Exercise was a massive part of my eating disorder. It shifted quickly from something that was a leisurely and fun part of my life to an extremely compulsive and dangerous numbing mechanism. My relationship to exercise got hijacked by my eating disorder, and I used it as a way to survive difficult experiences and emotions—a pattern that I commonly see among my patients as an eating disorder dietitian. In fact, a 2025 study of over 21,000 participants with eating disorders showed that about half of them were participating in excessive exercise.

So, is it possible to incorporate exercise into eating disorder recovery, even when it’s so closely intertwined with the eating disorder’s rules and values? The answer isn’t black-and-white and carries a significant amount of nuance (like most matters in the eating disorder world). Today, we’ll look at the benefits and risks of incorporating exercise into recovery, some ways to know whether you or your loved one is ready for movement, and how to reintroduce exercise in a safe way.

What are the benefits of incorporating exercise into eating disorder recovery?

Traditionally, exercise has been something that’s left out of the treatment conversation, something that’s meant for later, when full recovery is reached. However, recent research shows that—when implemented carefully and appropriately—exercise can be a useful tool that enhances recovery and offers mental and physical benefits throughout the course of their recovery processes. Some of those benefits include:

Improved physical strength, better mental health, and decreased eating disorder behaviors

One 2023 review of studies showed that thoughtfully supervised and adapted physical activity during eating disorder treatment can benefit those in recovery, especially when the focus shifts from compensatory and weight-control motives to functional and health motives—in other words, exercising to improve strength or balance, for example, rather than to lose weight or change how your body looks. The review showed that for people in treatment for anorexia or bulimia, carefully integrating movement into treatment had neutral or positive effects, like increased physical fitness and decreased compulsive exercise.

Another 2022 review showed that including closely monitored and individualized exercise therapy can be safe in treatment, and could have benefits for muscular strength, mental health, and reducing disordered exercise symptoms in those with anorexia. “Exercise can have positive effects on mental health, like stress relief and mood regulation,” explains Equip therapist Jalia Henry, MA, LMFT. Both reviews found no evidence that integrating exercise into treatment is harmful to eating disorder patients.

More research from 2025 found that incorporating exercise (particularly resistance training) into eating disorder recovery while under the supervision of a multidisciplinary team is linked to improved muscular strength and body composition (muscle and bone mass). It also led to better relationships with exercise, helping patients shift their focus toward healthy goals like building strength, and away from the eating disorder’s focus on weight loss or control.

According to the Safe Exercise Guideline at Every Stage (SEES) guidelines, which were created by leading eating disorder experts, appropriately and intentionally implemented exercise can help achieve positive outcomes, like improved eating-disorder symptomatology, general psychological well-being, cardiac functioning and musculoskeletal health, and increased adherence to meal-plans and treatment.

Embodiment, body appreciation, and joy

Movement can also help people connect with and appreciate their body, a huge shift after living with the disconnection and judgment that comes with an eating disorder. “Movement or exercise allows us to connect to our bodies and relearn how to be present in them without self-criticism,” says dietitian Ana Pruteanu.

Additionally, it can help improve body image. Research suggests that mindfulness-based activities such as yoga can support healthier body relationships. For example, a 2019 study of college students reported that practicing yoga was associated with better body image, greater appreciation for their bodies, increased self-compassion, and reduced preoccupation with physical appearance. “To move from a negative body image space to a more neutral space, we need to be able to tolerate being in our bodies and movement can help with this,” Pruteanu explains.

Finally, movement can be a source of joy when it’s approached from a healthy place. Joyful movement, which is one of the ten intuitive eating principles, is about focusing on how your body feels instead of how it looks, how many calories you’re burning, or how it will affect your body shape or size. It’s about moving in ways you enjoy and that enhance your well-being, and for reasons outside of appearance or emotional numbing—like feeling empowered, connecting with nature, or other goals that have nothing to do with changing the body. “Movement can also help athletes rediscover joy in their sport apart from appearance or performance outcomes,” says dietitian Korrinna Kelly, RDN. “The key is ensuring it’s done for self-care, not self-control.”

What are the risks of incorporating exercise into eating disorder recovery?

While it’s often helpful to integrate exercise into the recovery process, there are risks to consider.

First, it can exacerbate malnutrition. If you or your loved one aren’t consuming enough food to support the body’s energy needs, engaging in exercise can severely compromise medical status. “There’s an increased risk of stress fractures and bone loss, loss of regular menstrual cycles and potential fertility impairment, and deterioration of organ function, including potential heart, kidney, and liver damage,” Henry explains. According to the SEES guidelines, exercise may not be healthful or safe for all people with eating disorders, especially those who are medically compromised (e.g. experiencing cardiovascular issues or electrolyte abnormalities). “Exercising during this time puts additional strain on the body and can cause further harm,” Pruteanu cautions.

The other major risk is making the eating disorder worse, especially if it’s not approached intentionally, at a pace that matches recovery progress, and with professional guidance. If exercise is introduced too quickly or intensely, or without parameters or supervision, it can make the eating disorder even stronger than before. For example, one of my clients noticed urges to restrict food got stronger when she started exercising without guidance after being in recovery for a short time. In my recovery efforts, I noticed that if I exercised in the same ways and amounts that I did when my eating disorder was at its worst, it was a slippery slope back into its grips.

