You're listening to Food is Food, the podcast that will support you to ditch diet culture, break free from food rules, and debunk nutrition misinformation. I'm your host, Talia Chekelli, specialist eating disorder dietitian and founder of the TC Nutrition Clinic. If you would like to learn more about our one-to-one nutrition support and group program, or download your free portioning guide, head to wwwtaliachely.com. Each week we will cover topics that delve deeper into nutrition, intuitive eating, psychology, diet culture, and the consequences of under-eating. Our relationship with food is so complex and is influenced by our thoughts, emotions, and life experiences. Which is why healing from disordered eating is about more than just food. Welcome back to Food is Food. Daniel Manseray is a HCPC registered dialectical behavioral therapist and physiotherapist, dual-trained to combine integrative physical and psychological treatment to help people with and without an eating disorder to rebuild a healthy and meaningful relationship with exercise and address the eating disorder itself. Daniel is the clinical director of the ED Exercise Clinic, based in the UK, and has worked across inpatient, daypatient, and outpatient specialist eating disorder services. Daniel and I previously worked together on one of these inpatient units and we continue to share private clients as well. So I couldn't think of a better clinician to have this conversation with today. Welcome Daniel to Food is Food.
SPEAKER_00Hi, thanks for having me.
SPEAKER_02Thank you so much for coming today. For anyone listening today, Daniel and I go back a number of years now. So we used to work together on an eating disorders unit and have now both stepped into the full-time self-employment space. And Daniel runs an amazing clinic, uh, the ED exercise clinic. So I couldn't think of a better person to chat today about overcoming uh unhealthy levels of exercise and even just considering what is a healthy relationship with exercise like. So thank you so much again, Daniel.
SPEAKER_01No worries. No worries. I look forward to our conversation.
SPEAKER_02Fantastic. So I think, Daniel, a really good place to start is just thinking about what are the signs of an unhealthy relationship with exercise. And I say this because, you know, there's a part of me that thinks everyone would have a sense of maybe knowing that they might not have the best relationship with exercise. However, because of the world and the culture that we live in, with exercise being something that's celebrated even when it maybe isn't at the healthiest level, there can be a little bit of confusion as to, well, am I engaging in disordered exercise levels or is what I'm doing healthy and normal for me?
SPEAKER_01Yes, definitely. And it's quite complex. There's a lot of, I guess, different ways we could view what's healthy or unhealthy. Like you say, I guess the common ones, the ones we see most often, normally fall into categories around, let's say, exercising through injury, illness, sickness. Now, again, this one depends on certain contexts, but it's very common. Often using exercise to manage emotions. So whether that be to improve mood, almost a reliance on it to continuously improve your mood. Now, this one's important again in relation to not having any other kind of options or things in the week to improve mood. So very much I'm completely reliant and dependent on movement and exercise to make me feel good. And therefore, if I don't have it, you know, I'm really worried about I'm gonna fall into depression or have low mood. And then in the other side of things would be to avoid or reduce certain emotions we might not want to be feeling. So for example, if you're feeling really anxious or guilty, it might be used as a way to kind of reduce those emotions or prevent them from occurring. But then let's say you're constantly worried about certain foods or or body image, you then can fall into a trap of consistently exercising to forever kind of prevent and try and fight back the guilt or anxiety. So then again, you become dependent on the movement to prevent those emotions. In other terms, when it's kind of related to weight and shape, so in the sense that people often feel like they have to exercise to eat certain foods or to eat at all. And equally, because they've eaten the certain foods or in general, they now have to compensate through exercise, through movement. Rigidity, another big one. So again, we separate rigidity from having a routine. Rigidity is that concept where if one is to kind of stray from what has been set, it leads to a lot of distress or discomfort. So this idea that I have to do this amount of exercise today, no matter what happens, which can then affect you know relationships and prioritizing other things in life. So having very rigid exercise routines can be extremely unhealthy as well. And then social, in terms of social side of things, exercising instead of seeing friends consistently, so it actually damages the relationships. You know, not being able to go out or be spontaneous can then really affect social relations and family relations. And then physically, of course, often we see individuals who don't have a period or whose hormones have been affected. So continuing to exercise then can in theory be unhealthy. Depends how you look at it. And what I mean by that is there's ways that you can still exercise carefully whilst rebuilding or working on hormones or rebuilding physical health, but it's everyone's different, so it's hard to say specifically. And then, of course, literally whilst being injured, so not just the fact that you're exercising whilst injured, having an injury can impact things as well. So, yeah, ultimately we look at it as in a way biopsychosocial, so physiologically, is there anything unhealthy, whether it be really low weights, whether it be lack of periods, and are you exercising? That can be deemed unhealthy. Socially, how's it affecting your relationships and social life? And then psychologically, the psychological factors, is it become compulsive ultimately?
