Overcooked
Diet and exercise taken to the extreme
What happens when people take diet and exercise to the extreme? We hear from the experts, and one woman shares her story.
A PHYSIOTHERAPIST CAN tell if you’re overtraining by looking at your injuries. Often, my patients have developed an overuse injury that’s been bothering them for a few weeks, but they’ve continued to exercise through the pain. These injuries usually happen when you do too much too soon.
When I examine my patients, it’s crucial to identify the cause of their injury, whether that’s lack of knowledge concerning how to progress safely or if it’s an addiction and they’re training through the pain because they think having to reduce their training load would feel worse.
Healthy exercise can be a rewarding and pleasurable activity. You may do it because you enjoy running in the mountains and being outdoors, as an example. You follow a routine but can hit pause when necessary, and your motivation to exercise is to be healthy, fit and see positive changes in your body.
But if you use exercise to improve your mood and stress levels, escape from unpleasant feelings or transform your appearance to increase your self-esteem, your risk for developing an unhealthy addiction may be higher. You may refuse to reduce your training load but increase the intensity and duration of your sessions. You may also train through the pain of an injury because you anticipate that the withdrawal symptoms you’ll experience if you stop exercising will be worse.
Overtraining can cause overuse injuries, and you may experience burnout or a drop in your performance. Some women experience amenorrhea (loss of their period), excessive weight loss and osteoporosis (loss of bone mineral density), which is known as the female athlete triad. That puts them at risk of developing a stress fracture, which can take months to heal.
If I believe one of my clients is overtraining, I’ll educate them on the effects of overtraining or compulsive exercise. Then, I’ll refer them to a psychologist who can assist them with proper treatment for anxiety, depression or obsessive-compulsive disorder. A dietician can help them get their diet back on track.
TO DETERMINE WHETHER a person has an obsession with eating, I clinically assess their diet and exercise patterns to see if those negatively impact aspects of their daily lives, such as social, occupational and familial. Do they cancel social plans with friends to maintain an exercise regime? Perhaps they’re at a family gathering and refuse to eat what everyone else is eating to stay within a certain kilojoule bracket (this excludes those with a physical health condition that may enforce food restrictions, such as diabetes or inflammatory bowel disease).
Exercise addiction may be a symptom of an eating disorder (e.g. anorexia or bulimia), whereby a person uses exercise as a compensatory behaviour to prevent weight gain. A person who exercises obsessively may develop
“Do they cancel social plans with friends to maintain an exercise regime?”
an eating disorder if their excessive and compulsive exercise behaviours trigger the need to control their eating patterns, which may damage them and their family, social or occupational relationships.
Experts don’t formally recognise orthorexia as a diagnosable condition despite a rise in awareness. I’ve had experience in treating individuals who present with the obsessive need to eat healthily. Patients are often treated similarly to those who present with anorexia or bulimia in that they undergo an initial thorough multi-disciplinary assessment. Psychologists explore the person’s cognitive (thinking) and behavioural patterns when it comes to their eating habits to challenge specific unhealthy thinking patterns they may have developed over time and provide alternative ways of thinking and behaving to aid recovery.
Eating disorders and compulsive exercise may be a result of body image concerns, and psychological and emotional problems, such as trauma, low self-esteem or perfectionism.
People with a family history of eating disorders or mental health conditions such as depression, anxiety or obsessivecompulsive disorders are more likely to develop an eating disorder.
Individuals who struggle with eating disorders aren’t paranoid about food but may become preoccupied with maintaining a specific diet or restricting kilojoules due to the impact they believe it’ll have on their weight. As a result, they may engage in extreme or unhealthy behaviour patterns to maintain their weight and body image.
BALANCE IS THE KEY TO A HEALTHY MIND, BRAIN AND BODY, WHICH INCLUDES THE GUT.
Many people confuse eating too little and, especially, excluding crucial food groups, such as complex carbohydrates, as a way to lose weight. That’s not healthy eating. You need a balanced diet to provide the energy your body needs to function. Your gut is the primary gateway for your daily fuel and cellular function requirements.
