I feel so lazy and unproductive, and it feels so hard to do that.” It can be this fear connected to “This is my coping strategy. This is how I deal when things are feeling uncomfortable, or this is how I deal with my day to day. I fear if I lose this coping strategy, I don’t know how I’m going to be.”
There can be a fear of “I’m losing my identity. Everyone knows me as the fit one. Everyone knows me as the runner. Everyone knows me as whatever it is connected to the exercise or the movement I do”, so there’s this fear of “I’m going to lose that identity, and without this, who am I going to be?
There can be a fear of “How am I going to fill this time? I spend so much of my time doing this thing, or this is how I start every one of my days. I just don’t know how I would be able to cope if this thing is removed, and I don’t know how to spend my time outside of this.”
Your brain is really fighting this. What happens with an eating disorder is your brain, your nervous system starts to catalogue certain things as a threat. Eating certain foods is then felt as if there is this real threat, and it changes your breathing, it changes certain hormones in your body. It’s the same as someone putting a spider in front of you where you’ve got a fear of spiders. There is this body response that takes over.
This is what happens connected to the thought or the practice of taking time off exercise or stopping or reducing. The body then has this threat-like response that is turned on, so there is then this fear of “This is what’s going to happen. And when I take this break or I make this change and then I have this body response, that amps up the fear because I’m now feeling all of these things. I’m feeling that my chest is tighter or that I can’t breathe properly or I’m so worried.” So there’s all of this actual response. It’s not just the way someone’s thinking about this; it’s this whole-body response that happens connected to this. It feels unsafe for someone to stop, and obviously there’s a real fear around that.
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What often happens with this is that people then use logic connected to this and connected to why they don’t want to stop exercising. There’s the idea that exercise is healthy, so that’s why I shouldn’t be stopping exercise” or that “Being fit is really healthy, and that’s why I shouldn’t be making changes to my exercise.” There can be the idea that “This is good for my mental health, and it feels like if I stop this, my mental health gets worse, so this is why I need to keep doing it.” It could be “When I do take a break, I feel worse” – and that could be worse for mental reasons, it could be worse for physical reasons. Just “When I stop this, in the short term I feel worse, so it seems illogical that I should be stopping this thing.”
There can be all of the messaging that we hear from the government or from health groups or that we see on Instagram or whatever it is, talking about the importance of ‘getting in your 10,000 steps’ or the messaging around being sedentary or that ‘sitting is the new smoking’ and all the messaging that we get. So people are then able to say, “That’s why I don’t want to stop.”
It’s very common with an eating disorder for logic to be the reason why I keep doing certain behaviours and why I shouldn’t be stopping this thing. Often underpinning that logic is the fear piece that I was talking about, but if I’m able to use logic, I’m able to explain this in a way that seems like “Actually, me continuing to do this exercise is the better thing.” It gets me off the hook by being able to use that logic.
The thing that I would say connected to this logic piece is that we need to be thinking about health in a very context-specific way. There is universal health advice that is given out, but actually, we need to look at your unique situation. And yes, it might be true for someone that they do need to do a little more walking or it could be useful for their mental health to do more movement. It’s not that none of that can be true, and I think that exercise is healthy.
But the thing that makes exercise healthy is that the body is able to benefit and adapt from that exercise. You don’t get healthier just from doing exercise. You get healthier from exercise because the body is able to repair from that exercise, because there’s enough energy coming in for that; the body is able to repair because it’s getting enough rest by you giving it that ability to rest. And the body then adapts from that exercise, and that’s what leads to better health.
The problem for everyone with an eating disorder, or the vast majority of people with an eating disorder, with the exercise they’re doing, is it’s actually not enhancing health. It’s making health worse. In the context of that person’s situation, exercise is not a healthy thing to do. It’s not enhancing the quality of their life or their fitness or their health. It’s making things worse.
This is the thing that I always come back to. It doesn’t matter about the public messaging; it doesn’t matter what’s right for your neighbour or your mum or other people in your life. It’s, what is right for you at this moment? And at some point in the future, that will or may change, but right now we need to be looking at, what’s important for your health given the context of what is going on?
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What I want to do is look at why it can be important to take a break from exercise in recovery. I’ll go through lots of different reasons for this, and then I’ll look at other parts connected to how you do this, do we need to stop all at once, all of these things. But I want to explain, just to start with, why I think it’s important to take a break from exercise – and again, exercise can mean lots of different things, all kinds of movement as part of recovery.
One is we’ve got to look at this from a physical standpoint. When we’re looking at eating disorders, there are lots of different reasons for why eating disorders are occurring. I think of them as being biopsychosocial, meaning there’s a biological component, there’s a psychological component, and there’s a social component (socialisation and the messaging and all of the stuff we get in our environment).
But if I’m thinking from a biological standpoint – one, someone having the genetic predisposition to develop an eating disorder, but two, the thing that’s really driving this and turning this on is someone getting into a lower energy state. The body not getting enough energy that it needs and that then turning on the eating disorder. What happens as time goes on is that people get more and more into an energy debt state, and that means less repair is happening. It means the body’s having to turn off and turn down certain functions.
