Exercise Bulimia and Anorexia Athletica: Symptoms, Causes, Risk Factors & More 

The terms exercise bulimia and anorexia athletica are synonyms. They refer to a condition many live with, but few experts have studied it. If you have lost control of your exercise habit, you may need to keep reading.

Person hiking

People with anorexia athletica use excessive exercise to burn off ingested calories. Sometimes, people like this use a fitness episode in response to bingeing on food. But sometimes, people like this hit the gym to burn off calories from regular, standard meals. 

Exercise bulimia is dangerous, and it can lead to many health issues. If you’re using workouts to control your caloric intake, recognize that this is a form of an eating disorder. Therapy could be beneficial. 

What is Exercise Bulimia?

Medical books don’t contain entries for exercise bulimia or anorexia athletica. But many doctors have patients who describe an unusual relationship with fitness. 

It can be hard to separate a healthy workout habit from anorexia athletica, especially since we live in a fitness-loving culture. [1] But people with exercise bulimia use fitness in ways that would seem unfamiliar to healthy people. 

Exercise bulimia symptoms include: [2]

  • Working out when you’re tired, injured, or unwell
  • Exercising for hours at a time 
  • Working out every day, and feeling sick or anxious when you can’t
  • Not feeling satisfied with your body 
  • Working out instead of attending to your relationships 

These workouts are centered on helping people eliminate calories. People with anorexia athletica are desperate to be thin. Since they spend hours in the gym daily, they may seem incredibly fit.

But the mental distress associated with exercise bulimia is hard to overstate. People with this condition hate their workouts, and they don’t feel joy when they’re at the gym. Still, they feel compelled to stick with their routines, as they don’t want to gain weight. 

What Causes Exercise Bulimia?

Anorexia athletica is a form of eating disorder. It’s unclear why some people get these conditions and others don’t, but some risk factors are present in almost all forms of disordered eating. 

Those risk factors include the following:

  • Genetics: If your parents or siblings have eating disorders, you have a higher risk of developing them. 
  • Pressure: If you grew up in a home that prioritized fitness or thinness, you might have internalized those messages. They can be compounded when you’re around thin-loving peers at school or work. 
  • Messaging: Magazines, movies, and media often tie thinness to success. You may believe you’re not living your best life unless you’re small. 
  • Trauma: For some people, eating disorders are about control. They faced an issue in the past that left them feeling helpless. Moving forward, they will do anything to stay in control. Restricting their body size is a manifestation of that goal. 

Researchers say people with high self-esteem have a smaller risk of developing anorexia athletica. [3] When faced with pressure, they have the inner strength to support them. 

But participating in a sport or hobby related to thinness (like gymnastics or ballet) could increase your risk. Your time at the gym may enable you to succeed, but it may also bring adverse effects. 

Patient speaking with a doctor

3 Known Consequences of Anorexia Athletica 

Your workout sessions should make you feel better. But compulsive, excessive exercise can lead to very serious issues. These are just three of them.

1. Extreme Weight Loss

People with exercise bulimia often know just how many calories they’ve eaten every day, and they work out until they’ve expended a similar or more significant amount. Workouts like this leave your body with few reserves, and you can burn fats and proteins stored inside your body. 

You may see a very thin body when you look in the mirror. But your mind may tell you to stick with exercise until you lose even more weight. 

2. Fertility Issues 

When your body enters starvation mode, few resources are available. Your body can’t expend energy on things like menstruation or sperm production.

Women may stop having their periods, and men may have low sperm counts. This may not seem like a massive consequence to some people, but it could impair your future ability to have a child.

3. Pain

Workouts shouldn’t hurt. But people with anorexia athletica stick with fitness even when they’re sore, tired, sick, or injured. They may hurt almost all the time. Experts say exercise bulimia is tied to the following issues: [4]

  • Sore muscles
  • Joint pain
  • Bone pain
  • Discomfort from overuse injuries 

Despite your pain, you may still feel the urge to work out. Sometimes, people harm their bodies in permanent ways. For example, severe bone breaks, cartilage loss, and other orthopedic issues often require surgical interventions. But surgeons can’t do their work if people won’t heal after the procedures are done. 

How is Exercise Bulimia Different From Exercise Addiction?

Some people are fascinated with workouts for reasons that seem odd to someone with anorexia athletica. These people could have an exercise addiction, which differs from exercise bulimia in two important ways.

Weight Loss

People with anorexia athletica exercise to lose weight or keep it off. This is the primary reason they go to the gym, day in and day out. People with exercise addiction go to the gym because they are addicted to the physical sensation of working out. 

Bodies release many chemicals during workouts, lighting up brain pleasure centers. For some people, workouts are a way to get high. Weight loss, to someone like this, is a secondary benefit. 

Substance Dependence Features

Addictions cause the following: [5]

  • Tolerance: You must get more of the target (drugs or exercise) to attain the desired feeling.
  • Withdrawal: You feel sick or low when you can’t get or do the thing you’re addicted to. 
  • Loss of control: You can’t stop doing or taking the thing you’re addicted to, even if you try really hard. You can’t limit it, either. 
  • Time and commitment: You engage in the addiction behavior instead of anything else. 
  • Continuation: You keep participating in the addiction, even when you know it harms you. 

People with exercise bulimia may have some of these features. But they don’t typically have a tolerance for exercise or feel withdrawal when they can’t get work out. Weight loss is their goal, not the feelings of training. 

Treatment for Anorexia Athletica

Eating disorders respond to treatment programs that combine medications and therapy

Your medications can address chemical imbalances within your brain, leaving you ready to resist the urge to control your diet and punish your body at the gym. These medications could be especially beneficial if you have an underlying mental health issue, such as depression. 

Therapy helps to develop a healthy relationship with fitness. For example, you may work on what triggers you to exercise excessively. And you may focus on accepting your body for what it can do rather than what it looks like. Therapy sessions can be very intense, but the lessons you learn could change your life.

When you feel ready to exercise because you want to be fit and strong, not because you want to burn off calories in the foods you ate, you’ve regained control. But if you slip back into disordered workouts, you may need to return to therapy. Relapse is part of recovery from eating disorders. 

Do You Have Exercise Bulimia?

Think hard about what drives you to go to the gym. Do you go daily because you want to keep your body healthy? Are you trying to get ready for a sport or tournament? Or are you working out to eliminate the calories from a bite of cake you had earlier today?

Confronting your thoughts isn’t easy; it can take time to come to terms with your disordered habits. But when you do, a new life can emerge. 

If you think you have exercise bulimia, talk with your doctor or coach. Tell them how you’re feeling and ask them to work with you to find help. 

An eating disorder treatment program could be just what you need, and your close friends and allies will be critical as you heal. So include them in the conversation now.


  1. Brown M. (2010). Exercise Bulimia Sufferers Struggle with Guilt When They Miss a Workout. The Spokesman-Review. 
  2. Exercise Bulimia. (n.d.). Body Whys. Retrieved August 11, 2022.
  3. Gori A, Topino E, Griffiths MD. (2021). Protective and Risk Factors in Exercise Addiction: A Series of Moderated Mediation Analyses. International Journal of Environmental Research and Public Health; 18(18):9706. 
  4. Compulsive Exercise. (n.d.). National Eating Disorders Association. Retrieved August 11, 2022.
  5. Freimuth M, Moniz S, Kim SR. (2011). Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. International Journal of Environmental Research and Public Health; 8(10):4069-81.

Last Update | 11 - 8 - 2022

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