Exercise in Eating Disorder Recovery

People in eating disorder recovery tend to completely avoid exercise. They have abused it in the past, so they see no point in returning to it; if it wasn’t healthy then, what good could it possibly do now? They figure the best option is just to give it up, but that’s not entirely true. Exercise is a necessary component of physical and mental health, and in MODERATION, it can behove your heart, blood, bones, and mind.

Dr. Jonathan Meyers put it perfectly when he said ‘exercise has a favorable effect on virtually all risk factors of cardiovascular disease’. This is attributed to a dipartite strengthening of the myocardial muscle and a simultaneous elimination of excess adipose tissue, both of which lower blood pressure, stress, and low density lipoprotein (“bad”) cholesterol. The former occurs when the heart gets the stronger and expends less force pumping blood (thusly exerting significantly less pressure upon the arteries) while the latter is causes decreases in body and size and consequent oxygen demand, lowering the rate and force which the heart has to pump. A reduction in body fat also lessens the risk for diabetes (ergo diabetic heart problems including diabetic cardiomyopathy and glycolic arteriosclerosis).

There is evidence, too, that exercise increases “good” cholesterol synthesis and survival (circulation) by 25% and 27%, respectively. It is involved in increasing the production and action of several enzymes that function to enhance the reverse cholesterol transport system (the uptake and excretion of cholesterol by high density lipoproteins). These enzymes are lecithin cholesterol acyltransferase (LCAT), which promotes the esterification of free cholesterol and synthesis of HDL via lipoprotein core sequesterization and hydrophobic gradient formation, as well as lipoprotein lipase (LPL), which delipidizes LDL precursors (chylomicrons and VLDL) for energy expenditure and metabolism causing consequent decreased triglyceride concentration and remnant-based HDL synthesis. Furthermore, endurance training burns adipocytes (for fuel) and preconditions myogenesis, further raising HDL cholesterol by developing LPL synthesizing/secreting (muscular) tissue and decreasing LDL cholesterol through elimination of its partial moiety (triglyceride stores). As HDL cholesterol increases and LDL cholesterol decreases, the risk of cardiovascular disease decreases proportionally by 1% per mg/dL.

Exercise also benefits your blood and bones. Workouts expending 4.2 to 5 megajoules (of energy) per week can increase blood plasma volume by up to 15%, and the stress of weight-bearing induces bone-strengthening osteogenesis, the latter occurring when osteocytes signal the multiplication of osteoblasts. Bone disorders such as osteopoenia and -porosis can thereby be reversed and treated while blood disease and deficiency problems are remitted and managed. This is especially important for people with eating disorders, many of whom have low plasma volume and bone density values due to malnutrition.

Last but not least, exercise is crucial to mental well-being. It improves memory via neurogenesis and elevates energy by transiently increasing cardiac output (stroke volume x heart rate). Exercise is also known to tripartitely alleviate anxiety and depression through thermogenesis (heat production in certain brain regions resulting in feelings of physical and psychological relaxation), endorphin release, and activation of monoamine metabolic pathways. There is an additional correlation between exercise and self-esteem, attributed to the prerequired perspectival shift from body appearance to function, making you not only think but feel better!

The American Heart Association recommends three to four thirty minute sessions of moderate intensity activity per week. Ask your doctor if you’re healthy enough for exercise, and get up and get moving. Take a walk, try a dance class, do some yoga! Find what works for you and have fun with it!

(Thank you so much to Dr. Sheila Sahni and Kaleigh Kessler, RD for your help on this post. You are both spectacular and so, so smart.)

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