The more that that occurs, the more the eating disorder thoughts are coming up, the more that there are worries about this, the harder it becomes, and someone then gets into this place where they’re avoiding doing things that are uncomfortable, and taking time off exercise is one of those things.
So from a physical standpoint, taking a break from exercise allows energy that would otherwise be used as part of exercise to be channelled in the direction of other things as part of the repair or healing for the body. Some of that in the very beginning is that it’s going to be very focused on weight gain. That’s the most important thing to start with as part of recovery because the body is pretty unsure of “When is this famine going to end? What’s going to happen next week? What’s going to happen next month?” So to begin with, the first thing the body wants to do is store energy, and that gets stored as weight.
But as time goes on and as the body feels more comfortable that more energy is going to be coming in or more rest is taking place, then it can start to channel more of that extra energy towards repair. But in the beginning, it’s going to focus a lot more on bringing in and putting on weight to store stuff because it doesn’t know what’s going to happen in the short term and in the long term. From an energy debt perspective, it’s really important to be taking that time off exercise so the body can start to channel that extra energy into the repair process.
It can be really important for injury recovery. Again, this is part of repair, but so often, what I find with people – they’re either exercising through injury, like “I have this issue with my foot or I have this thing going on with my back, but I’m just continuing on with exercise”, and maybe they’re doing something slightly different so that’s not feeling like it’s so much of a problem, but they’re still continuing on with this. So it’s taking a break so that the body can genuinely heal and recover from any injuries that are going on.
For a lot of people, they’re experiencing osteoporosis, osteopenia. This is the bones becoming more and more brittle because (1) the body’s having to pull so much more of the resources out of those bones to use as an energy source and to keep going, but (2) it’s not prioritising the repair of those bones because it doesn’t have the resources to do it. I think one of the logical ways that people think about this in terms of why they keep up eating disorder behaviours or why they keep up the exercise is this idea of “Well, for really good bone health, we need to be doing exercise. We need to be doing weight-bearing exercise.”
The reality is, if you’re not taking in enough food, if you’re not giving your body enough rest, doing those kinds of exercise is not actually helping your bones. It’s just making things worse. So having more energy that is now being able to channel towards bone recovery is another important reason for having a break.
It’s important for hunger hormones. It’s so common for people when they are exercising for this to really interfere with their ability to get this good feedback in terms of when they’re hungry and noticing that. And that can happen for a window of time, so often someone will exercise and for the next handful of hours, they’re like “I’m not feeling that hungry.” But depending on the amount of exercise someone’s doing, it can really affect it all across the day, constantly. So having that break allows those hormones to come back into the right levels for you to be able to get that feedback, to be able to hear those things more properly.
Taking a break helps to support metabolism. Again, if the body’s not getting enough energy, it has to turn things down and turn things off, so the metabolism becomes much more suppressed because there’s a limited amount of food coming in; the body’s hand is being forced to spend this allocation on exercise because you’re doing this amount of exercise, so it only leaves this small amount to do everything else with. So it has to make adjustments, and it can’t keep spending in the way it would ordinarily like to, so it has to pull everything down.
By taking that break, it’s allowing more energy to come into the system that’s not being used on exercise, and that allows things to be turned up and turned back on, and that in turn then increases metabolism. And this is alongside more food coming in, but when those two things are combined, then someone’s metabolism can start to be turned back up – which is basically just your body being able to look around and think, “We do have the capacity now to spend on things that are more about long-term health as opposed to just survival and getting through this day with the rations of energy that we have.”
00:19:23
In terms of other things outside of the physical perspective, one is breaking the compulsion and having the ability to have psychological flexibility. You don’t want to be in a situation where “I have to do exercise every day. It doesn’t matter whether I’m sick, it doesn’t matter how busy I am, it doesn’t matter what’s going on with the kids, it doesn’t matter if I’m on holiday, I still have to do these things.” You want to be in a situation where “I can choose whether I’m doing exercise or not. If I want to have a month off, I can have a month off and it has no bearing on how I feel or my self-worth or my anxiety or any of those things.”
So having that break is how you can start to get to that place. I think it’s really hard, or nigh impossible, to get there if you’re not having a break. It’s really important to then be able to break that compulsion and develop that psychological flexibility.
I think another thing is there’s this connection between movement and this being the thing that allows you to earn the food. Often, there is this feeling of “Well, I was allowed to eat this amount because I did this amount of movement” or “If I’m taking a break from movement, I need to bring down my energy intake.” That’s obviously not the way that I want someone to be thinking about their eating; this is very much connected to the eating disorder thoughts around this, and having a break is the thing that allows someone to really break away from that line of thinking. Again, I think it’s hard to do this if you’re not having a break. You’re still staying in that same mentality.
