Thursday, September 2, 2010

Excercise Buliema Difficult To Detect

As a high school sophomore, Brett Zorich was a record-setting track star. Ultimately, however, her fiercest opponent turned out to be herself.

While experiencing a 5-inch growth spurt at 15, she fought to maintain the 100 pounds she carried as a 5-foot-2 freshman. And that's when she "got psycho," she says.

Zorich exercised more than two hours a day and restricted her calories. It was an obsession that turned into what experts call exercise bulimia. Her symptoms included amenorrhea (loss of the menstrual cycle), fatigue and depression.

"Looking back, I definitely should have been getting help," says Zorich, now 20.

There is such a thing as too much exercise. Up to 11 million Americans annually suffer from eating disorders, according to the National Eating Disorders Association. Of those diagnosed with bulimia, more than 80 percent of them use excessive exercise to control their weight, according to a 1999 study. Exercise bulimia, also known as compulsive exercise or exercise addiction, involves burning off calories through excessive exercise.

The disorder is often difficult to detect, especially in a society that praises fitness. So how do you know if you're crossing the line from fitness enthusiast to exercise bulimic?

Jackie Holmes, director and founder of Casa Serena Eating Disorders Program in Concord, Calif., has seen a steady increase in patients seeking care for exercise bulimia.

"I think it's always been there, but it's so much more pronounced now because of this intense push from the fitness craze that has hit the country," Holmes says. "There's been a shift from dieting, and everyone's gotten into being really fit."

The compulsion to exercise is not the only indicator of the disorder. It can be better understood by gauging the feelings someone relates to exercising, says Holmes.

"Someone who is healthy and just enjoys fitness may have an intense workout they do regularly but wouldn't mind changing it or skipping a day because of illness, injury, or something that takes priority in their life over exercise," Holmes says. "Someone with exercise bulimia would be extremely hesitant to make any changes and would suffer from guilt and anxiety if they were forced to miss the workout."

Zorich says she continued to run and exercise on a broken ankle and an injured hamstring. Both were caused and worsened by overworking, she says. Even after her coaches instructed her not to run with her injuries, she would sneak out of her house at night to go running. Track went from being a fun activity to what felt like an obligation or a chore.

"My love for the sport started to dissipate," she says.

There is often a codependent disorder, such as being obsessive compulsive, associated with exercise bulimia, Holmes says. The codependent disorder could be completely separate from an eating disorder, such as anxiety, or could involve symptoms from a related eating disorder (anorexia or classic bulimia). However, someone suffering from exercise bulimia could use exercise exclusively and fail to show symptoms of other disorders.

Recovery from exercise bulimia isn't like some other addictions. Unlike an alcoholic who gives up drinking, it isn't realistic for an exercise bulimic to give up exercise for life.

When evaluating a person's recovery, professor James Lock, director of Stanford University's Child and Adolescent Eating Disorder Program, looks for normalized thinking as well as normalized behaviors. He says a normalized relationship with exercise is when exercise is done according to a schedule or desire to be fit, as opposed to being done in excess and in response to what a patient eats during the day.

"In someone who is exercising excessively, they would have to abstain from the behavior for about three months and then reintroduce it safely," he says.

Cynthia Bates, a yoga instructor and nutritionist, has been a recovered exercise bulimic for 15 years, yet she still has the occasional urge to slip back into unhealthful habits.

"I am tempted mostly when I start feeling out of control in my life, big changes are happening, I'm having difficulty in a relationship, or my job isn't going as well as I want it to," Bates says.

At the peak of her disorder, she was eating around 800 calories a day, with little or no fat in her diet, and exercising for 2 1/2 hours daily, she says.

Finally around 25, her life began to turn around. Though she didn't seek traditional therapy, she began to embrace healthy eating, yoga and a balanced lifestyle. Much of her initial recovery was inspired when she was teaching English in Japan. She found success in eating according to the macrobiotics diet, popular in Japan at the time.

Like Bates, Zorich never sought out professional therapy but says her coaches played a large part in her recovery. They kept an eye on her during the summer, advising her to mend her injuries.

Zorich now runs for the University of Nevada, Las Vegas track team. Though exercise is still a big part of her life, it comes with limitations.

"I don't get caught up in it," she says. "If I don't win, it doesn't break me like it used to."

Signs of exercise bulimia

Here is what to look for, according to Jackie Holmes, director and founder of Casa Serena Eating Disorders Program in Concord, Calif. She said most of her patients are between 15 and 35 years old, the majority of them women.

•Guilt if person has to miss a workout

•Amenorrhea (loss of the menstrual cycle)

•Anxiety and stress, including fatigue and depression

•A compulsive nature

•Bone loss

•Drop in protein levels

Source: Chicago Tribune 9/2/10

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