SPEAKER_02You shared so many really good points there because I can just hear so many of my clients saying things such as, but exercise makes me feel good. So why would I reduce it? Or how do I reduce something that does make me feel good, even though I know that it's bad? Similar to this fear around like the enjoyment of exercise. So people might say, but I enjoy exercise. So again, why do I need to make the change? And I imagine that's something that you help so many people with.
SPEAKER_01Yes, definitely. I hear that very often. And that those two beliefs can really impact even seeking help or wanting to start change. So the enjoyment one is an interesting one. I do often hear I enjoy exercise, which can definitely be true. You know, there's all sorts of exercise and sport that can be really fun. But really commonly, often in terms of compulsive exercise, let's say running, running's a common one. Often people say I really enjoy running. But actually, when we dig a bit deeper and we explore, okay, what do you enjoy about it? Have you actually mindfully connected to the moment to work out is this fun or not? Often people say they like being outdoors, they like being around nature, having time to think, maybe listening to a podcast. Very rarely is it I enjoy running. It's all the things that come with it. So sometimes we say, I wouldn't necessarily recommend this, but it's this concept of if you were to run on a treadmill without music, would it be fun? For some people it might be, but for many people it's not. And so when you really break everything down to just the pure sport itself, in that moment in time, is it fun? Or after the sport, is there a perceived kind of uh perception of change or relief that's happened? For example, oh fantastic, now I've run, I feel less anxious. So did I enjoy the run? Or do I like that how I've perceived what the run's given me? I now feel less anxious. So we try and really separate the enjoyment of the sport itself versus the feelings you might feel afterwards. You know, sometimes we can combine the two. Don't get me wrong, it's it's slightly complex, but the first layer, do we really enjoy it? Have we actually mindfully connected in the moment to notice what was fun about it? And for the second point, well, in fact, your first point around it makes me feel good, so why would I stop? I do hear that again very often. And I guess the key here is accepting and being more mindful again of it might make me feel good in this moment in time, but as a result, what are the negative consequences that occur? So, for example, a gym session might make someone, you know, feel better. But what does feeling better mean? Often, in these terms, it might be less guilt, less anxious, but as a result, they're now more tired. They've not prioritized a friend's birthday, so they feel sad or kind of left out, or their partner gets annoyed at them because they've spent time at the gym and they've not spent time with them. So actually, in the bigger picture, even though in that moment they felt good, in the long term, the consequences ultimately lead to them feeling bad or you know, lower in mood or more lonely or more sad. So we try and separate in that moment versus the long-term concept.
SPEAKER_02Yeah, that's so important. And I also liked what you're saying about the emotional connection as well, because and this is where the relationship with exercise is so complex and has so many layers, as you said, is that you know, sometimes we might want to move our bodies because it helps to manage stress, for example, is a really common reason why we move our bodies. But as you said, if it's the only coping mechanism that you have. So if, for example, you were to get injured, is maybe more of an extreme example, and therefore that form of movement was taken away, that can be a real eye-opener to people when they realize, oh, I don't have any other ways of coping with this emotion or something that's happened in my life.