Current research shows normal intestinal (gut) bacteria produces at least 90% of serotonin (a feel-good neurotransmitter). The vagus nerve (the only cranial nerve that branches throughout the whole body and is in charge of the parasympathetic nervous system) works best when you’re relaxed. So, worrying about what or what not to eat hinders your digestive system, meaning you can’t digest and absorb food properly. That may lead to all sorts of issues, from indigestion to irritable bowel syndrome.
Experts have realised both the gut microbiome and immune systems are involved in many psychiatric illnesses, including eating disorders. That should come as no surprise, given the crucial roles of diet composition, eating patterns and daily caloric intake in modulating these biological systems.
But too much of a good thing can also be harmful. Research shows that excessive exercise (your maximum threshold is two hours of strenuous endurance activity at 60% of your maximal intensity level, which may be less depending on your fitness level) may cause gut damage.
Prolonged vigorous exercise activates a stress response that interferes with gut function, causing blood to flow away from it and towards your working muscles. That creates intestinal (or gut) cell injury, which may cause cell death and leaky gut (allowing intestinal bacteria to enter your general circulation).
“Moderation is best when it comes to exercise and a healthy gut”
It may also cause gut bacteria imbalances leading to inflammation (damage to your protective gut lining) and systemic immune response. It’s known as an exercise-induced gastrointestinal syndrome, and it appears that the risk of impaired gut function and gut injury increase at the same rate as exercise intensity.
Moderation is best when it comes to exercise and a healthy gut. Opt for the correct type of exercises (a combination of strength and endurance training) to improve gut health and function, and consult an expert for a proper exercise regime.
OVERTRAINING COST ME almost four years of racing, ankle surgery from which I’ve never fully recovered, and a psychological reset that made me face my demons. My coaches and I believed I was mature and emotionally stable enough to know when to stay in bed if I had a scratchy throat, stop doing speedwork if I got injured or go to a sports physician for blood tests if I experienced night sweats, a plummeting appetite or mood swings.
It started with below-average training sessions and missing my target time in races by 30 to 40 minutes, despite having given it my everything. I was depressed, weepy, but perhaps the most tell-tale sign was lethargy; I wanted to train, but I didn’t know how I’d get through it. Yet, somehow, I did. Thus began a six-year battle from which I’m only beginning to emerge.
I ended up here because I needed to belong to something to define myself, somewhere to direct my anguish and anxious energy. Triathlon was my identity. It was a lot like an addiction, characterised by escapism, denial and compulsion, which eventually inflicted harm. I hadnt addressed the eating disorders I suffered from when I was in university and it became a socially acceptable – even admirable – hiding place for my compulsive behaviour, as I desperately attempted to escape the suffocating loneliness that comes with trying to win. It became the only relationship I cared about, and in the process, wrecked quite a few others.
A major stumbling block in using training as an outlet for my emptiness was how I viewed suffering. As athletes, we pride ourselves (as we should) on our ability to get up at dawn and grind through interval sessions before the sun’s up. While that’s impressive, our identity and self-respect are rooted in our capacity to suffer. That makes it difficult to tell when you have to dial back the beast and consider whether it’s physiologically wise or even possible to keep pushing through.
I refused to take a step back, so surgery dragged me, kicking and screaming, into obscurity. The cartilage damage in my right ankle that physically prevented me from running was easy enough to fix with surgery, but my body took longer to bounce back. I had to stop training, the fallout out of which proved disastrous.
Despite my assault on my endocrine system, I’ve begun to emerge from overtraining. It’s taken me five years and an agonising psychological deep dive, but now I handle myself better than I did before. What I’ve learnt is that if you’re not in an emotional and mental space to step away when you’re too tired, stressed, bored, or simply not keen, then you may be in dangerous territory. Only you can judge that.
I don’t think I could’ve avoided overtraining because the headspace I was in had to run its course for me to understand the consequences of perpetually running into a wall. I can’t tell you how to avoid it, but I know where you’ll end up if you don’t catch yourself. I’m optimistic that with time, I’ll be able to train hard again without breaking out in night sweats or getting sick. It takes honesty and courage to admit you recognise the signs. It may feel like failure and weakness — it still does for me – but it isn’t. You need to reach within yourself to summon your courage. It might just save you from plunging your adrenal system into the red, and it may save you from having to take a multiyear hiatus.
“I refused to take a step back, so surgery dragged me, kicking and screaming, into obscurity”