It helps someone develop the ability to rest. Rest is really important. It’s important for our mental health, it’s important for our physical health, it’s important for lots of different reasons. It’s, again, really difficult to do that and to really embrace rest and to be okay with rest and be able to take a break where there isn’t guilt around it, there isn’t the worry “I have to be productive”, without having some time off exercise. Having that time off exercise allows you to go from “Man, I feel like I’m crawling out of my skin, I feel like this is the wrong thing to do” to getting to the point where “Actually, I can take a break and I can listen to my body, and I know that in the future, if I’m sick or if I’m tired or if it’s a rainy day outside, I don’t need to be going and moving my body and forcing myself to do this thing.”
Also, having a break helps you to learn other coping skills. For so many people, movement and exercise is their one and only coping skill. Maybe restriction is another one, but for lots of people, when they’re feeling overwhelmed or when this thing happens or whatever, “This is where I up my exercise” or “This is where I go for that longer walk” or whatever it may be. It’s hard to learn other coping skills when this is the thing I’m constantly doing.
What having a break allows you to do is take away that coping skill, and that can feel hard to begin with, and it can feel very naked or like “Wow, I’ve now lost this one thing that I could always depend on”, but it’s then through that that you’re able to learn other things and other ways. Again, I think it’s hard to do that without having a proper break.
It’s also the thing that truly helps you to develop a new relationship with exercise. The long-term goal with this isn’t that you stop and then you never do exercise again. As I said a moment ago, I do think that exercise is healthy, and I do think it is good for the body. And people can do this in varying amounts; it’s not that everyone has to be going out and doing a ton of exercise. But exercise is something that is beneficial, and it’s only beneficial if the body is in a state to be able to adapt from that and to really benefit from it.
The goal long-term with having a break is that you’re able to, at some point in the future, reintroduce this – and reintroduce it in a way where you have a totally different relationship with exercise. It’s not compulsive. You do things that you truly enjoy. You are able to know when you need to have a break here or you need to get more rest or whatever it is. You’re able to have a totally different relationship with exercise. That is very hard to do, again, if you’re continuing to do it. It means there’s always that compulsive element; there’s been this inability to actually take some time off, so that interferes with someone’s ability to have a better relationship with exercise.
So I really think having a break helps with that. And it may mean that when you come back to exercise – and I’ll talk about this more in a moment – you actually come back to it doing things that are different, or at least to start with, you’re doing things that are different. If your exercise has always been around running and that’s always been the thing that’s been really compulsive for you, it might be that when you’re reintroducing exercise, that’s not the thing you start with, because it’s going to be a lot more difficult for you to start with that thing and have a healthy relationship with food versus starting with something that you’ve never connected to your eating disorder before, and this is truly about things that sound like they’re fun or “things I used to do when I was a kid” or whatever it may be.
So the relationship with exercise piece is really important, and especially important longer term. This is why having a break can be so important.
00:25:25
The next question, I imagine, is “How long do I have to take a break for?” There isn’t a right answer with this in terms of “this is the universal thing that everyone has to do.” It really depends on the individual. When I’m working with someone, we’re figuring this out based on what is right for them. But if I’m thinking about this generally, we’ve got to look at what someone’s level of movement has been up until this point, how long that has been going on for, how much it feels like this has been a real central part of their eating disorder.
For some people, there’s some movement going on, but it’s not the be-all and end-all as part of their eating disorder. Then there are other people where it’s like, “This is the thing that is really driving your eating disorder. You’re spending a real amount of time on this every day, or this feels really compulsive for you.” That’s going to have an impact on how much time someone needs to have a break from it.
But if I’m giving some general ballpark ideas, it could be as little as 4 to 6 weeks that someone’s having some time off, and at the longer end it could be 12 to 18 months that someone’s having time off. And look, that could even be longer depending on the individual. It might be that when you’re bringing something in – if we’re looking at that longer term person who is taking longer, it might be that they’re able to bring in more gentle movement earlier than this, but it then takes longer to bring in other things.
The thing that might be hard to understand connected to this is in the beginning, there’s all this fear around this and fear around stopping and fear that “I’m never going to start again”, and you might hear the number and be like “God, I’ve got to take 12 months off? I could never do that.”
And what actually happens when people do start to take a break is the recognition of how much of a compulsion this thing really was and how much of an impact it was making on their life and in an everyday way, where I’m having conversations with people where they’re saying, “Hey, I don’t think I’m ready to bring exercise back in yet.” “Hey, I think I need to have longer time off because I’m worried that it is going to be compulsive again and I don’t feel like I’m at a stage yet to be able to do it.”
So it really shifts from me being the one suggesting “Hey, I think we need to have a break” to someone being able to really recognise that “This thing wasn’t working for me, and I’m not at a stage yet to start to bring this back in.” I think it’s important for me to mention there is that shift, because it can otherwise feel like “I’m going to be crawling out of my skin for 12 months” as opposed to the reality of the situation is, in the beginning it can be hard, but then there’s this realisation of “Hey, I want to bring exercise back in, but only at the time that it’s going to truly be beneficial for me and truly where I can create this new relationship with it, because I don’t want to go through this again.”