SPEAKER_01100%. So, like you said, even if one is aware or not aware that it's used as the main coping mechanism for stress or or to manage mood or emotions, like you say, when a life event or something happens which ultimately might remove exercise temporarily or long term, that's when a lot of difficulties can occur. I'd say a key time when many, many people we see started developing an unhealthy relationship with exercise, or at least noticing it more, was during COVID. And this idea that let's say normal society was kind of stopped, maybe it be work or finding meaning or whatever was giving people purpose, was kind of removed. Suddenly they're faced with, oh wow, whether it be more emotions or having to sit with their emotions, you know, so that need to kind of move and avoid drastically increased. Now that's slightly separate from being injured, but the same premise. Another example would be how often individuals, once they're injured, they then really struggle because they can't exercise in the way that they had before. And suddenly they don't have any coping mechanisms for to manage emotions, to manage stress. You know, so then often there can be a knock-on effect on a relationship with food and their mood. So that's why it's so important to be able to have a whole range of coping mechanisms for difficult situations or to manage emotions, so that exercise isn't just that one thing holding everything together. Yeah.
SPEAKER_02And there's so many beliefs that we see in our clinics that really hold people back from being able to get the support. We've already identified some of them. There's a few more that I want to sort of name as well because I think it'd be really helpful for people just to realize that they're not alone in this as well. One of the really common ones that I see is this fear of losing my fitness and the identity of being a quote unquote fit person. And well, what if I lose that identity of also being a fit person? Is that something that you support people with, Daniel?
SPEAKER_01Yes, definitely. So we see, yeah, there's many fears that can affect people wanting to change, similar to the ones you mentioned, maybe losing fitness, identity, fear of weight gain, fear of changing structure, and often also fear of even not wanting to exercise. If they start working on it, they might suddenly just stop. They fear to stop all exercise. So a key thing we find in fear is it often exists in the vague. So when it's not specific. So for example, fitness can mean something different to you and mean something different to me. So it's always important, you know, to define to truly understand what do we mean fitness, for example. Someone assumes that it means I'm gonna do less cardio or run for less amount of time. I guess the debate with this is actually if you look at the facts long term, if you're consistently over-exercising or compulsively exercising or underfueling, you're actually damaging your body long term. And therefore, even it might take six months or two years, however long it takes, you're actually definitely going to decrease your fitness, if this makes sense. So a lot of the fears will actually occur if people don't change. But unfortunately, they're not necessarily aware of that. And it's harder to be aware of it if you haven't broken down what is the fear really? What does that specifically mean? You know, so whether it be identity, again, if your identity is I'm the fit one, you know, I'm the fit one in the friend group or in the family, and I don't want to lose that. The other angle is, well, if I keep going at this pace, underfueling, exercising every day, or exercising for injury, how long can I actually maintain this? And what happens when it's removed from me without my choice, i.e., I get really badly injured, or I get developed osteoporosis and I can no longer exercise like I used to. So a key thing really with that is understanding the fears, breaking them down, and truly understanding what does each fear mean, what does it mean truly? And then noticing that actually most fears will actually occur long term if people don't make the changes or rebuild that healthy relationship with exercise.
SPEAKER_02So it comes back to that longer-term thinking, like you mentioned before, is what is the impact of my behaviors right now and how is it going to impact me in five, 10, 20, 30 years.
SPEAKER_01Exactly, exactly. It's always trying to connect that short-term action but with a long-term consequence, which is what makes it so hard, because it can, of course, be hard to think long-term, you know, often as humans, it's human nature to think about what's affecting me right now and what do I want right now.
SPEAKER_02Yeah, I understand. So I think the exercise and nutrition relationship is so intertwined. Um, so I see the same things in terms of long-term, focusing on nutrition for the long haul rather than in the moment as well. Daniel, you mentioned osteoporosis, which comes up a lot in the work that I do. Again, the interplay between nutrition and movement and the impact that that has on our bone health. And one of the questions that I get quite often from the clients that I work with is around the types of exercise to do to support bone health long term, especially if they have been diagnosed with osteopenia or osteoporosis. And it's a really layered conversation to have, but just for the listeners to understand in terms of is weight-bearing exercise something that is recommended throughout sort of the recovery or nutritional rehabilitation process, especially in the context of like osteoporosis or osteopenia.
