When you’re not allowed to run during eating disorder treatment

Not allowed to run during eating disorder treatment

It’s fairly common for a treatment team to ask people not to run during eating disorder treatment. This can be complicated since many times being athletic is a major part of a person’s identity and social life. The decision to pull a child from sports should never be taken lightly. But sometimes it is necessary to keep the child safe.

The letter

Dear Ginny,

My son was recently diagnosed with bulimia and is now in treatment. He seems to be doing well, but he’s really angry that his treatment team says he’s not allowed to run during eating disorder treatment.

He fell in love with running a few years ago and has been a star member of the cross-country team since then. I feel like running is his one joy in life. I feel so guilty enforcing the rule that he can’t exercise while he’s an eating disorder treatment.

Do you think it would be OK if he got back to running?

Signed, Shanna

My response

Well, Shanna, I totally get your frustration and I understand why you’re questioning his treatment team. Asking someone not to run during eating disorder treatment is hard. I’m going to walk you through a few of the reasons why parents typically don’t want to pull their kids off sports teams. And then I’ll give you some ideas about what to do.

1. Exercise is healthy, right?

The first reason a lot of parents want to keep their child on a sports team is that we know exercise is good for mental health. So if that’s true and if we have a child who’s struggling with their mental health, why in the world would we pull them out of exercise?

There are two things to know here. First of all, the studies about the health benefits of exercise are based on everyday movement, not competitive sports. We don’t need to compete in order to get the health benefits of exercise.

Next, while some exercise is definitely great for mental health, we also know that over-exercise is a major symptom of eating disorders.

So in early treatment, it’s going to be really hard to pull these two things apart. It will take time for his treatment team to be able to recognize the difference between what healthy exercise looks like for him and what’s part of the eating disorder.

Since their first mission is to keep him safe, they’re going to ask him not to run at least during the initial stages of eating disorder treatment. They need to do this so they can figure out how much exercise plays into the eating disorder itself. Figuring this out can take some time, and that’s probably their main reason for asking him to refrain from running right now.

2. Not running feels like a punishment

The second reason parents want to keep kids on teams is that not being able to run might feel like a punishment for having an eating disorder.

Since your son clearly enjoyed being on the team, it’s a serious issue to pull him out of that. I definitely don’t take that lightly and I really hope that his treatment team isn’t taking it lightly either. I wouldn’t expect them to.

Each eating disorder is unique. So that’s why your treatment team is probably doing their very best to try and evaluate your unique child. They need to evaluate the cost-benefit analysis of maintaining the running compared to successfully treating the eating disorder.

There are probably really good health reasons why his treatment team wants him to not run right now. But it’s not that they’re saying he can never run again. It’s just that he needs to work on recovery so that he’s healthy enough to run.

I think it’s important to address this head-on with him. Tell him directly that you can see how not running can feel like a punishment, but that your first priority is his health.

It’s better to name the elephant in the room than not actually acknowledge that this can feel really bad. And I think if you approach it this way, recovery may feel like an incentive rather than a punishment.

3. I don’t want to enforce the rule

OK, the third reason parents often want to keep kids on teams is that you might not like this rule at all, but you’re stuck enforcing it. And I totally get this.

Parenting a child through an eating disorder is exhausting at the best of times. It’s even harder when we feel as if we’re stuck enforcing rules that we don’t understand or believe in.

I think it’s important for you to get clear about the metrics your son’s treatment team is using. Ideally, he’s being monitored by a physician. His physician is the one who can clear him physically for exercise. Then his therapist should be consulting with his physician to clear him for exercise, both physically and mentally.

It’s a team effort, both the physical and the psychological clearance. Being cleared for exercise after an eating disorder may feel a little bit arbitrary to you, and that can be frustrating.

Sometimes it’s really clear and sometimes it’s not as clear. And it’s OK for you to ask his treatment team for more information about the milestones they’re looking for. Find out how much of a symptom running has been for him. Keep talking to them about this.

You’re part of your son’s treatment team. You’re not outside of it. And you should feel reasonably informed about the choices being made for his health and safety.

When you’re on board, he’s more likely to be on board. So don’t be afraid to ask questions and really be engaged with the team.

Health complications of bulimia

In addition to the fact that running can be a symptom of an eating disorder, there are also some pretty serious physical side effects of bulimia.

Probably the main thing is that we know bulimia can create cardiac complications. Symptoms include an irregular heartbeat and even heart failure. Bulimia is also associated with other complications like dehydration, ulcers, esophageal inflammation, and more.

There are some good reasons for not doing strenuous exercise when you’re in bulimia treatment. These issues are even riskier if he is at a lower BMI. But even if he’s at a higher BMI, it still doesn’t mean he’s necessarily safe to run.

His treatment team is going to be looking at the different factors involved. And they are qualified to make these choices. They’ll make the decision based on his physical and his emotional health.

But that doesn’t mean you have to be on the outside. You’re allowed to ask questions and find out more information. Hopefully, you can find a way to trust their judgment if you get the information you’re looking for.

I think it would help if you get clear about the metrics that the treatment team is tracking. Be part of that treatment team. I think that will go a really long way to making you feel more confident about your son’s health, both physical and mental. This matters both today and for the rest of his life.

Investigate the team dynamics

While you and his treatment team are collaborating on whether and when he can get back to competitive running, you can also be doing some research into the cross-country team itself.

Teams can be a great place for inspiration, motivation, and camaraderie. But sports teams can also be a place where eating disorder behaviors are encouraged or even taught.

If I were you, I would talk to the coaches and find out how they approach food and weight issues. I would try to listen in on team conversations, listening for red flags like fat-shaming or diet advice.

We really don’t want coaches or teammates making weight recommendations, weighing each other, criticizing people when they gain weight, or praising people when they lose weight.

And we also don’t want coaches and teammates to make nutritional recommendations beyond the most basic advice of eating enough food.

Yes, running can be healthy. Being on a sports team can be healthy. But both can also be a hotbed for eating disorders.

It’s wise to be cautious and do your research before you clear him to return to the team. Because remember, as long as he’s a minor, it’s actually your decision.

All of your reasons for wanting him back on the cross-country team are valid. But you also need to consider the bigger picture of his health. An eating disorder is a serious physical and emotional crisis that needs adequate treatment.

Shannah, I know that keeping your son off the team is so hard. I’m so sorry you have to go through this. I hope this advice has been helpful.

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Published by Ginny Jones

My mission is to help reduce body hate, disordered eating, and eating disorders.