Is Your Dedication to Exercise Making You Less Fit?

Activity Disorder: Too Much/Little Of A Good Thing

From "The Eating Disorders Source Book"

WebMD

Accompanying the steady increase in the number of people with eating disorders has been a rise in the number of people with exercise disorders: people who are controlling their bodies, altering their moods, and defining themselves through their over-involvement in exercise activity, to the point where instead of choosing to participate in their activity, they have become "addicted" to it, continuing to engage in it despite adverse consequences. If dieting taken to the extreme becomes an eating disorder, exercise activity taken to the same extreme may be viewed as an activity disorder, a term used by Alayne Yates in her book Compulsive Exercise and the Eating Disorders (1991).

In our society, exercise is increasingly being sought, less for the pursuit of fitness or pleasure and more for the means to a thinner body or sense of control and accomplishment. Female exercisers are particularly vulnerable to problems arising when restriction of food intake is combined with intense physical activity. A female who loses too much weight or body fat will stop menstruating and ovulating and will become increasingly susceptible to stress fractures and osteoporosis. Yet, similar to individuals with eating disorders, those with an activity disorder are not deterred from their behaviors by medical complications and consequences.

People who continue to overexercise in spite of medical and/or other consequences feel as if they can't stop and that participating in their activity is no longer an option. These people have been referred to as obligatory or compulsive exercisers because they seem unable to "not exercise," even when injured, exhausted, and begged or threatened by others to stop. The terms pathogenic exercise and exercise addiction have been used to describe individuals who are consumed by the need for physical activity to the exclusion of everything else and to the point of damage or danger to their lives.

The term anorexia athletica has been used to describe a sub-clinical eating disorder for athletes who engage in at least one unhealthy method of weight control, including fasting, vomiting, diet pills, laxatives, or diuretics. For the rest of this chapter, the term activity disorder will be used to describe the overexercising syndrome as this term seems most appropriate for comparison with the more traditional eating disorders.

SIGNS AND SYMPTOMS OF ACTIVITY DISORDER

The signs and symptoms of activity disorder often, but not always, include those seen in anorexia nervosa and bulimia nervosa. Obsessive concerns about being fat, body dissatisfaction, binge eating, and a whole variety of dieting and purging behaviors are often present in activity disordered individuals. Furthermore, it is well established that obsessive exercise is a common feature seen in anorexics and bulimics; in fact, some studies have reported that as many as 75 percent use excessive exercise as a method of purging and/or reducing anxiety. Therefore, activity disorder can be found as a component of anorexia nervosa or bulimia nervosa or, although there is yet no DSM diagnosis for it, as a separate disorder altogether.

There are many individuals with the salient features of an activity disorder who do not meet the diagnostic criteria for anorexia nervosa or bulimia nervosa. The overriding feature of an activity disorder is the presence of excessive, purposeless, physical activity that goes beyond any usual training regimen and ends up being a detriment rather than an asset to the individual's health and well-being.

Girls' Self-Image May Affect Future Weight

CHICAGO, Illinois (AP)
Where a teenage girl sees herself on her school's social ladder may sway her future weight, a study of more than 4,000 girls finds.

Those who believed they were unpopular gained more weight over a two-year period than girls who viewed themselves as more popular. Researchers said the study showed how a girl's view of her social status has broader health consequences.

The girls in the study were still growing -- their average age was 15 -- and all of them gained some weight. However, those who rated themselves low in popularity were 69 percent more likely than other girls to increase their body mass index by two units, the equivalent of gaining about 11 excess pounds. (The body mass index, or BMI, is a calculation based on height and weight.)

Girls who put themselves on the higher rungs of popularity also gained some excess weight, but less -- about 6 pounds.

Both groups, on average, fell within ranges considered normal. But a gain of two BMI units over two years is more than the typical weight gain for adolescent girls, the researchers said.

"How girls feel about themselves should be part of all obesity-prevention strategies," said the study's lead author, Adina Lemeshow, who began the study as a Harvard School of Public Health graduate student. She now works at the New York City Department of Health and Mental Hygiene.

The research, appearing in January's Archives of Pediatrics & Adolescent Medicine, used data from an ongoing study used frequently by scientists studying childhood obesity.

Weight and height data were reported by the girls themselves rather than getting weighed and measured by doctors; that's a weakness in the study that the researchers acknowledged.

The researchers took into account the girls' weight and BMI at the start of the study, along with their diet, household income, race/ethnicity and whether they'd reached puberty -- and still found the link.