SPEAKER_01Yeah, no, good question. I'd say it's a very complex question, maybe more complex than people realize. And again, in relation to, let's say, eating disorder or disordered eating and compulsive exercise population, I'd say something very different. So, really and truly it's so individualized, it would be hard to say what is or isn't appropriate. But generally speaking, the first rule of thumb is truly nutrition. Without kind of a solid, consistent nutritional plan, whether it be weight restoration or whatever it might be for that individual, it's very hard to then think about the weight-bearing piece. So I guess rule of thumb always to be thinking about the nutritional side first, and then it would completely depend on the individual. So just for example, there might be someone who has compulsive exercise. So the exercise I might give them still might be different to someone else who doesn't compulsive exercise. So it's about the details for each person that are very important. So if I were to say a specific weight-bearing advice now, someone might take it out of context. So it's really important that people accept the first rule of thumb in terms of progressing with whether you have osteopenia or osteoporosis, we'll be exploring that nutritional side of things. And then being aware of what can come next through day exercise, making sure the compulsive part is worked on first before adding or thinking about what physical exercises can be can be given. And on that might disappoint some people, people might want some clear advice, which makes sense, but I'd say it's so individualized when it comes to advice, especially for those with an unhealthy relationship with exercise, that it's important to just accept as a process and I guess the nutrition and then the exercise and that kind of rehab comes with time, depending on their relationship with exercise.
SPEAKER_02Yeah, thank you. It's so important to consider because I'm just thinking about just how many different factors there are to consider when we think about the recommendations around physical activity, and as you said, nutritional status is one of them. Then we have other things such as bone health. Is someone who can menstruate menstruate? What is their blood work indicative of? What is their psychological and social well-being like? Like there's so many things that we need to take into account to be able to then provide those recommendations for the type of activity and amount of activity that someone can do. And so I'm really glad that you said that it needs to be individualized because it's just one of those things that we cannot give bulk standard advice for.
SPEAKER_01Yeah, 100%. And often I do see many people, for example, who've seen physios or whoever it might be, who of course are treating, let's say, the injury. But actually, even then, we need to be rethinking like how do we give exercises, especially to someone who does compulsively exercise? Because the base of a physiotherapy kind of treatment plan, on paper, it can become rigid very quickly. 10 sets of three reps every day. And the individual can then be quite confused and think, well, I've been told to be doing this amount. Whereas actually, before thinking of that physical injury, depending on what it is, we still want to be taking awareness of the psychology, the compulsive relationship with exercise. And actually, if someone's underfueling, whether they're compulsory exercising, actually can they even build strength depending on their physical situation? So, how effective are, for example, strength-based exercises at that point in someone's treatment? Again, it's so individualized. You know, we have to take everyone individually understand their situation and also their goals and what they want.
SPEAKER_02Yeah, and I see it so commonly in a lot of people that I support who are weight suppressed or underweight and trying to build muscle and have to have a quite a very direct conversation to say that you're not able to build muscle until your nutritional intake and your energy intake is above sort of in that surplus range. But then we have the eating disorder side that's saying, well, my muscles have become more visible, and then it's a challenge that we're saying actually that's because your body fat percentage is really low. So again, there's just this difference in terms of what might be sort of misinterpreted from an eating disorder self versus what the reality of the situation is as well.
SPEAKER_01Yes, 100% agree. And that's what's so important. I often advise people is to truly understand first what are your exercise goals. So when people are, let's say, compulsive exercising, maybe doing abdominal crunches in their room, for example, I'm always intrigued and want them to think, okay, so I'm just curious what are you hoping to gain from doing that? And often it does say a toned stomach. And then again, what does that truly mean? And often people assume that means ultimately, you know, visible six pack. But like you said, to get that, you need to build muscle. And often individuals are losing weight, undernourished, underfueling, whilst doing, let's say, exercises. So interestingly, once you understand this goal, you can then educate people to realize you're actually potentially burning that muscle. You're actually potentially decreasing the chance of what you want. And that's why it's so important at the beginning to understand people's beliefs and goals around exercise and then include the education piece. Because I've worked with many people actually, once just with the education, it suddenly changed the exercise they were doing because they realized, oh, what I'm doing is actually getting me further away from what I want. And that can be quite a nice way to start the treatment already, kind of breaking some beliefs with education. The power of education is really important, and I can often be missing an eating disorder treatment in general, because there aren't that many physios, for example, commonly seen in uh eating disorder treatment, which can impact things.
