iMove - Helping Clients Heal from Compulsive Exercise

Movement and exercise are positive forces in our lives that can boost mood, health, and energy. But is it possible to have too much of a good thing when it comes to exercise? That’s a question I often hear from others when I mention the term “compulsive exercise.” Our culture (at least currently) idolizes health and fitness, so it is difficult for many to wrap their mind around the concept of too much physical activity.

Amy Gardner, founder of iMove and dietitian in the Boston area, writes in her iMove book that it is estimated that “3.0 to 3.5% of the general exercising population meet the criteria for compulsive exercise” which increases to “6.9% in sport science majors.” Within the context of eating disorders, the prevalence jumps significantly.

As you likely know by now, I incorporate movement into many sessions through outdoor therapy. I also specialize in working with eating disorders. The combination resulted in me seeing more and more people who struggle with over-exercising and I wanted to be able to sufficiently help people heal their relationship with their body and movement. In December 2021 I completed a 12 week certification course in iMove. Amy Gardner developed iMove as a group program to support clients in gaining awareness of their relationship with movement and their body and heal from compulsive exercise. Below I provide a very general overview of the defined problem and outline the healing journey in hopes to raise awareness of the problem and options for support.

While it’s different for each individual, here are some red flags that may indicate someone struggles with compulsive exercise:

  • Using exercise as a means to earn food

  • Scheduling around exercise or missing out on events in order to exercise

  • Increased agitation or anxiety when one is not able to exercise (think withdrawal symptoms)

  • Tendency to ignore or not respond appropriately to body cues and/or professional directives to decrease or abstain from exercise

  • Increased injury, pain, discomfort, or other medical risks

  • Feeling exhausted outside of time spent exercising

  • Difficulty taking rest days or feeling guilty for resting

  • Exercising out of a sense of obligation

  • Frequent or obsessive thoughts about exercise, including scheduling, type of activity, or output—whether calories, heart rate, time, reps, personal records

In order to understand the problem, it is important to understand the function of an eating disorder and compulsive exercise is a way of coping with uncomfortable emotions and experiences and results in an individual disconnecting from their body in order to escape from or decrease distress. Healing from an eating disorder and compulsive requires one to learn how to safely reconnect with their body by strengthening the mind-body connection and listening to cues about hunger and fullness—for food and movement—while finding more adaptive coping skills for emotions.

Of note, while an individual is in a treatment facility for an eating disorder, it is often recommended they minimize movement altogether while restoring to a healthy weight to support the healing process. Unfortunately, there has not been a lot of guidance for clients or clinicians alike as far as how to support clients in safely reincorporating movement after treatment and healing from compulsive exercise. This is a big undertaking and requires a great deal of support.

iMove incorporates education and experiential activities to increase awareness and introduce adaptive coping options to support a healthy relationship with movement.

An overview of the iMove program, often provided in the form of a 12 week closed group:

  • Inventory and assessment as well as journal prompts to help clients increase awareness of their exercise patterns, motives, and its impact on body sensations and emotions.

  • Education around iMove’s foundational framework of Polyvagal theory. More information can be read by clicking the link, but to summarize: our nervous system is responsible for motivating us for action to keep us safe as well as calming us from an activated state. Polyvagal theory introduces a third part to our nervous system which supports healthy nervous system response and healthy connection. Those struggling with compulsive exercise utilize physical activity as a way to calm the nervous system, so in iMove we consider alternative embodied ways to calm the nervous system and establish a sense of safety in connection.

  • Engaging in activities that support a stronger mind-body connection, including deep breathing, mindfulness/meditation, sensory exercises, and integrating mindful movement to promote nervous system regulation and promote integration and awareness.

It is a powerful approach that meets a significant need and we are thankful for Amy Gardner’s excellence in putting these pieces together.

As of now, at Wildernew we incorporate iMove components into individual sessions as relevant to a client’s goals, with the potential of starting a group in the future. If you or someone you know is interested in learning more about iMove or scheduling an appointment, please send an email here.

If you or someone you know is struggling with an eating disorder or attitudes and behaviors around food, I would love to help connect you with a professional who can help. Please contact me or visit the National Eating Disorder Alliance for additional information.