In the study, perceived popularity was measured in 1999 by how the girls reacted to a question next to a picture of a 10-rung ladder: "At the top of the ladder are the people in your school with the most respect and the highest standing. At the bottom are the people who no one respects and no one wants to hang around with. Where would you place yourself on the ladder?"

The researchers put the girls into two groups: the 4,264 who said they were on rung 5 or above, and the 182 who said they were on rung 4 or below. The weight gain link was based on those two groups.

Clea McNeely of Johns Hopkins Bloomberg School of Public Health called the study strong. She said she wanted to know more about the 4 percent of girls who rated themselves below average in popularity, particularly whether they already were gaining weight faster before they rated themselves as unpopular.

"The reason this paper is so important is it has broader implications beyond weight gain," said McNeely, who was not involved in the research but wrote an accompanying editorial. "Subjective social status is not just an uncomfortable experience you grow out of, but can have important health consequences."

Experts know little about how to intervene in teenagers' peer groups to improve health, McNeely said, but when adults set standards in schools, students treat one another with more respect.

Teenagers may give grown-ups "bored looks," she said, but "adults are still the most important influential figures in their lives."

The study was supported by a grant from the National Institutes of Health.

Moderate Fitness Also Cuts Women's Stroke Risk

NEW YORK (AP) -- Being merely moderately fit -- walking briskly half an hour a day -- can lower the risk of having a stroke, according to a new study whose findings apply to women as well as men.

Physical activity can help prevent blood clots and the buildup of artery-clogging plaque.

Much of the previous research on stroke and fitness has been on men and relied on participants to report their physical activity, said Steven Hooker, who heads the University of South Carolina's Prevention Research Center in Columbia and led the study. About a quarter of those in the new study were women, and everyone had a treadmill test to measure his or her fitness level.

"It seems that benefits we've been observing in men for many years ... are also observed in women," Hooker said.

He said even those who were moderately fit had a lower risk of stroke. Most people can reach that fitness range by walking briskly for 30 minutes a day, five times a week, said Hooker, who presented the findings Thursday at the International Stroke Conference in New Orleans.

Stroke is the nation's third-leading cause of death. It occurs when blood flow to the brain is stopped when a blood vessel is blocked by a clot or bursts. Hooker said physical activity can help prevent blood clots and the buildup of artery-clogging plaque.

For their research, Hooker and his colleagues used data from a study of more than 61,000 adults at the Cooper Aerobics Center in Dallas, Texas. After taking a treadmill test, the participants periodically answered health surveys. The latest research divided the group into four levels of fitness and looked at how many of them had strokes, following them an average of 18 years.

Overall, there were 692 strokes in men and 171 in women.

The study found that men in the most fit group had a 40 percent lower risk of stroke than the least fit men. The most fit women had a 43 percent reduction in their risk of stroke compared with women in the least fit group.

For moderate levels of fitness, the risk reduction ranged from 15 to 30 percent for men and 23 to 57 percent in women.

The lower risks held true even when taking into account other risk factors for stroke such as smoking, weight, high blood pressure, diabetes and family history.

Fitness is "a strong predictor of stroke risk all by itself," Hooker said.

In its stroke prevention guidelines, the American Stroke Association recommends at least 30 minutes of physical activity of moderate intensity on most days of the week. The new study "is certainly consistent with all of the recommendations that we already have in place," said Dr. Larry Goldstein, a spokesman for the group and director of the Stroke Center at Duke University.

Teaching Myself to Love Exercise

By Jackie Adams
CNN

Hardly a day that goes by that you won't find Tracey Wygal working out at the gym. Tracey Wygal weighed 295 pounds before starting a "clean diet," keeping a food journal and exercising.

The 30-year-old middle-school teacher does cardio exercise, strength trains and follows what she calls a "clean diet."

That's quite a change for a woman who tipped the scales eight years ago at 295 pounds.


Wygal first started gaining weight in her early teens. A fast-food diet and little to no exercise helped her pack on the pounds, and her weight ballooned to over 200 pounds.

"It was my first year out of college, and that number, along with being diagnosed as morbidly obese, was very frightening," remembers Wygal. "I went to several doctors, trying to get them to prescribe a weight-loss pill."

But none of her doctors would give her the quick fix she was looking for. Instead, a physician handed her a 1,600-calorie-a-day diet and told her to start moving.

At first, Wygal was shocked and refused to begin a diet that she thought was too restrictive. Even though her weight was rapidly approaching 300 pounds, she believed she had a pretty good diet and an active lifestyle.