“Exercise can easily become a disguised form of the eating disorder if it’s reintroduced too soon or without the right support,” Kelly says. "Psychologically, it can reinforce compulsive behaviors, guilt, or ‘earning food’ mentalities if those thought patterns haven’t yet been addressed.” Even mindfulness-based exercise like yoga can cause issues if it’s approached inappropriately or prematurely: in a 2021 study that examined eating disorder providers’ thoughts on yoga, they agreed that higher intensity practices (like power and hot yoga) can be especially detrimental and sometimes dangerous to people with eating disorders who are early in recovery or medically unstable (or both).

How can I know if it’s okay to resume exercise?

Now that you know the benefits and risks of exercise in recovery, take some time to consider your or your loved one’s unique circumstances to determine whether or not it’s safe to start exercise. “Readiness to resume movement depends on nutritional stability, medical stability and behavioral readiness,” Henry emphasizes. Start by answering these questions:

• Are you/your loved one medically stable (e.g. vital signs and labs are within healthy ranges)?
• Are you/your loved one consuming enough additional calories to support the increased demand from exercise (on top of your baseline and recovery energy needs)?
• Do your healthcare providers agree that you/your loved one are well enough to exercise?

If you answered “yes” to the above questions, it’s a good sign you may be ready to return to exercise. But if you answered “no” to any of them, it’s likely you still need more time before resuming movement beyond activities like stretching or restorative yoga (more on that later). All three questions are important—if you don’t feel confident about any of them, it’s probably best to hold off for now. “Being medically cleared to resume exercise is one of the first steps,” Pruteanu says. “In addition to that, the person needs to be willing to fuel their body for whatever exercise they want to incorporate, meaning they need to be willing to eat more than their baseline eating.”

If all of those fundamental questions are a yes, it’s helpful to ask a few additional questions that probe more deeply at the mental and physical impact movement might have. Ask yourself (or your loved one):

• Does movement cause physical pain?
• Is your/your loved one’s desire for movement driven primarily by a desire to change body size/shape?
• Does exercise feel compulsive and rigid?
• Does exercise increase mental distress or preoccupation with body size or weight?

If you answered “no” to the above questions, you might be ready for exercise, but if you answered “yes” to any, it’s likely you’re not there yet. Henry says it’s time to pause exercise if you’re doing any of the following: working out in secret; lying about the frequency, duration, or intensity of workouts; using external metrics like calories burned or time spent to dictate food intake, mood, or self worth; experiencing intense anxiety, guilt, or distress if you miss a workout. “Additionally, if you’re prioritizing exercise over essential recovery activities, such as attending meals, therapy appointments, or social commitments, it’s time to take a step back from exercise,” she says.

Best practices for incorporating exercise into recovery

Since everyone’s eating disorder recovery process is unique, whether exercise needs to be a part of yours (or your loved one’s) is up to you and your treatment team. If you’re interested in incorporating exercise into your recovery, here are some rules of thumb to consider:

Go at a slow pace

It’s best to start with gentle movement like walking, stretching, or restorative yoga. The SEES framework and guidelines is a helpful, evidence-based tool that lays out exercise readiness in recovery, based on physical and mental health symptoms and recovery status. While it was created for clinicians to guide exercise recommendations, it can be a helpful tool to understand how and when to increase exercise intensity and duration, and reference alongside your treatment team. Equip developed the Staged Approach for Exercise Reintroduction (SAFER) protocol, which is based on the SEES framework and helps patients safely and gradually return to exercise in a way that supports long-term recovery.

Work closely with a healthcare team

As the research suggests, having the guidance and support (and sometimes supervision, depending on your medical status) of a multidisciplinary team will help protect recovery and transform your or your loved one’s relationship to movement. This team should generally include an eating disorder dietitian, a therapist, and a medical provider. An eating disorder-informed dietitian is particularly important, as they will help ensure that you’re adequately fueling your workout. “Talk to your dietitian about what fueling can look like based on your personal needs,” Pruteanu encourages.

Choose something different

“Start with forms of exercise that in the past have not been tied with the eating disorder,” Pruteanu says. “For example, if running was at one point part of the eating disorder, try rollerblading or swimming instead.” You may be able to go back to running in a healthy way later.

Focus on how movement feels

Before, during, and after exercise, take note (mentally or in a journal) of how you feel physically, emotionally, and mentally. Taking inventory regularly will help keep you accountable and your relationship to exercise genuine and healthy, and you can notice any harmful patterns, like exercising when you feel sick or tired.

Keep connecting with your “why”

Regularly check in with yourself and make sure your reasons for exercising are in alignment with your authentic core values. “Be mindful of your reasons for wanting to exercise and how your approach may be changing,” Pruteanu suggests.

Take a break when necessary 

If you notice the eating disorder taking over before, during, or after movement, pump the brakes and reassess with yourself and your team. “It is ok to pause and restart if it doesn’t feel good,” Pruteanu adds.

Find what brings you joy

To reclaim exercise from my eating disorder and develop a healthy relationship to it, I had to get honest with myself about which forms of movement brought me joy, and make a commitment to leave any disordered exercise behaviors behind. Now, my movement practice helps me celebrate my body and connect with nature and loved ones, rather than adhering to an illness’s rigid rules. Take some time to consider which types of movements and ways of doing them you truly enjoy, and if you’re not sure, consider how you loved moving as a kid—that’s always a genuine place to start.

As an eating disorder dietitian living in full recovery, I believe that anyone with an eating disorder that has hijacked their relationship to exercise can reclaim it, and—with the right support, guidance, and intentions—experience a vibrant and joyful movement practice.