Recovery is hard, and at some point you get to the place where “I’ve done so much work with this that I don’t want to rush getting back into something that’s going to cause a problem for me. I don’t want to rush getting back into exercise and then in a short amount of time find myself back in a not-great place. I want to do the things that are truly going to support me so that longer term, this is really healthy, and longer term, I have a good relationship with this thing.”
I know 6 months or 12 months can feel like a really long time, but in the whole scheme of the entirety of someone’s life, it’s a pretty small amount of time. So spending that extra amount of time to get those things right means that longer term, it just makes such a difference for you.
00:29:12
The next question could be, “Do I have to start here? When I’m starting recovery, do I have to immediately stop exercise?” My answer to this is: not necessarily. I think to start with recovery, the goal is to change that energy debt, as I talked about earlier. It’s coming from being in this low energy state, so the goal is that we need to have more energy either coming in or have more energy available. And having more energy available, there’s two real levers for that: one is “I need to do less movement”, or two, “I need to be bringing in more food.”
So there can be times where someone is like, “I just can’t start with the exercise piece”, and if that’s the case, okay, we need to up what you’re eating. And it might be we need to up what you’re eating even more because you’re still keeping up that energy piece. So it’s not that we have to start there; what I would say is if someone is doing fasted exercise – so someone’s waking up, they’re doing exercise first thing in the morning before they’re eating – I will typically say that we need to be bringing some food in here. Because what happens is the more you’re getting into that energy-depleted state, the more there is the eating disorder thoughts, the more it becomes harder to make changes throughout the rest of the day.
So, it might not be that we start with the exercise piece, but we need to be bringing in more energy, and bringing in more energy at the right times, to be minimising that as much as possible. Then at that time, we can start to make changes in terms of someone’s movement and looking at the exercise piece.
I would say, though, that there are some cases – and it’s more common than people might want to admit – where it is just obvious how much movement is connected to the eating disorder. What often happens is either (1) someone does stop it immediately and they benefit from it, or (2) their real recovery starts at the point when that exercise is either really reduced or we’ve actually taken a break from it. It could be that for the first couple of weeks or the first couple of months, someone’s making all these changes to their food and they’re noticing some benefits from doing it, but it’s actually when we have this pause on the exercise that we really start to notice some positive shifts.
With everything with recovery, I don’t treat it in a black-and-white way of “This is a must and you have to do this” or “You can never do this.” So in terms of, do we have to start there? – I would say not necessarily, but if I’m putting my hat on of what is absolutely best for recovery, my suggestion would be this is one of the places to start with, because I think you’ll get the biggest bang for your buck by doing this in terms of the physical changes, or all the reasons I gave earlier on about why taking a break is important. You start to benefit from them immediately as opposed to there being more of a delay to get to that place.
00:32:19
The next question is, do you have to go cold turkey? Do you have to immediately stop, or at the point when you are making a change, do you have to stop it all at once? My answer, again, is no, not necessarily. You do not, but I actually think in most cases it makes it easier.
I think there is this idea of “I’m doing this amount, and if I just halve it or if I take a couple of days off and we work our way down, then it will make it easier.” Generally, I don’t believe that to be the case, and that’s just not people’s experience. What often happens is as you’re continuing to do that movement, even if you’re trying to do less of it, the compulsion’s still there. There’s that ‘objects in motion stay in motion’, so even if someone says, “Okay, I’m going to now only do X number of minutes today”, once they start doing it, it then feels hard to not do it, and then there’s more of the guilt about the fact that “I’m doing less”, and it becomes much harder versus someone who has this cold turkey and says, “Right, I’m just going to completely stop with this.”
Typically, when someone does stop, it really is the first 7 to 14 days that are the most difficult. And yes, there will be outliers where it’s difficult for longer than this period, but really, it’s that first initial phase that is typically the most challenging, and then after that it starts to get easier – not easy. And then as time goes on, there is much more of that recognition of “Oh my gosh, I realise how much I needed to have that break” or “I notice how tired I am” or “I feel a relief that I don’t have to do this.”
Because typically, when I’m speaking to people, there is this real fear around stopping this thing and all of the logical reasons why they shouldn’t stop it, but there’s also this part of them that really does want to stop. It’s like, “I’m not enjoying this in the way that I used to enjoy this” or “This feels so much yet I just can’t stop doing it.” There is the recognition that “This isn’t actually healthy for me.” It’s just that there’s all these fears connected to it. But once there is that pause and that time goes on and someone’s able to adjust to that, there is this feeling of relief, of “My God, I’m just grateful at this point that I’m not having to do that anymore.”
00:34:50
Another thing I want to mention is some symptoms that can start to occur as you have a break from exercise, or as you reduce your exercise.
There can be lots of aches and pains. People can often feel worse when they stop doing exercise, especially if this has been going on for a really long time, especially if there’s quite a lot of exercise. You can feel a lot worse when you first start to have a break from exercise. There’s lots of aches and pain; there can be more oedema, or water retention. Your body can feel much more sensitive to touch. It feels like the lightest touch is painful and you’re so aware of every part of your body, and this can be especially around the belly. There’s this real sensitivity that gets heightened.
