Tuesday, December 30, 2014

When staying sedentary is healthy: exercise and recovery

Myth dispelled: there is no such thing as getting "fit and healthy" during eating disorder recovery.

There is no such thing as gaining purely lean muscle weight. I don't care how many protein shakes and bars you choke down. I don't care if you go lift for three hours a day (please don't!), supplement with fat burners, and live off of chicken breast and broccoli. It is physically impossible to gain muscle mass without also gaining some fat.

It's nothing new to claim that we live in a world that is fascinated by exercise. Ever since I was young, I remembered being told that exercise is necessary for a healthy lifestyle and I won't disagree that it. Exercise is great: it strengths the heart and lungs, increases muscle mass, increase serotonin, etc. However, this only applies to a normal, healthy individual. Imagine that I have just broken my leg. Is it advantageous for me to go running? Of course not! Or what if I just got out of the hospital for pneumonia, should I resume my bi-weekly hot yoga classes? No!

The same applies for an eating disorder. Whether we want to admit it or not, whether we believe it or not, but food restriction has made our bodies very, very sick. We may not feel particularly ill, maybe even better, more high energy that we have felt in years, but that is our bodies working to compensate for the lack of energy. The truth of the matter is that our bodies are deep in starvation mode, our organs are being damaged, muscles eaten away, heart weakening. Eating disorders are silent, but deadly. Just because we don't "think" we are very sick doesn't mean that we aren't.

Of course, exercise addiction is also extremely common in eating disorders. Whether it is used as a way to "purge" calories or to "allow" for eating, the very bottom line is generally the same: it seems nearly impossible to stop. I've seen so many girls say that if they don't exercise, they can't eat, feel extremely anxious, have panic attacks, or can't sit still and I can assure you that you are not crazy. This exercise dependence is secondary to your body's energy imbalance. In fact, the more you starve yourself, the more your body is compelled to keep moving.

Unfortunately, this compulsion can very well kill you. First, let me preface this by saying that internal damage to your body and most importantly to your heart does not only happen when you are severely underweight. In fact, it can happen at any weight as long as your body is restricted of adequate nutrients and calories. First, as you calorie restrict, your heart atrophying (shrinking away) as your body is attempting to gain access to more calories, catabolizing cells from all over your body to do so (not just your fat stores). The smaller your heart becomes, the harder it must work to pump blood all over your body. Next, restriction and other behaviors commonly associated with eating disorders like purging, laxative, and diuretic abuse cause massive electrolyte imbalances all over your body. Electrolytes are critical for all muscle and nerve function, including your heart. In fact, the lethal injection is merely a electrolyte imbalance designed to stop the heart from beating. Third, when you exercise during an eating disorder, you put yourself at a markedly higher risk for injury. Restriction causes nerve demyelination (the same thing that happens in diseases like multiple sclerosis and Guillain-Barre syndrome) which means your coordination is compromised. In addition, those who suffer from amenorrhea and osteopenia are at risk for bone fractures.
Thus, it is critical to cease ALL extraneous physical activity until complete weight restoration, physical and mental recovery. This means no more sports, dance classes, martial arts, physical education in school, bike riding, at home workouts, yoga, long-distance walking, strength training. And yes, this applies to you even if you have played sports your entire life, if you are an athlete, dancer, if you just LOVE going to the gym, if you get panic attacks when you don't exercise. Yes, this applies to you. 

Think about it this way: exercise is not a right, it is privilege you have when you are physically healthy. Even professional athletes take time off to heal from injuries. You are no different. Your health matters so much more than your athletic ability; to put it plainly, you can't strength train, play sports, or dance if you are dead.

Trust me, it wasn't a breeze for me to stop my compulsive exercise. Ask anyone who has recovered from an eating disorder, it never is easy. But it must be done. True, there is strength and discipline in going to the gym every day when a person is healthy but there is just as much strength and discipline in skipping the gym when a person is sick. It's all about doing what is best for your body at that point in time.

So for now (and any time in fact), it's okay to lounge around. In fact, it is great to spend all day in bed cuddled up with some books or a good movie. Your body needs it. Exercise will still be there when you are recovered and trust me, it will be a thousand times better when you are enjoying it rather than feeling compelled to do it.