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Compulsive Exercise in Women

​How It Connects to Eating Disorders and How Recovery IS Possible!

If exercise feels less like a choice and more like something you have to do, even when you are exhausted, injured, or falling behind in the rest of your life, you are not alone, and you are not “dramatic.” Compulsive exercise can be deeply connected to eating disorders in women, and it often shows up alongside anxiety, perfectionism, rigid rules, and a loud inner critic. Research describes compulsive exercise as movement done to relieve distress about what might happen if you do not exercise, and it can continue even when it is harming your health, relationships, or daily functioning.

 

woman sitting on the floor at the gym

What is compulsive exercise?

Compulsive exercise is not simply “working out a lot.” It is exercise that has a compulsive quality, meaning it is driven by distress, fear, rules, or the need to prevent a sense of guilt, anxiety, or perceived consequences of stopping. It can be pursued even when someone is sick, injured, or clearly running on empty.

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Many people with compulsive exercise patterns describe an all-or-nothing feeling around movement. Missing a workout can trigger panic, shame, irritability, or a sense that the day is “ruined.” The routine can become non-negotiable, and life starts bending around it. Check out this study from the Journal of Eating Disorders. 

How is compulsive exercise connected to eating disorders in women?

Compulsive exercise often shows up as part of eating disorder symptoms, especially in anorexia nervosa, bulimia nervosa, orthorexia, and disordered eating patterns that use movement as compensation. In an eating disorder context, research suggests compulsive exercise may be maintained by eating disorder thoughts, emotion dysregulation, compulsivity, perfectionism, and behavioral rigidity, and can function to reduce anxiety tied to food intake or to influence body shape and weight.

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This matters because it helps explain why “just rest” can feel impossible. When the nervous system has learned that movement is the way to manage fear, guilt, or distress, stopping can feel like losing the only coping skill you trust. Over time, that pattern can reinforce the eating disorder and keep recovery feeling out of reach.

Multiple studies and reviews (e.g., Scharmer 2019) find that compulsive exercise is strongly tied to ED pathology, particularly regarding:

  • Eating disorder severity
     

  • Cognitions tied to weight/shape control
     

  • Obsessive or compulsive thoughts and behaviors
     

  • Negative outcomes like treatment resistance or poorer recovery trajectories
     

Clinical practitioners also consider compulsive exercise as a transdiagnostic feature of eating disorders - meaning it often contributes to both severity and maintenance of the disorder, not only in athletes but in non-athletic adults as well. That is not meant to scare you. It is meant to validate you. This is real, it is treatable, and it deserves care.

plus size woman sweating at the gym

Why compulsive exercise can be hard to spot

Compulsive exercise can hide behind praise. In our culture, discipline and “never missing” are often celebrated, especially for women who are taught that being “good” means being controlled, productive, and small. That social reinforcement can make it harder to notice when movement has stopped being supportive.

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It also gets missed because eating disorders do not have one look. A woman can appear successful, social, high-achieving, and “fine,” while quietly organizing her entire life around burning off food, earning meals, or managing anxiety through rigid routines. When exercise becomes the way to cope with stress, it can look like motivation on the outside and feel like fear on the inside.

What compulsive exercise can feel like day to day

Here are a few experiences we hear often, written out plainly because so many people think they are the only one:

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You feel anxious or guilty if you rest, even when your body is begging for a break. You make rules about what “counts” as exercise and feel like you have failed if you do less. You exercise to manage food guilt, to calm panic, or to feel “safe” in your body. You promise yourself you will be flexible, then feel a rush of distress when plans change. You keep moving even when you are injured, sick, dizzy, or undernourished. You cannot enjoy movement because it feels like a requirement instead of something that adds to your life.

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If any of that lands, it does not mean you are broken. It means your coping system got overworked.

When is exercise a red flag in eating disorder recovery

A helpful way to check in is to look at intention, flexibility, and cost.

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Intention: Are you moving to care for your body, or to change your body, manage guilt, or quiet fear

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Flexibility: Can you take a rest day without spiraling, bargaining, or compensating later


Cost: Is exercise stealing from sleep, relationships, nourishment, school, work, or your physical health

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In our free guide, we invite clients to explore questions like what narratives you tell yourself about exercise, what rules you have, and whether those rules align with your values. That values check matters because recovery becomes more sustainable when your choices match what you truly care about, not what the eating disorder demands. Check out our guide “Making Peace with Exercise” here.

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How therapy helps with compulsive exercise and eating disorder recovery

Therapy for compulsive exercise is not about shaming movement. It is about helping you build safety, flexibility, and trust in your body again.

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That usually includes:

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  • Recognizing the anxiety cycle and the rule system that keeps it going

  • Learning emotion regulation skills so exercise is not the only way to cope

  • Challenging perfectionism and rigid thinking patterns that fuel “must do” behavior

  • Rebuilding nourishment and rest so your brain can think clearly and your body can heal

  • Practicing small, realistic behavior changes that create momentum

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In our guide, we also share gentle, doable steps we use with clients, like making a list of movement that brings joy and experimenting with that, taking an inventory of how much time you spend exercising and shaving off a few minutes, and using those minutes for something you love.

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Progress is allowed to be small. Five minutes counts.

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Another powerful step is getting honest about intention. When exercise is primarily being used to change the shape of your body, it may be time to pause and reassess, and it reminds readers that many people struggle here because of cultural messages around size and discipline. That is exactly why support helps. You should not have to untangle this alone.

How we help at Recovered and Restored

At Recovered and Restored Eating Disorder Therapy Center, we help women work through compulsive exercise as part of eating disorder recovery and body image healing. We are a team of recovered professionals, and we take a compassionate, practical approach that helps you feel understood while you learn new tools.

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Our work is fully virtual, which means you can access care from a private space without commuting. We support clients across Pennsylvania, New Jersey, Delaware, Maryland, Connecticut, Vermont, South Carolina, and Florida, and we also offer recovery coaching worldwide.

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Depending on your needs, therapy may include approaches like cognitive behavioral therapy, dialectical behavior therapy skills, acceptance and commitment therapy, trauma-informed care, including EMDR when appropriate, nutrition support, and family and parent services.

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Compulsive exercise rarely exists in isolation, so we look at the whole picture: anxiety, OCD traits, perfectionism, food rules, body image, stress, and the ways you have learned to cope. If you are reading this and thinking, “I want help but I do not know if I am sick enough,” please hear this clearly: needing support is enough. You deserve help before things get worse, and you deserve a team that takes you seriously.

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