SPEAKER_02Yes, I couldn't agree more. I wish there were more of you, Daniel. And I think that one of the other beliefs that's often intertwined with the conversation that we're having, and I see it with from a nutritional side as well, is that quote unquote, I'm at a normal or healthy weight. So therefore, the way that I move my body is fine. And that's also really important for us to bring into the conversation today is that having an unhealthy relationship with exercise and having a negative impact on your physical and psychological health can happen in any body, shape, or size.
SPEAKER_01Yes. Many of our clients have the same difficulty or the same belief sometimes. Um, first This client group are often quite invalidated. Often they see the GP or they or they see different health professionals and just their environment in general. And people often say, Oh, you're fine, or you look fine, or you're quote unquote a healthy weight. And that, of course, confuses people and makes them question how bad is this? And so that really affects people, whether they seek help or they even think there is a problem. So that's the first thing. And then I would say exact 100%. Number one, we often see a lot of people with high levels of muscle mass. And so actually, when we look at their BMI, we can't see it as effective or clear-cut because we have to question how much is muscle mass covering up the real issue here. So that's that's something really important that, again, is often overlooked. And then, yes, exactly, people have to accept there's still physiological issues, regardless of if the weight is healthy or unhealthy, there can still be physical issues. We see many people whose again, weight according to BMI, would be healthy, but who don't have a period, for example. Okay. And then equally the psychological side of things and the social side. So maybe, maybe on paper, physiologically, they are okay. And that's fantastic. But at the same time, maybe they're losing their friendships. They feel like they're constantly preoccupied with exercise or food or weight or shape. They can't enjoy holidays because they have to wake up at a certain time, they have to do certain movement. So the real thing, the most important part of the beginning process at least, is understanding what is exercise taking away from me. So maybe it isn't affecting my physical health, but okay, how about my psychological health or my social life? And how does my future look in a few years if I don't uh challenge it? So it's really important to accept whether physical health is okay, well, how is it affecting everything else, you know, and other parts of my life?
SPEAKER_02Yeah, for sure. And the the behaviors that can often be celebrated in our society as well. So if you gave the example waking up early on a holiday to go to the gym, people around you might be like, well done, that's so disciplined, that's great that you're exercising on holiday, without understanding the intention behind that person driving them to wake up early on holiday. It's not coming from a healthy place. And I'm saying this just to reiterate how hard it can be to reach out for support when, as you shared previously, a lot of the fears and the beliefs and the experience is being invalidated by people around you. So I really just wanted to highlight today if you are experiencing any of those struggles that Daniel has mentioned, it is enough of a reason to reach out for support with someone such as Daniel. Like please do reach out to his clinic. Because as we've said, these short-term behaviors are taking away from your long-term health. So this is your sign, please, to definitely reconsider getting support and taking that courageous step.
SPEAKER_01And just to double down on that, I'd say this client group, and in terms of client group, I mean people who struggle with their relationship with exercise, very invalidated often. You can't blame the environment, but it can happen from the environment in the sense that from physical health, from friends, from family, it is easy, like you said, to say amazing discipline or I wish I could be like you. But again, that makes the individual number one question, okay, why is things so hard? Why am I so unhappy if I'm so disciplined? And equally it then really strengthens that identity, which is I'm the fit one or I'm the disciplined one, which unfortunately again makes it harder to then try and rape that or remove it because people feel worried about losing that sense of self or that sense of self-worth as being the disciplined one, being the fit one. So I guess the key thing is for people to pause and look at their own life and just think more about am I happy? Is my relationship where I want it to be? Are my friendships how I imagine them to be? Do I feel like I'm living the life I want? And that's the first thing to explore before kind of acknowledging the environment or how they might be trying to praise, let's say, the wrong things. It's to think a lot more around what do I want? And is is my relationship with exercise giving me the life that I I want or deserve?