People can feel way more tired. It can feel like, “Oh my gosh, I feel like I’ve been hit by a bus now that I’ve stopped doing the movement I was doing.”
You can feel a lot hungrier, which I know can feel scary, it can feel counterintuitive, it can feel like “Oh, but I was doing so much more and now I feel hungrier and now I shouldn’t be eating more because I’m doing less.” That can be an uncomfortable thing to deal with, but this is what happens. The exercise in a lot of ways was suppressing that hunger, and when we’ve taken a break, you’re now starting to notice, “I’m getting the feedback that I am really needing much more energy.” And that, as scary as it is, is a real benefit by taking a break from exercise.
You can be more irritable or more anxious, and that’s very normal. I think it’s important to find ways to fill that time void, especially if exercise or movement was taking up a long part of your day. To go from “I have all of that time filled with this thing” to now having this time void, it’s “How do I be intentional about how to fill that?” When working with people, we’ll go through different ways of filling that time. But I think if you just think “I’m going to wing this”, that typically doesn’t work out well. It’s “Let me think about what I’m going to do to fill that time.”
I think body image can definitely get worse in the beginning when someone stops exercising. It can feel a lot more difficult to deal with. Again, I think this is temporary, or at least temporary in terms of either (1) the intensity or (2) your capacity to feel like “I can’t handle this.” I think the longer you have a break and the longer it goes on, even if the body image is still hard or it doesn’t feel great, there’s more of the recognition of “I’ve been able to do this for a long time now, and I know that I can cope even though it is uncomfortable.”
With all of these symptoms, they are temporary, but depending on where someone’s body’s at, how long they’ve been exercising, how depleted it is, the amount of exercise, all of these things will dictate how long this stuff goes on. Some of these symptoms can be around for a while, and I understand that that’s unpleasant, but the reason I’m mentioning it is I am a big one for wanting to manage expectations. I think when some of these come up, it can feel like “I must be doing something wrong. I’m doing something wrong in my recovery, I shouldn’t be doing this because it feels like my body’s getting worse, so that’s why I need to go back to the exercise.” And actually, this is a temporary situation and it’s connected to your body starting to do the repair work and why these things are coming up.
00:38:40
The next question is, how do you bring exercise or movement back in? As I’ve already alluded to or mentioned, you’re wanting to really think about this from a long-term perspective, and “How do I truly create a new relationship with exercise that is not about compulsion, it’s not about the eating disorder, it’s not about burning calories, I’m coming at this from a completely different angle?”
How to bring it back in would be slowly, and being really intentional. This isn’t or shouldn’t be a rush. Spending extra months bringing this in more slowly will pay dividends because it means that you don’t end up back in a place where it is compulsive again and “This isn’t serving me.” Spending that extra time now, or at the point that you’re reintroducing it, really does help you for the years and decades to come.
Typically when someone’s bringing things back in, some of the things I think about are, one, can we start with things that are gentle, things that are fairly easy for the body? And doing this for a set amount of time, where we’re going to just do this for 15 minutes, or we’re going to do this for 20 minutes. Doing this in this very gentle way where we’re not rushing into it, we’re not instantly saying, “We’re doing this now 4 days a week” – it’s “We’re doing this 1 day a week, and then we’re going to wait 7 days or 10 days, and then we’re going to do it again, and then we’re going to wait another 10 days and then we’ll do it again” – just so that you’re not having this compulsion connected to this thing. You’re able to do it and then you’re able to really take a break from it.
It can be finding things that are new or fun or things that you used to do as a child. As I talked about earlier, if running was your thing, maybe we’re not going to start with running. Let’s come back and do something that is totally different and that you can then start to have a relationship with that new kind of movement. It’s not that we can’t bring running in at some point; it’s just from my perspective, I probably wouldn’t be suggesting that as a starting point because we want to create a new relationship with exercise, and it’s easier to do that with new things.
As part of doing this, you’re wanting to disconnect it from things like burning calories or the amount of time or the amount of mileage, and it’s hard when you’re going back to doing something you’ve done before. Like if you knew how many miles you used to run each week or you knew how many calories you used to burn because of your watch as part of doing this exercise, first starting with that exercise again can be really difficult versus if we start with something completely new where it’s got no connection to any of those things, that is a lot more helpful.
It can also be helpful to do this with a friend or to do it in a group environment. It’s not the case for everyone, but for the vast majority of people I speak to, so much of their struggles around exercise or movement is that they’re doing it in a solitary way. It’s them on their own doing this thing. So if we’re trying to start a new relationship with this stuff, how do you do it with other people? How do you do it in this group environment or just that one friend that you’re with so that “This movement wasn’t just about moving my body; it was also about the social aspect of doing this thing. I got to catch up with a friend, we got to be outside.” It’s, again, creating this new relationship with it and something different from before.