As her weight crept up, Wygal grew more frustrated, and eventually she decided it was time to gain control of her life.

She started by keeping track of her daily calorie intake in a food diary and soon realized that her eating was worse than she thought.

"I was amazed by how many calories I was eating," Wygal said. "The food diary showed me that I really needed to get my food intake under control and helped me maintain my diet realistically."

She also started exercising.

At first, Wygal says, she was too embarrassed to go to a gym, so she bought an elliptical machine and started working out 15 minutes a day in her apartment.

"It was all I could do at first. I didn't give up, though," she said. "Gradually, my endurance improved. After losing about 30 pounds, I decided to join a small gym."

Several months later, Wygal was ready to take the next step. She hired a trainer and began a short strength-training program.

That's when something clicked.

Instead of feeling intimidated, Wygal started to love her workouts and the physical changes taking shape with her body. Ready to take the next step, she joined a larger gym, began researching different workouts and got into weight training.

Over the next three years, she lost 120 pounds and dropped seven dress sizes. Wygal, who's 5 feet 10 inches tall, says the fear of gaining weight motivates her to stick to her diet and exercise regimen because she never wants to look like she did at 295 pounds.

Now comfortable with her weight, which she says fluctuates between 170 and 180 pounds, Wygal works out at least five to six days a week. She says the key to losing weight and keeping it off is being honest about what you eat, writing it down and staying consistent. She wants people to know they can do it, but there are no quick fixes or easy outs -- just hard work.

"It won't happen overnight," Wygal advises. "Know that it will take time but it is worth it in the end."

NEW YORK (CNN) -- The New York City Board of Health voted unanimously on Tuesday, to require all city chain restaurants to post calorie data on their menus. The order requiring New York chain restaurants to post calories on their menus comes after months of litigation.

Some restaurants already make the calorie counts of menu items available, but beginning March 31 they will have to put the numbers on menu boards and menus.

The change will affect restaurants with 15 or more outlets -- roughly 10 percent of all city restaurants, according to a news release from the city's health department.

The Department of Health argued in October that "calorie information provided at the time of food selection would enable New Yorkers to make more informed, healthier choices."

The expectation is that the information will help combat obesity in New York, a city in which 54 percent of adults are overweight or obese, according to a 2005 Community Health Survey.

"Today, the Board of Health passed a regulation that will help New Yorkers make healthier choices about what to eat; living longer, healthier lives as a result," said Dr. Thomas R. Frieden, New York City's health commissioner.

I Blogged My Weight Off

By Jackie Adams
CNN

She was never really skinny or terribly overweight. Lynn Bering weighed 296 pounds and wore a size 30 in 2004. She now weighs 129 pounds and wears a size 4.

















But Lynn Bering knew something wasn't right when she realized she'd gained more than 100 pounds in just four years.

Doctors blamed a sluggish thyroid but Bering said that was only part of the problem. She also admitted to bad eating habits, which included a lot of carbohydrates.

Wearing a size 30/32 and weighing nearly 300 pounds, Bering said it became difficult to move around and she felt tired and run down.

Even though her husband and family were supportive, Bering said she often passed on social events and work assignments out of embarrassment.

"I was the features editor at the local newspaper [and] getting increasingly uncomfortable with how I looked," Bering recalled. "I was increasingly giving up stories to interns so I didn't have to be out in public as much."

So, when a local antiques store went up for sale, Bering jumped at the chance to switch careers, but for the wrong reasons.

"I had no self-esteem. I was still me inside. I just didn't like how I looked," Bering admitted.

Ashamed of her looks, the store acted as a fortress for Bering, who said she became a hermit for nearly four years. The weight also was starting to take a physical toll.

"My antique store had 19 stairs and they were hard to climb. ... I would be out of breath," Bering said. "I thought, 'What if I got sick? How would they get me down those stairs?' "

Even though doctors told Bering the weight wasn't good for her health, it was the stairs that helped motivate her to change.

"I was 296 pounds at my highest weight and I'd had enough," Bering said. "I was tired of being fat, tired of not taking care of myself."

In February 2005, Bering was finally ready to do something about it. Never one to join a club or like big crowds, she started walking at the track at a local university and also joined an online weight loss program. At first, she walked a mile and then a mile and a half, two miles and eventually she completed a 5K in 38 minutes.

But Bering said the one thing that's helped her most is her blog.

Writing down her thoughts and feelings about why she ate helped Bering do the inner work, which she believes is necessary before anyone can do the outer work and lose the weight for good.