SPEAKER_02Yeah, really good question to ask and to reflect on. Are there any sports, Daniel, that people should be avoiding in recovery? I know that's another quite a common question.
SPEAKER_01Yes, I'd say it's really important. One really important part of building a healthy relationship with exercise is understanding that every sport can have a different impact. So actually understanding the details about different exercise, different types of sport is really important and again often overlooked. So it's just understanding different sports have different risks physiologically and psychologically. So I would say again, it's hard to say because it's completely individualized. Everyone's different. But based on my experience, and also from a questionnaire, we could see different results. The most common uh sports that we'd say are compulsive or can increase the chance of developing compulsive movement would be walking and running and cycling. These three specifically, now again, any sport in theory can be done compulsively. It might be hard for shooting or those kind of sports, but other than that, generally speaking, you can always compulsively exercise. So it's not to say that these three are the only ones that can become compulsive, but we find that things like walking, running, easy to do by yourself, low barrier to entry, very easy to measure, very easy to compare. There's so many apps these days where you can kind of compare the speed that you ran with someone else. It's endurance-based, so it can be potentially have higher risks towards physical health. So there's so many layers to each sport that we find. So it depends on the person, but we find that the kind of individualized, very easy-to-access sports that you can do by yourself, low social connection, often can become compulsive.
SPEAKER_02And yeah, as you're speaking, I just wrote down walking because I think that's such an important one that people can sort of dismiss in that they don't count it as movement. It's I'm just walking. But actually, what I see in practice is that people will replace one form of maybe higher intensity activity such as running for walking for a longer period of time or not even a longer period of time. But it's that that notion of, well, I'm replacing one unhealthy behavior with what I think is a healthier behavior, but actually it's just equally as unhealthy. It's just disguised in a different way.
SPEAKER_01Yes, exactly, exactly. And often again, people understandably want to get fresh air or they want to, you know, see nature or be outside. But unfortunately, they that can be confused with the underlying compulsion as well. Both can be true. I can want fresh air, I can want to clear my mind. And equally, I feel a need or an urge to do this walk. It's not necessarily done naturally or spontaneously. And actually, that often we do see walking can become a big issue when it becomes so entrenched and rigid in the day that I have to get my walk in, I have to do this amount of steps. And actually, that's something that would be important to challenge in terms of let's say inpatient treatment. Now, this is a whole nother conversation. But again, this challenge of you have X amount of time to go on a walk can actually increase rigidity and increase the compulsion. But again, there's many more layers to on picking and understanding why one is given X amount of time or a walk. But it's just to understand walking in itself can become very rigid and very compulsive and is often, like you said, overlooked because people don't necessarily view it as exercise.
SPEAKER_02Yeah, and I think what I'd be really interested to hear, and I think I already know your answer, but in terms of fitness watches, so Fitbits, Apple watches, etc., what are your thoughts on those when when we're thinking about this topic of unhealthy compulsive exercise?
SPEAKER_01Yes, destroy them. Destroy them. But in general, sometimes you often advise if you can just break it, give it to someone else. Unfortunately, it is a very, very big maintainer of compulsive exercise because it gives that feedback, which is oh, I did X amount of steps, now I feel less anxious or I feel less guilt. People become reliant on their Apple Watches or Fitbit, for example, whether it's to feel good, for self-worth, just to reduce those emotions. And it disconnects, it really disconnects people. Um, I actually saw a really interesting, I'm sure it went viral. There was a clip from I think a marathon, and a guy thought he was winning the whole way, and someone took him over last second. But in those last few seconds, he was checking his Fitbit or his time on his watch. And it's just an interesting, it's quite a symbolic clip to show how it disconnects us from the moment. It actually leads to a lot more stress and difficult emotions in theory, if you look at the bigger picture of it. So, yeah, I'd say I guess they can have their place in society. It can be useful, it can be done effectively or nicely. But specifically when rebuilding a healthy relationship with exercise, I would avoid as best as possible using Fitbits or trackers because that really does maintain the individual's need to keep moving or that urge or that obsession because of what the numbers, you know, what they might believe or connect to those numbers.
