‘I Would Constantly Find Ways To Burn Calories’: When Exercise Becomes Compulsive

It’s described as the ‘Cinderella’ among eating disorder symptoms.

Thomas Grainger would obsessively exercise for hours a day, finding any opportunity to burn calories, even push-ups in the bathroom.

These days, he enjoys a healthier relationship with exercise, with long walks and some sessions at the gym, but that was far from the case five years ago. 

Thomas developed an “excessive” and “ritualistic” relationship with exercise that he said was strenuously tied to his eating disorder.

At 24, Thomas Grainger enjoys exercising as part of a balanced lifestyle. Image: Supplied

“At the heart of my anorexia, I would exercise two to three hours every day. I would run for several hours, in my lunch breaks, do push-ups in the bathroom,” the now 24-year-old told ten daily.

“I would constantly find ways to burn calories.”

Obsessive-compulsive exercise is the neglected “Cinderella” among eating disorder symptoms but has attracted growing attention from researchers.  

“It has been there since the very beginning of people studying eating disorders, but it has not been the focus,” Australian psychiatrist Dr Phillipa Hay, Director of Wesley Eating Disorders Centre, told ten daily.

“People often think about dietary restriction, which is a very serious problem that can lead to people becoming undernourished and underweight. Exercise has been put to the side, but it equally causes distress.”

Thomas Grainger was diagnosed with an eating disorder when he was 15. Image: Supplied

Studies have shown that compulsive exercise occurs in half of all patients with an eating disorder and up to 80 percent of those with anorexia nervosa.

For Grainger, a media producer living in Sydney, exercise was easier to conceal.

“People don’t question it,” he said.

“It sounds like a healthy pattern, and especially if you’re eating, it is easier to mask. At the end of the day, it is a balance between what is going in and what is going out.”

Grainger described his eating disorder as coming in waves -- starting in the months prior to his diagnosis, aged 15 -- through which his diet and exercise became increasingly restrictive.

“It used to be ritualistic for me. I became obsessed,” he said.

Thomas with his family during his battle with an eating disorder. Image: Supplied

Compulsive exercise is understood to be driven by two pathways, Hay said.

“The placid one that we think of is exercise as a means of weight control. In the bigger picture, we are encouraged to exercise for our health, but it can become part of that need to control your weight, and drive fear of not losing weight if you don’t exercise,” she said.

“Probably less recognised is exercise as an important part of modulating mood. Sometimes through that grows fear of what will happen to a person’s mood if they don’t exercise.”

“We ask individuals how they would feel if they couldn’t exercise tomorrow? How long could they last without feeling distressed or fearful of the consequences?

It’s a vicious cycle that resonates with Grainger.

“If I was to do less exercise, I would have this underlying fear of gaining weight,” he said. 

“The more exercise you do, the more you feel compelled to do more. You get stuck in a rut and it’s extremely self-deprecating.

“I was severely underweight at the time, so it became very difficult to maintain that. It was slowly killing me.”
Thomas now sees exercise as something that should be enjoyed. Image: Supplied

But this cycle can be broken down. Hay is among researchers who have devised a cognitive behavioural therapy (CBT) approach.

“It’s a therapy that involves changing how we think about and perform exercise,” she said.

“It challenges a person’s belief and finds way to integrate exercise into their life in a way that is positive to their health and wellbeing.”

This approach worked for Grainger, who is now in a healthy weight range and maintaining long-term health conditions that he developed.

“It came down to making that decision within myself. Did I want this eating disorder to control my life? Because I wanted a social life and a career, I realised I needed to relinquish that control,” he said.

“Exercise isn’t a task -- it should be something that you enjoy,” he said. “That’s not to say I don’t have days where I feel self conscious or question what I’m eating or how I’m exercising. It’s all about finding what works for you.”