"Gaining weight has as much to do with emotional well-being than physical," Bering said. "You don't just get to 200 pounds because you're eating bad food. You're eating bad food for a reason."

Initially, she started "Lynn's Weight Loss Journey" to keep herself accountable and update her sister and friends on how she was doing. It wasn't until she started receiving comments from people she didn't know -- thanking her for sharing her story -- that Bering began to realize she might empower others.

As she blogged, the pounds melted off.

Today, Bering, who's 5 feet 5 inches tall, has dropped 13 dress sizes and weighs about 129 pounds. She eats a mostly vegetarian diet, works out five days a week and maintains her weight loss through a network of friends she's met online via discussion boards.

"Being thin makes me feel good physically. ... I can move around, lift my granddaughter," she said. "I like the way I look and the way exercise has shaped my body."

Even her husband, Larry, who's one of her biggest supporters, has lost 25 pounds and kept it off for three years.

Bering said the weight loss has taught her to respect her body and live in the moment. She's traded in the antique shop for freelance writing and spends more time with her family and a wider circle of friends.

"I can love and appreciate that woman who [was] 300 pounds but I don't want to go back there," Bering said.

"It's taken a lot of work to get where I am, but I love that feeling."

He's Half the Man He Used to Be

By Jackie Adams
CNN

Two years ago, Phill Novak weighed 387 pounds. After losing 192 pounds, Phill Novak, 41, says he feels there's nothing he can't do.

















He wasn't happy with his weight and neither were his doctors. In addition to taking medication for high blood pressure and cholesterol -- his physician warned him that he was on track to become a diabetic.

Reality hit in January 2006 at a Pittsburgh Steelers game. Novak had gone to smoke a cigarette.

"We were walking back up to our seats, and I started getting winded," says Novak. "I didn't feel right, I started sweating. I didn't think I would make it back up. My heart [was] beating a million times a minute; I thought I was having a heart attack."

Novak stood against a cold wall for 20 minutes to catch his breath. Fortunately, he wasn't having a heart attack but he was so frightened that thoughts of his family began to race through his mind.

"A lot of things went through my head, about saying goodbye to my kids," says Novak choking back his tears. "I told my friend, 'This is it, I'm not going to live like this no more.' "

Novak, who was approaching his 40th birthday, made it through the football game. As he ate two double-cheeseburgers and a milkshake, he began to think about the limitations of obesity and how it was keeping him from living a full life.

Novak said the extra weight kept him from riding bikes with his kids. He dreaded doing anything physical like mowing the grass, shoveling snow or just moving -- period. Novak says even sleeping became difficult.

"When I was big, I could only sleep one way ... so I could support my belly," says Novak. "My back always hurt ... I could barely sleep and I remember always being tired."

The next day, Novak devised his own game plan and started his weight-loss journey.

He began simply by walking -- one mile a day and started eating healthier.

"I walked off my first 100 pounds," he says. "Walked it off, an hour a day. I lost 100 pounds in seven months."

Novak continued to lose weight and as he built up his endurance he started jogging. Even though he had never belonged to a gym, he wanted to incorporate strength training. But the first time he went to the gym, he was intimidated by the loud music and weight lifters. He says he quickly "scampered" out and tried a few other places until he finally found a club where he felt comfortable. Watch more on how Phill Novak got motivated to lose weight. »

Two years later, Novak has lost a total of 192 pounds. Today, he runs 30 to 40 miles a week, works out two to three hours a day, does yoga in the morning and squeezes in a push-up whenever he gets a chance at work.

Now maintaining his weight at 195 pounds, Novak says he's made a lifestyle change and rarely takes a day off from exercise.

Still, he doesn't take all of the credit for his weight loss. Novak says he couldn't have done it without the support of his family -- which he thanks for allowing him to be selfish.

"I am so proud of myself ... for the first time in my life," beams Novak. "Besides my kids, [this is] the first time I'm proud of myself."

Novak says losing weight has boosted his confidence and made him realize that he can do anything he sets his mind to. He says people also treat him differently and no longer stare at him. In fact, he enjoys the fact that people, who haven't seen him in a while, recognize only his Pittsburgh accent.

When he looks back at pictures of himself at nearly 400 pounds, he says it's hard to believe he treated his body that way.

Would he ever go back to being heavy?

"No way! Ain't going back there ... won't do it, can't do it," says Novak.

"I've never been happier in my life!"


Matt Sloane contributed to this discussion.