SPEAKER_02And I would say if someone's listening in and wears an Apple Watch or a Fitbit and they're thinking, oh, maybe do I have an unhealthy relationship with this, I'd encourage you to take it off for 24 hours and see what happens. See what emotions come up, see what you feel like at the end of those 24-hour periods. Um, because that can be a really telling experiment to do. And one of the other really common questions that, well, actually, just on the Fitbit conversation, because I know that this will probably be a question that comes up in people's mind when they listen to that. The 10,000 step guidance, I know this wasn't part of what we'd planned to talk about, but is there anything that you wanted to say with that? Because I know it's something that people will say, such as, oh, well, government guidelines recommend 10,000 steps or the you know the 10,000 step sort of recommendation floating in the air. So therefore, I need to hit 10,000 steps in order to be healthy. Yes. Would you like to bust that myth, Daniel? Yes.
SPEAKER_01So in terms of, I guess, government guidance or guidance on hitting 10,000 steps or whatever it might be, the key is we always say is to go back to self. It's impossible to give guidance to every human. Every human's different. So by default, any kind of generic guidance you have to take with a pinch of salt. We always say, look at your own life, look at your physical health, emotional health, social life, all of these things again, ultimately is exercise, is walking that amount, for example, giving you the life you want or taking away from it. And often if people reflect and think, okay, what do I have to do to get X amount of steps? Okay, I have to wake up at 5 a.m. and now I'm tired the rest of the day. And now my work, my career is affected. So it immediately is taking away from life. Or I don't have a period, but I feel the need to keep walking and keep moving. Again, it's going to affect my physical health. The key with that is coming straight back to, regardless of guidance, even if the guidance was true, it doesn't mean it's true in relation to that individual. Does that make sense? The guidance doesn't say 10,000 steps if you have a compulsive relationship with exercise or if you have an eat disorder. So again, it's just thinking about how am I different? What's my own personal situation? And even if somehow it is still healthy for me, is it what I want? Does it give me the life that I want? So always just coming back to does it give me what I want long term, is it truly connecting to my values and helping me live the life I want?
SPEAKER_02Yeah, so important. We keep going back to that message, don't we?
SPEAKER_01Yes, I guess a key part of the approach is always build a life worth living. So it's always connecting back to why am I doing this? What life do I really want to build? Which can be extremely hard to think about for a lot of people and can often still be interlinked with compulsive movement or eating disorder, disordered eating concepts. So we still want to separate those things and truly think what is going to make life worth living ultimately.
SPEAKER_02Yeah. And there's one more question, Daniel, around completely stopping exercise in recovery. So I know that this is something that often comes up when we think about recommendations and treatment. So, in answer to that question, what are your thoughts on do you need to completely avoid exercise during recovery?
SPEAKER_01Yes. Another big question, complex question in terms of should one avoid all movement or exercise during recovery. Again, I would always say so individualized. I could never say one thing for everyone. But what I would say, a lot of the research actually does show how this can have a negative impact on people in different ways, but again, very individualized. What I would say is very rarely have I seen that work effectively. I guess in situations where it really is physically impossible or so physically dangerous, of course that will make sense. If someone's at super high risk and there's all the clear physical health markers that would truly show it doesn't make sense to exercise. The same way someone lies in hospital bed post-operation, physically it doesn't make sense to get up and start exercising. So that I completely understand. But in terms of recovery, generally speaking, if someone's identity is deeply intertwined with movement, for example, if you suddenly remove all exercise, what are they going to do? Where are they going to go to in that moment? Chances are might lean more towards food restriction or body or you know something else that they can connect to their identity that's somehow related. So even just thinking of it from a psychological point of view, it can have negative ramifications. But also many people who compulsively exercise do enjoy some parts of it or could enjoy some parts of it. So actually, how do we rebuild that relationship? It can mean reducing exercise or adapting it, but how do we think about rebuilding it instead of just pulling it away? Because ultimately they're going to exercise at some point in their life afterwards. And in theory, it can be healthy when done psychologically, healthfully, and physiologically in a healthy way. It can be a positive exercise is positive for longevity, for health, for well-being. We know it's positive. But of course, when done in a healthy way. So in theory, I think we can set individuals up to fail if we just remove exercise, if we're not going to then help them rebuild and reintegrate it, because often it's a big part of the people we see is life. So there's no way they're not going to restart. So it's almost a disservice to not at least help them rebuild and rethink about it and build that relationship if you were to remove it. But yeah, generally speaking, I wouldn't everyone's different, but we rarely, rarely suggest removing exercise. And it's more about understanding the individual and rebuilding based on their own needs.
