Do you have exercise bulimia? Inside the eating disorder that men don't talk about

Do you find yourself plagued with obsessive thoughts about whether you’ve burned off enough calories during your last workout? These are all symptoms of exercise bulimia, a condition that, while lesser known than eating disorders like anorexia, is more common in men than you’d think.

Exercise bulimia is a psychological disorder in which a person feels compelled to compensate for eating (or, in some cases, binge-eating) through exercise. Someone with exercise bulimia might want to immediately hit the trails after a large lunch, or tack on an extra ten minutes to a workout if they opted for a side of fries over your usual broccoli.

Exercise bulimia is a subset of bulimia, in which people feel compelled to vomit or purge after meals. “Bulimia will always entail some type of compensation - so the behavior here is compensating food eaten through physical exercise rather than purging, or a diabetic skipping insulin for example,” says Kate Rosenblatt, MA, LPC, the clinical director of BALANCE eating disorder treatment center in NYC.

Although there are no solid numbers on the prevalence of exercise bulimia, Melainie Rogers MS, RDN, CDN, CEDRD says it is fairly common among men. While for women, it’s usually more about losing weight, for men “it may manifest as a desire to reduce body fat or to gain muscle,” says Rogers.

Generally speaking, eating disorders are often under-reported, as many men and women are not properly diagnosed or treated for the condition. We know that eating disorders in general are more common among women — per the National Eating Disorders Association (NEDA), approximately 20 million American women will have an eating disorder at some point in their lives, as opposed to 10 million American men. But that number may not reflect reality, due to the taboo associated with men seeking out help to deal with their eating disorders. “There is a lot of stigma around this issue,” says Rosenblatt.

After an episode of binge-eating, “in desperation to not ‘undo’ all their hard work at the gym, they will then resort to even harder workouts to ‘work off’ or ‘erase’ the overeating. This becomes an extremely vicious cycle,” explains Rogers. If you prioritize workouts before things like social engagements or work, Rosenblatt says, that could be a sign that you have a problem.

That said, it’s not just about how often you exercise — it’s also the obsessive nature of your thoughts. How often are you thinking about food, exercise, and the two of them paired together? Does the number of minutes of exercise per day affect how many calories you’ll eat?

“If you are questioning whether or not you have a problem with exercise bulimia, see what it is like to skip a workout. Does it cause a lot of anxiety? That can give you a good gauge on what kind of impact this exercise is causing in your life and mental state,” says Rosenblatt.

For instance, if you always exercise at 5:00 p.m. on Thursdays, and one day you have a doctor’s appointment and can’t go to the gym at that time, you could start feeling tense and worried, as though you won’t be able to make up for that lost time later.

Like most eating disorders, exercise bulimia can result in serious consequences for your health. Over a long period of time, “exercise bulimia can cause dehydration and physical exhaustion….men can be at risk for a reduction in electrolytes (sodium, potassium, calcium) and this can cause cramping at a minimum, and heart failure at the extreme,” says Rogers.

That’s because every time you exercise, you lose electrolytes and deplete mineral stores, which you’ll need to build back up through food and re-hydration. But if you’re not fueling adequately or if you keep exercising too much, they will be chronically low. That’s why, even if you don’t feel the immediate physical effects of over-exercise, you can often feel fatigued or moody.

Overall, “in the short term there may be a sense of relief coming from exercising, but in the long term it leads to isolation and suffering,” says Rogers.

How To Treat It

If you suspect you might have exercise bulimia, the first step is to consult with a therapist who has experience treating such disorders. It’s crucial to discuss how often you have intrusive or anxious thoughts about exercise, as well as the specific nature of your thoughts. It may also be beneficial to consult with a medical doctor, psychiatrist, and a dietitian “to improve the relationship with food and exercise and to work on anxiety and underlying issues,” says Rosenblatt.

Most of all, it’s important for men to know that there’s no shame in struggling with an eating disorder. Now that more men are coming forward about struggling with eating disorders, there are more resources available specifically for men, such as support groups and treatment centers.

If you are struggling with an eating disorder, please seek professional help or call the National Eating Disorders Association Helpline at 1-800-931-2237.