With this, as you’re continuing on and you’re bringing either more things in or you’re doing things more often, you want to just keep proving that you’re in the driver’s seat. So even if you feel like “From a physical standpoint, I feel really good with this. I feel like I could be doing it X number of times a week”, you want to keep regularly taking time off to prove that you can do this.
It might be “This week, I did this thing 3 times a week, and next week I’m not going to do anything, and then the week after that, I did it twice, and then the week after it I didn’t do anything.” You’re wanting to just keep proving that you’re in the driver’s seat, because so often when I speak to people, there’s this idea of “But I really love doing what I do in my exercise. It’s so important for me. I just love doing it.” But when I say, “I get that you love doing it; can you take some time off?”, there’s an inability to actually take time off. It really makes me question, how much do you love this thing if you do have an inability to take time off? Because if you can’t not do this thing, then are we really seeing that you love it? Or is it just this thing feels safe to keep doing or unsafe to not do?
For example, I love playing golf. It’s one of my most favourite hobbies. But if I had to stop playing it for a couple of months, there is no problem with doing it. And living in Scotland, in the middle of winter, that’s what often happens. I want people to have the ability to go on holiday for multiple weeks and not having to exercise, and they don’t have to even think about that. Or someone in their family gets sick and “You know what? I just need to focus on this, and I don’t have time at the moment to exercise. It’s just not important for me.” Or “My only exercise at that point is I meet up with a girlfriend and we go for a walk and a bit of a chat and that’s it.” But I’m not doing the other stuff that I usually do, and there’s no anxiety, there’s no worry, there’s no fear connected to any of that.
So as people are bringing this back in, you constantly want to prove that you are in the driver’s seat. Often when I’ve done this with people, we might start to bring things back in and then realise, “This isn’t working. We’re starting to see more issues connected to your food coming up again, or there’s more body image issues coming up again – we need to take another break from this.” So we take a break, and it might be we have another month off or we have another 6 weeks off or whatever, and then we can try doing this again and see what happens. Just being okay with that.
And I know that can feel frustrating or disheartening or disappointing, but again, recognising this is about the long term. This isn’t just about “I’ve got to get the result as quickly as possible.” It’s “I want to create this totally different relationship with exercise long term, so if I need to take another pause on this thing, that’s okay.” Really just not being in a rush with either getting started with it again or “When I am getting started with it again, I need to ramp this up and start to do more and more.” So that would be how I think about bringing movement back in.
00:45:34
Another thing that comes up a lot when people are either thinking about taking time off movement or are starting taking time off movement is all the eating disorder thoughts about this. And this can be connected to the fears that I talked about earlier on, but it’s all these things around the worst case scenario that’s going to happen, whether that be to my weight or to my fitness or to my identity or whatever it is. I think we need to really start to reframe what this is really about.
So coming up with reframes that are useful and specific to your situation, and that actually land with you. I’ll give a few of these, and then you can think about it for yourself. But I do think that rather than thinking “I’m giving up on exercise” or “This is me being lazy” or “This is me lacking willpower”, it’s framing this in a different way that actually makes this a very positive thing, makes it a very empowering thing – that “Actually, I’m doing something really helpful and healthy and important for my body.”
For example, “I’m actively healing my metabolism. I’m taking time off exercise to actively heal my metabolism.”
“I’m strengthening my body so I can exercise in the long term and truly benefit from it.” As I talked about, to benefit from exercise, you need to be able to rest and adapt, and for the body to repair properly. “At this point, my body’s not able to do that, so I’m strengthening my body so I can exercise longer term.”
Unlearning an unhealthy compulsion. So rather than “I’m being lazy”, it’s “I’m unlearning an unhealthy compulsion. I’m taking this break so that I can have a different relationship with exercise.”
“I’m choosing full recovery over a half-recovered life.”
Those are just a few ideas. Maybe you can come up with some of your own. But I do think being able to frame this in a way that is pro-recovery and makes you realise why this is a really helpful and important thing – and not just because “Oh, Chris is saying that this is a thing I should be doing”, but really understanding it from your perspective of what this will give to you.
This won’t necessarily remove all the fears. It won’t take away the ambivalence. But at least there is this healthy part of you that is able to see logically why this is actually the right thing to do and an important thing for you to do.
So that is it in terms of what I wanted to cover today. I realise that I’ve probably just scratched the surface with this, and as I said at the top, I feel like this is more of an overview podcast on this area. I’m happy to do another one or multiple ones going deeper into different coping strategies while you take time off exercise or busting myths connected to the various eating disorder thoughts, or how to reintroduce exercise and what are some of the red flags to look out for.
So if those are areas that you want me to go into more detail, let me know. If there are areas that I’ve missed and you want me to go into it, let me know. If there’s things that you’re personally wondering about or struggling about, let me know, and as I said, I can include that in a future episode. Just send an email to info@seven-health.com. Put ‘exercise’ or ‘exercise in recovery’ in the subject line – I mean, whatever you put in the subject line, I’ll still get it, but if you just put that in there, then I can put all of these responses into a Word document, and when I do the next one I can then make sure that I hit these.