SPEAKER_02And Daniel, for the people listening, I think one of the questions that they would have, because it can be so overwhelming to know where to start. How, you know, what is that first step that I need to take to improve my relationship with exercise? Do you have any advice on what that first step might look like?
SPEAKER_01Yeah, definitely. This can be the hardest part, really and truly, is actually making that first step towards change or seeking help or whatever that might be. Often there's an interesting way we look at things. Often when the pain of someone's reality or their desire for a different future outweighs their fear of change, that's often when the first shifts begin to occur. So it's being able to accept and start to notice a lot more how much is this impacting my life? What is it taking away? What happens if I keep going in money is time? So almost increasing that pain and discomfort about it, it might sound a bit weird, but that's what's in theory gonna be more likely to make people think, you know, I'm sick of this, I'm desperate now, I really need help. Or often that desire for a different future. Maybe a wedding's coming up, or a holiday's coming up, or they really want a different career. That desire for something, when they realize if I keep going the way I am, I won't reach what I want. This desire as well can then outweigh the fear of making those changes. So often we advise people to do a lot of work around acceptance and awareness. To be able to accept if I keep going, can I truly manage this? What's going to happen? Am I gonna get osteoporosis? Am I gonna be able to have kids? And equally awareness, becoming aware of what is happening day to day. Oh, I have this set routine or I do this specific behavior or I have this specific thought. So just becoming more aware of what are the behaviors that are affecting me. So that combination of acceptance of reality and deeper level of awareness, we always work on first, and we find there's a super important way to at least start the process. Because if we're not accepting there's a problem or we're not aware of the problem, it's impossible to make changes. So yeah, that's what we'd advise. But it is very difficult, we accept, and we appreciate it's very hard for people because the fear of change can be so strong.
SPEAKER_02Yeah, yeah. But we have worked with so many people who have been able to make that change, and the first step generally is the hardest, isn't it? Or one of the hardest.
SPEAKER_01Definitely. Often we find as soon as people make that first step, things start to fall into place. Of course, it still takes time, a lot of commitment, a lot of time, but at the same time, they can see really positive changes once they've made that first step.
SPEAKER_02Yeah, yeah, definitely. Thank you so much, Daniel. I think that we have covered so many really important points today when thinking about what an unhealthy relationship with food looks like, and for our listeners to be able to just reflect on those different areas, so the physical, psychological, and social elements of what having a healthy relationship with exercise looks like. And then we've also spoken about types of movements, we've spoken about common fears and beliefs. So I really hope that this episode is going to be helpful for so many people. I'll also include this in the show notes, but just to end, Daniel, where can people find you?
SPEAKER_01Yeah. So our website is the Eating Disorder Exercise Clinic and Instagram, again, the ED Exercise Clinic, which I'm sure you'll attach it to or collaborate with us as well. The best would be the website or our Instagram page. Great.
SPEAKER_02Fantastic. Well, thank you so much today for coming on and we'll stay in touch.
SPEAKER_00Thanks. Thanks for having me.
SPEAKER_02Great. Thanks so much, Daniel. Thank you for tuning in to Food Is Food. If you found the episode nourishing, hit subscribe so you don't miss our weekly episodes. And just before we wrap up, a little reminder that the discussions in each episode are for informational purposes and don't replace individualized advice. Because every recovery journey is so unique. Please consult your healthcare provider for support. That's all for today. Stay nourished and see you next time.