Can I Exercise During Eating Disorder Recovery? Why Movement Deserves the Same Care as Food

Content note: this article discusses exercise and eating disorder behaviours. It doesn’t include numbers, weights or calories. If you’re in treatment, please talk with your team before making any changes to how you move.

If you’ve been through eating disorder treatment, there’s a good chance food got a plan.

Meals were planned and supported. Fear foods were named and slowly challenged. Your relationship with food was talked about openly, often for months, with people trained to help.

Movement, on the other hand, usually got one word: stop.

And then? Often, nothing at all.

Food gets a plan. Movement gets a “stop.”

In eating disorder care, we are very clear and deliberate about food. We know that recovering a healthy relationship with eating doesn’t happen by accident. It takes time, support and a lot of gentle, repeated practice.

But for many people with an eating disorder, exercise is part of the illness too. It can be compulsive, driven or used to compensate, and it can continue even when someone knows it’s risky or has been advised against it by their doctor or physiotherapist.

Historically, our answer to that has been simple: stop all of it.

Sometimes, that’s exactly the right call. When someone is medically unwell, rest can be essential for safety, and I’m not arguing otherwise. The problem isn’t the stop. The problem is what happens next.

The question nobody really answers

“When can I exercise again?”

It’s one of the most common questions people ask in recovery, and one of the least well answered.

As a physiotherapist in a paediatric hospital, I’m often asked it by young people who are so unwell they’ve been admitted to the ward. And honestly? I answer it poorly, every time.

Not because I don’t care, but because I don’t know. No one does. I wish I could say, “On the 12th of June, you’re good to go!” But the real answer has far more nuance than that. There’s physiological stability. There’s psychological readiness. And there are a million other things, from what movement means to that person to what’s happening in the rest of their life, that make when, where and how such tricky questions to answer.

What I do know is that the answer shouldn’t come from a single checkpoint. Yet too often, the green light comes from a box being ticked:

“Your bloods and heart rate are stable now.”
Or, worst of all, “Your weight is high enough.” (Don’t get me started. Especially in adolescents, whose bodies are still growing and changing.)

Medical stability matters. It’s necessary. But it isn’t the same as being ready. A number on a scale tells us nothing about the thoughts that come with someone’s first walk, run or class in months. It tells us nothing about whether their relationship with movement has actually changed.

We would never consider someone’s relationship with food “fixed” just because their body had been medically stabilised. So why do we do it with movement?

Why “just start again” so often goes wrong

Picture this. Someone has been given the all-clear. They put on their shoes for the first time in a long time. And alongside any excitement, there’s fear.

What if the old thoughts come back? What if I can’t stop once I start? What if it’s just like last time?

That fear makes sense, because from experience, the old patterns often do creep back.

You’ve probably heard the term “muscle memory”. It’s the reason you can ride a bike years after you last tried. But it isn’t only our muscles that remember. Our brains link movement with everything that came with it: the rules, the guilt, the urge to earn or burn, the anxiety of missing a session. When someone returns to the same type of movement, in the same places, in the same way, those old thoughts and feelings can come rushing back with it.

Asking someone to return to movement without support is like expecting them to return to eating without a meal plan, and hoping for the best.

Without guidance, people are left to navigate one of the riskiest parts of recovery on their own. Many decide it’s easier to avoid movement altogether, sometimes for years. Others slide quietly back into old patterns, without anyone noticing.

Hidden in plain sight

Compulsive or driven exercise is common in eating disorders. Some studies suggest it affects up to around 80% of people with anorexia nervosa at some point in their illness. Yet it’s also one of the easiest eating disorder behaviours to hide.

That’s because we live in a world that tells us exercise is always good. More steps! No days off! You can never do too much!

(Cough, cough.) Oh yes, you absolutely can.

Restriction usually raises concern. Driven exercise is more likely to be praised. People hear “you’re so disciplined” or “I wish I had your motivation”, when what’s really happening is distressing, exhausting and, at times, dangerous. When a behaviour is applauded, it’s much easier to mask, and much harder to ask for help with.

So, can you exercise during eating disorder recovery?

The honest answer: it depends. And it shouldn’t be decided by you alone, or by a single number or weight, which is too often (and wrongly) used as a stand-in for readiness.

For some people, a longer break from certain types of exercise is the right thing for a while, and that’s okay. For others, a carefully supported return to movement can become a meaningful part of recovery.

What makes the difference is approaching movement with the same care we give food. A safer return to movement usually looks something like this:

Medical safety first. Decisions are made with your treatment team, not around them.
Exploring your relationship with movement. What does exercise do for you? What happens when you can’t do it? What would you like movement to feel like?
Starting small and structured. Gentle, low-intensity movement, often with support, rather than diving straight back into old routines alone.
Changing the context. Trying different types of movement, places or people, so you’re not walking straight back into the patterns of the past.
Having a plan for the hard moments. Knowing the early warning signs, and what you’ll do if old thoughts start creeping back in.
Building towards movement that adds to your life. Movement for connection, strength, fun or calm, rather than to compensate, earn or punish.

This is where a physiotherapist who understands eating disorders can help, working alongside your GP, psychologist and dietitian as part of your team.

We can do better

To my fellow clinicians: we’re passionate about supporting young people and adults through recovery from their eating disorder. The treatments and therapies we offer are carefully planned and supported. Meals and eating certainly are. Movement deserves the same intention.

If driven exercise is part of the illness for so many people, then movement has to be part of recovery, not just something that recovery happens around.

Movement can be part of healing. It just needs the same care as everything else.

If you’re struggling, please reach out to your GP or treatment team. You can also contact the Butterfly Foundation’s National Helpline for free, confidential support on 1800 33 4673 or at butterfly.org.au.

For clinicians who want to feel more confident supporting movement in eating disorder recovery, I offer one-on-one clinical supervision and an on-demand webinar on eating disorders in physiotherapy practice.