If I get enough interest and it feels like a topic that people want me to dive into again in more detail, then I’m more than happy to do so.
So that is it for this episode. I hope you’ve got some benefit from this. I know that often just hearing about this can feel very scary and overwhelming and it can be very paralysing, but I also want people to understand why it can be important to take time off exercise and how it can be having an impact on someone’s recovery, and why it’s actually a really helpful thing to do, even if it does feel scary to do so.
As I mentioned at the top, I’m taking on new clients. If you want to fully recover from an eating disorder, then please send an email to info@seven-health.com, and I can then send over the details and we can have a call to figure out if we’re a good fit and if the way that I work is going to be helpful for you.
That is it for this week. I will be back next week with another episode. Until then, take care of yourself, and I will see you soon!
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Lieber Herr Sandel,
vielen Dank für diese Folge über Sport in der Genesung. Entschuldigen Sie bitte, dass ich in Deutsch schreibe. Ich verstehe die englische Sprache sehr gut, Leider kann ich mich jedoch schriftlich nur schwer in der englischen Sprache ausdrücken. Hoffentlich haben Sie ein Übersetzungsprogramm!
Ich hatte über 30 Jahre Anorexie, die meiste Zeit eine atypische Anorexie in Kombination mit einem Sportzwang. Ich war Leistungsschwimmerin und später weitete ich das Trainingspensum immer mehr aus, auch Joggen und Radfahren kamen hinzu. Über die ganzen Jahre habe ich jeden Tag meinen Körper mit endlosen Trainingseinheiten gefordert und das im Untergewicht.
Vor vier Jahren kam der Zusammenbruch. Ich hatte immer wieder versucht, mir Hilfe zu suchen, aber die langen Wartezeiten bei Therapeuten und Therapiemethoden, die mir nicht wirklich weiterhalfen, ließen mich erkennen, dass ich es selbst versuchen muss. So las ich unzählige Bücher, sah mir Videos von ehemaligen Betroffenen an, die mich so motivierten, dass ich anfing mehr zu essen. Der Sport war allerdings immer noch so zwanghaft, dass ich ihn nicht beenden konnte. Nun erhöhte ich also meine Essensmenge drastisch und aß viele Kohlenhydrate, was ich lange zeit vermieden hatte. Eines Tages wurden die Bauchschmerzen unerträglich, mein Oberbauch war hart und ich verdaute nicht mehr. Dennoch machte ich weiter Sport bis es so schlimm wurde, dass ich mich erbrechen musste. Mein Körper schrie danach, dass ich endlich aufhörte und meinem Körper, die Ruhe gab, die er brauchte, um die Nahrungsmenge zu verdauen. Ich bekam Medikamente, es wurde besser, aber das sollte erst der Anfang sein.
Meine Muskulatur verspannte sich und mir tat Alles weh.. Meine Kiefermuskulatur ( ich hatte jahrelang mit den Zähnen geknirscht) war so verspannt, dass ich beim Kauen Schmerzen hatte. Dann ging eine Odyssee von Zahnarztbesuchen los, die mir nur noch mehr Angst machten. Ich hatte Panikattacken.
Ich war körperlich und psychisch am Ende. Ich klammerte mich trotz allem an meine Essensstruktur von sechs Mahlzeiten am Tag. Mir war klar, dass ich nicht mehr zurück zur Essstörung will, aber die Schmerzen, die Erschöpfung, die psychische Instabilität waren so groß, dass ich mir oft gewünscht hätte, es würde ein Ende nehmen. Ich weinte wochenlang…soviel habe ich in meinem ganzen Leben nicht geweint…aber durch viele Bücher und eine Osteopathin, die mich auch auf seelischer Ebene sehr stützte, wusste ich, dass dieser Prozess wichtig war, um zu heilen. Alle Emotionen, die ich die ganzen Jahre verdrängt hatte, brachen in dieser Zeit in einer Welle über mich herein. Heute nach über zwei Jahren bin ich stolz, dass ich mithilfe meiner Familie und einigen “Engeln” wieder ohne Schmerzen leben kann. Die lange Pause vom Sport, die ich machen musste, weil mein Körper einfach nicht mehr konnte, haben mir geholfen, dass es mir so gut geht. Ja, regelmäßiges Essen, viel Arbeit mit dem Nervensystem (Atmung und Übungen für den Vagusnerv, Yoga), Veränderung meiner Gedanken durch Journaling und Dankbarkeit haben mich wieder ins Leben zurückgebracht 🙂 Ich bin so dankbar, dass ich durchgehalten habe….es hat sich so gelohnt. Heute tanze ich leidenschaftlich in einer Line Dance Gruppe. Die Bewegung zur Musik, zusammen mit anderen liebgewonnenen Menschen ist großartig. Ich möchte Sie in Ihrer Ansicht bestärken, dass eine Sportpause einen wirklichen Vorteil bietet. Zum einen wird die Kopplung zwischen Essen und Bewegung aufgelöst, zum anderen dem Körper die Möglichkeit gegeben, sich zu erholen. Die Verdauung hat soviel zu tun, wenn man wieder normale Mengen ißt, dass zusätzlicher Sport eine echte Belastung darstellt. Restriktives Verhalten ist aus meiner Erfahrung so belastend für den Körper, dass Cortisol durch den Körper strömt. Wenn man dann aufhört, sich einzuschränken und Sport zu treiben, wird dem gesamten Stresssystem gesagt, dass es sich zurückziehen soll. Dann fühlt man erst den Schmerz. Während man restriktiv isst und Sport treibt befindet man sich gleichsam auf der “Flucht” und rein vom biologischen Gesichtspunkt hat die Flucht vor einer Gefahr Vorrang vor der Verdauung oder Schmerz. Der Schmerz war die ganze Zeit schon da, nur er war in dieser Stressphase nicht wahrnehmbar. Ich würde mich freuen, wenn Sie auf das Thema, Schmerzen /Müdigkeit/Erschöpfung/Depression in der Genesungszeit näher eingehen könnten.
