17th May 2023
Exercise bulimia is an eating disorder where a person binges on food and compensates for the binge with excessive physical exercise. While it is not an official diagnosis, it is widely regarded as a subset of bulimia nervosa, an eating disorder characterized by binge eating and purging. Exercise bulimia can be treated with a range of therapies, such as CBT, interpersonal therapy, and family therapy.
Exercise bulimia is a term sometimes used to describe a form of bulimia where the purging behavior used to offset the calories consumed in binge-eating, is excessive exercising.
Exercise bulimia is not recognized as a separate condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , which is the manual used by mental health professionals in the USA to diagnose mental health problems. Instead, it is merely one way the purging behaviors in bulimia can manifest.
The DSM-5 considers bulimia to be one condition and lists excessive exercise as one of the possible ways an individual struggle can compensate for binging. However the term ‘exercise bulimia’ has been in use for at least 20 years  and may help some people to distinguish their experience from the perhaps better-understood forms of purging such as vomiting and laxative use.
If you have exercise bulimia, you will experience episodes of excessive eating, where you consume a large number of calories in a short time. You will then seek to burn off those calories by exercising excessively.
Exercise bulimia can have a huge impact on your life but with the right support you can recover.
Common symptoms of bulimia are:
The symptoms must have been present for at least three months to qualify for a diagnosis of bulimia. A doctor or mental health professional making a diagnosis will also want to rule out anorexia, another eating disorder, first.
In some people the condition may be relatively mild, with ‘compensatory behaviors’ such as excessive exercise happening perhaps a couple of times a week. For others, it will be extreme and happen more than once a day.
Bulimia, including exercise bulimia, often starts in adolescence. It is rare that it starts before puberty or after the age of around 40. It seems to affect more women than men, though it is likely that prevalence in men is underestimated.
There are a number of possible causes for bulimia, and triggers for individual episodes, including:
An individual experiencing exercise bulimia would be diagnoses with bulimia. As with other mental health problems, there are a series of criteria that determine a diagnosis.
The nature of the condition means that some people may show physical signs of illness because of vomiting, laxative use or excessive exercise. These symptoms may include low blood pressure, electrolyte imbalances, dental problems, and fatigue.
Diagnosis will be done by a doctor or mental health professional following a psychological evaluation, which includes discussion of signs and symptoms, a review of medical history and sometimes questionnaires.
The main treatment for exercise bulimia is mental health therapy. Suitable therapies include:
There is no medication for eating disorders but you may be prescribed medication to treat an underlying or associated mental health problem, such as an an.
There are a number of medical complications associated with exercise bulimia that can occur if it is not treated. These include:
People with eating disorders are also at an increased risk of suicide. However, early recognition of symptoms and commitment to treatment can help patients to successfully manage their symptoms and live a full life.