Why Living in a 'More Exercise Is Better' Culture Is Hard for Someone With Chronic Illness


For some people it’s a dirty word, for others it’s a struggle that offers rewards, and yet for others it’s what keeps them going every day. Its benefits are numerous: studies show it can help mood, sleep and weight control and it can help manage or prevent type 2 diabetes, heart disease and many other illnesses from arthritis to Parkinson’s disease. Some research suggests it can help prevent some cancers and even perhaps the onset of Alzheimer’s disease.

Exercise is perhaps the closest thing humans have to a cure-all, it seems, and our culture increasingly reflects that belief, with the ubiquitous Fitbits, apps to track the amount of exercise we get and big-box stores advertising treadmills and yoga mats throughout the year. All the messages we get are that exercise is crucial to an ever-healthier society – and what’s wrong with that?

Well, for me, the ever-increasing publicity of the importance of exercise – and the more exercise, the better – isn’t helpful or inspiring. It’s actually harmful to my mental and physical health. I’ve had severe juvenile rheumatoid arthritis (JRA) since I was 8, and for the past 20 years, I’ve also had debilitating chronic fatigue. I’ve never used those conditions as excuses not to exercise; quite the opposite: I have a difficult time giving myself permission not to exercise, even when I know a modest amount of it will leave me too exhausted to do anything but lie in bed for at least a day afterwards.

You see, I also have obsessive-compulsive disorder (OCD) with a strong dose of perfectionism, and those aspects of my psychological health contributed to the onset of anorexia nervosa when I was 19. I never vomited or used laxatives as a way of “controlling” my weight – I had too many gastrointestinal issues from my JRA drugs to make those viable options. Instead, I tried to “purge” by exercising as hard as I could. For me, this looked different than it might for an otherwise healthy person with an eating disorder; where “over-exercise” for many people with anorexia might consist of two hours on a treadmill and another hour doing weights, followed by an aerobics class, for me it meant walking two blocks as fast as I could with painful, damaged knee and hip joints.

I’ve worked hard on my recovery from anorexia, and I know to ignore articles with headlines like “Foods You Should Never Eat” or “This Diet/Exercise Plan Will Help You Drop 10 Pounds in a Week!” And I no longer think of exercise as a way to lose weight. But when I read articles promoting exercise in reputable magazines, such as those put out by health organizations like the Arthritis Foundation, it’s difficult for me to take what’s useful and ignore what’s not. If a clinical study says one should get at least 150 minutes of moderate cardio exercise per week, then I’ll do that, no matter how bad I feel during and afterwards. Given a choice between listening to my body or conforming to what I hear or read, I’ll do the latter, whatever the physical or mental cost.

In our present-day culture, with its endless barrage of “exercise more!” messaging reinforced by research demonstrating health benefits of exercise, I think a nuanced approach to movement based on individual situations and health can get lost. Even my clinicians who know my history of over-exercise, arthritis and chronic fatigue seem now to do as I do (in a less obsessive way, of course) – to value all the studies and news about exercise benefits over what’s good for the individual. My wonderful doctor, when I told her that exercising for an hour three days/week was leaving me bedridden the rest of the time, said she really didn’t want me to decrease my exercise – that I could as a short-term remedy, but not a long-term solution. Given how much I trust her, I took her words at face value and, after a two-week break, started pushing myself again, even though I felt no better.

I know information about the benefits of exercise is helpful and useful to many people, and I also know many people are better able than I am to do what they can and no more than that. But I still believe that for those of us fighting eating disorders – as well as those of us whose illnesses mean we just can’t push harder and harder – the pervasive calls to exercise more, and the idolization of those who push themselves beyond their limits, can be demoralizing and even dangerous.

If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237.

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Thinkstock photo via nd3000.

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