Es gibt nicht viel über dieses Thema und ich hätte mich damals nicht so einsam gefühlt, wenn ich über diese Symptome etwas erfahren hätte. Vielleicht hilft es einer Betroffenen, die sich jetzt in der Genesung befindet. Thank you so much for your help! Cathy
Hey Cathy,
Thanks so much for your comment. It’s obvious you went through a long period of suffering to get to where you are now, but I’m glad you had the break from exercise to get to this better place. I have translated your message and put it below so anyone who wants to benefit from your experience (and doesn’t read German) can do so. Thanks for sharing.
Chris
Translation of Cathy’s comment:
Dear Mr. Sandel,
thank you very much for this episode about sports in recovery. I apologize for writing in German. I understand the English language very well, but unfortunately I have difficulty expressing myself in writing in English. Hopefully you have a translation program!
I had anorexia for over 30 years, most of the time an atypical anorexia in combination with a sports compulsion. I was a competitive swimmer and later I increased my training more and more, including jogging and cycling. Over the years, I challenged my body every day with endless training sessions while being underweight.
Four years ago, I broke down. I had tried again and again to seek help, but the long waits with therapists and therapy methods that didn’t really help me made me realize that I had to try it myself. So I read countless books and watched videos of former sufferers, which motivated me so much that I started to eat more. However, the exercise was still so compulsive that I couldn’t finish it. So now I drastically increased the amount of food I ate and ate a lot of carbohydrates, which I had avoided for a long time. One day the abdominal pain became unbearable, my upper abdomen was hard and I was no longer digesting. Nevertheless, I continued to exercise until it got so bad that I had to vomit. My body was screaming for me to finally stop and give my body the rest it needed to digest the amount of food. I was given medication and it got better, but that was only the beginning.
My muscles tensed up and everything hurt. My jaw muscles (I had been grinding my teeth for years) were so tense that I was in pain when I chewed. Then an odyssey of visits to the dentist began, which only made me more anxious. I had panic attacks.
I was physically and mentally devastated. Despite everything, I clung to my eating structure of six meals a day. I realized that I didn’t want to go back to the eating disorder, but the pain, the exhaustion, the mental instability were so great that I often wished it would end. I cried for weeks…I have never cried so much in my whole life…but through many books and an osteopath who also supported me a lot on a spiritual level, I knew that this process was important to heal. All the emotions that I had repressed all those years came crashing over me in a wave during this time. Today, after more than two years, I am proud that I can live without pain again with the help of my family and a few “angels”. The long break from sport that I had to take because my body simply couldn’t take any more has helped me to feel so well. Yes, regular eating, lots of work with the nervous system (breathing and vagus nerve exercises, yoga), changing my thoughts through journaling and gratitude have brought me back to life I am so grateful that I persevered….it was so worth it. Today I dance passionately in a line dance group. The movement to music, together with other loved ones, is great. I would like to encourage you in your view that a break from sport offers a real advantage. Firstly, it breaks the link between eating and exercise and secondly, it gives the body a chance to recover. The digestive system has so much to do when you eat normal amounts again that additional exercise is a real burden. In my experience, restrictive behavior is so stressful for the body that cortisol flows through the body. When you then stop restricting yourself and exercising, the whole stress system is told to back off. That’s when you feel the pain. While you are restrictively eating and exercising, you are on the run, so to speak, and from a purely biological point of view, running away from danger takes precedence over digestion or pain. The pain was there the whole time, it was just not noticeable during this stress phase. I would appreciate it if you could elaborate on the topic of pain/fatigue/exhaustion/depression during recovery.
There is not much out there on this subject and I would not have felt so lonely at the time if I had learned about these symptoms. Maybe it will help a sufferer who is in recovery now. Thank you so much for your help! Cathy
Translated with DeepL.com