Monday, June 22, 2015

Exercise: it's more than just physical

I've touched up upon exercise and recovery before, but my previous post focused more on the physical reasons why it might be more prudent to stop exercise when recovering from an eating disorder. However, I still get questions and emails from people who are recovering asking if they can start exercising if they are "weight restored" (what does this even mean? Frankly, I can't stand this term but that's a different post for a different day), if strength training is okay, and how exercise should be added back in so this post will be addressing a more internal side of exercise.

I think that I have made it very clear that I am highly interested in the hormonal implications our diet and recovery has, so today's post will take a endocrine and nervous system-centric approach to the effects of exercise during and post recovery.

As I have mentioned before in my amenorrhea post, the endocrine system (aka hormones) is one of the last to recover after an eating disorder. This is can take months, even over a year, after a healthy weight and set point is reached. And your hormones matter much more than just letting you bleed (and want to rip your ovaries out) every month. In fact, they control essentially every single system in your body, from mood and digestion to blood pressure and cerebral pressure.

Unfortunately, exercise is extreme taxing to the nervous and endocrine systems. When you exercise (and I don't care whether you're on a treadmill or lifting pink 5-pound dumbbells) you elevate heart rate and blood pressure, increase oxygen demand, raise cortisol levels, and create systematic inflammation. Essentially the "harmless" exercise that you are performing is creating a response evolutionarily equivalent to getting chased by a hungry bear. And when you're getting chased by a bear the last thing your body is thinking about doing is recovering. It's just trying to stay alive. Rather than using the extra energy and resources that you are eating to create and release hormones to bring your body back to a baseline healthy, it's creating hormones like adrenaline to keep your body in a stressed state to keep up with the exercise demands.

And this combination of hormonal stress and neurological demand is exactly why I am so adamant in recommending that people do NOT incorporate a strength-training routine during recovery. Yes, you may burn less calories lifting weights than running during the workout session however:

  1. Hormonal and muscular recovery in the post-training period requires much more energy than cardio alone 
  2. Strength training generate a lot of excess demand on your neurological and endocrine system that likely still not recovered from restriction

While I know that the current trend is to be "strong-not-skinny" I must remind you that muscle growth does NOT happen in the gym. Training merely stimulate the muscle, but for it to grow, it must recover properly. The term "over-training" is quite popular in bodybuilding circles and does not refer to physically over-taxing the muscles but training so hard that the central nervous system cannot keep up to direct muscle recovery and if it can occur to these 200+ pound, often steroid-using, otherwise healthy men who are often eating well over 4000 calories a day, image the toll muscle recovery has on someone who is sick and still recovering from years of hormonal and physical damage.

So put down the weights and hang up your running shoes for a while. The gym will always be there and trust me, throwing around weights is a lot more efficient when your body has the capacity to sustain it.