The Center for Eating Disorders Blog

In response to Dr. Drew ~ Exercise bulimia is not a mild mental health issue

Recently the well-known celebrity internist, Dr. Drew Pinsky, shot this video for CNN iReport. During the segment he answers viewers’ questions about mental and physical health,  including one about healthy exercise and another regarding diet pill addiction in which he references underlying eating disorders as a serious concern.  What seems to be warranting concern is not the answers he’s giving to the viewers so much but the opening statement of the video in which he lightheartedly discloses his own struggle with something he refers to as a “mild” mental health issue called exercise bulimia.  Dr. Drew’s remarks were as follows:  

I got a whiff of exercise bulimia. You sort of exercise too much, and if you miss it you freak out. You have to constantly exercise.  I don’t feel right if I don’t do it.  But, you know, a little whiff of mental health issue never hurt anybody. 

In actuality, “exercise bulimia” is not a formal diagnosis but is a popular term often used to describe a subset of individuals with anorexia or bulimia diagnoses who feel compelled to engage in excessive exercise as a form of compensation for calories.  Some of the signs and symptoms associated with excessive exercise include:  

  • Engaging in exercise even when sick or injured
  • Becoming seriously depressed if you can’t get a workout in
  • Exercising above and beyond what would be considered a normal amount of time 
  • Refusing to build in any days of rest or recovery days
  • Inflexibility as to time of day and mode of exercise
  • Prioritizing exercise over social dates, family functions, work, or school
  • Intense fear at states of rest
  • Intense anxiety at situations where preferred method of exercise is unavailable
  • Intense guilt when forced to stray from exercise routine
  • Refusal to eat if unable to exercise
  • Defining self-worth in terms of exercise performance

Upon seeing the video above, The Center for Eating Disorders’ Director, Harry Brandt, M.D., had serious concerns regarding Dr. Drew’s statement about exercise bulimia and specifically the public interpretations that would follow. 

“In the age of the internet and personal blogs there will always be misinformation out there, but it’s particularly concerning to see high profile medical professionals, in this case an internist, minimizing what is a very serious disorder for a lot of people”  said Dr. Brandt.  He went on to say that “eating disorders are difficult to identify and treat partly because they are a socially normative disease.  Common symptoms like weight loss, dieting, negative body image and excessive exercise are all reinforced in our society.   This can make it very difficult for people with serious eating disorders to recognize their behaviors as problematic and part of a more significant mental health problem.  Statements like Dr. Drew’s trivialize a dangerous behavior and unfortunately make it more difficult for individuals to justify getting help.”       

Dr. Drew’s opinion that, “a little whiff of mental health issue never hurt anyone” is actually far from true.  Something that may seem minor or mild could actually be indicative of a full-blown eating disorder or might represent the first signs that one is developing.   Eating disorders have the highest mortality rate of any mental illness.  Without treatment anywhere from 5-20% of individuals with eating disorders may eventually die from complications related to their illness.  Individuals with eating disorders who struggle with excessive exercise in particular are at risk for the following health problems: 

  • Increased injuries such as stress fractures, strains and sprains
  • Possible permanent damage to bones, muscles, joints, ligaments and tendons
  • Increased susceptibility to infections, fatigue and exhaustion
  • Muscle wasting (the body begins breaking down muscle mass as a source of energy)
  • Fatigue
  • Dehydration
  • Osteoporosis (bone loss)
  • Arthritis
  • Menstrual irregularities and reproductive problems, including infertility
  • Heart problems

Excessive or compulsive exercise does not always occur alongside an eating disorder but when it does, it can provide some of the first signs that someone is struggling with food and eating. We encourage influential health professionals like Dr. Drew to be mindful of the messages they share with the public and to take great care not to normalize or trivialize behaviors that could indicate someone is suffering from a serious mental health problem.

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If you are concerned that you are a loved may have an unhealthy relationship with exercise, please call us at (410) 938-5252 or visit our website at www.eatingdisorder.org .

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