{"id":5032,"date":"2023-06-27T00:31:21","date_gmt":"2023-06-26T17:31:21","guid":{"rendered":"https:\/\/loudhdtv.com\/?p=5032"},"modified":"2023-06-27T00:31:21","modified_gmt":"2023-06-26T17:31:21","slug":"in-eating-disorder-treatment-exercise-is-banned-thats-harmful","status":"publish","type":"post","link":"https:\/\/loudhdtv.com\/?p=5032","title":{"rendered":"In Eating Disorder Treatment Exercise Is Banned\u2014That&#8217;s Harmful"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script><br \/>\n<\/p>\n<div>\n<p> <span class=\"drop-cap__first text-dropcap \">I<\/span> was standing by the window when a voice interrupted.<\/p>\n<p>\u201cYou need to have a seat.\u201d<\/p>\n<p>A therapeutic assistant at the residential eating disorder treatment center where I was then a patient stood nearby, glaring at me.<\/p>\n<p>I had been standing while talking on the phone with my mom, when the staff member interrupted. I was only allowed a few minutes for the call, so I decided it wasn\u2019t worth the fight and sat down.<\/p>\n<p>Standing wasn\u2019t the only forbidden activity at the facility. Motion of any kind was so frowned upon that providers even coined a term for it: \u201cexcessive body movement.\u201d<\/p>\n<p>\u201cAny kind of movement in [eating disorder] treatment\u2014from fidgeting to formal exercise\u2014is closely surveilled, monitored, structured, and overall limited,\u201d says <a href=\"https:\/\/www.staciefanelli.com\/about\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.staciefanelli.com\/about\">Stacie Fanelli, LCSW<\/a>, of <a href=\"https:\/\/revolutionaryedpsychotherapy.com\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/revolutionaryedpsychotherapy.com\/\">Revolutionary Eating Disorder Psychotherapy and Consulting<\/a>.<\/p>\n<p>As someone with anorexia recovery, I can attest to this: At all five treatment centers where I have been a patient, movement was forbidden.<\/p>\n<p>During my first inpatient visit, an assistant sat in my room with me until I fell asleep, which I believe was meant to ensure that I didn\u2019t exercise. At another treatment center, I once was sitting on the floor during a group therapy session, rocking back and forth. I didn\u2019t even realize I was doing it; the motion just felt soothing. Almost immediately, a therapist rushed over, signaling for me to stop. It didn\u2019t matter that I had been self-soothing\u2014my coping skill wasn\u2019t allowed.<\/p>\n<p>\u201cEven for those for whom over-exercise and under-fueling has been the primary behavior at play, how are they supposed to repair their relationship with [exercise] when we\u2019re sending an abstinence-only message?\u201d Fanelli says. \u201cWhen my clients are told they have to drink a supplement when they\u2019re \u2018excessively standing\u2019 or engaging in joyful movement like hanging upside down off a couch, they\u2019re getting validation that movement is in fact a form of currency that you use to earn food, which is exactly what many eating disorders are telling them.\u201d<\/p>\n<p>For me, not being able to move during treatment only took away a key tool that I\u2019ve used to heal.<\/p>\n<div class=\"related-content \" style=\"\" data-module-init=\"related-content\" data-module-immediate=\"\" v-cloak=\"\">\n<div class=\"related-content__wrapper \" v-cloak=\"\" :class=\"{'is-loaded':isLoaded}\">\n<p> <span class=\"inline pr-6 text-seafoam-dark\">Related Stories<\/span> <\/p>\n<p> <related-content class=\"related-content__links\" parent-article-permalink=\"https:\/\/www.wellandgood.com\/eating-disorder-treatment-exercise\/\" current-title=\"Many Eating Disorder Treatment Centers Ban Movement\u2014For Me, That Only Made It Harder To Heal\" current-image=\"GettyImages-eating-disorder-treatment-exercise.jpg\" v-on:parsely-posts-loaded=\"onPostsLoaded\" start-date=\"2022-12-26\" tag=\"div\" inline-template=\"\" url=\"https:\/\/www.wellandgood.com\/eating-disorder-treatment-exercise\/\" secret=\"w5ztterVB03LGZJLfXS0hf3EvQBuFFIWew9hmVQxthU\" apikey=\"wellandgood.com\" limit=\"3\"> <\/p>\n<div>\n<div class=\"related-content__card mb-[10px] sm:mb-[20px]\" :class=\"{'related-content__card--full':posts.length === 1}\" v-for=\"(post, key) in posts\"> <a v-on:click.prevent=\"trackLinkGA($event, key)\" :href=\"https:\/\/www.wellandgood.com\/eating-disorder-treatment-exercise\/post.url\" data-url-source=\"related-content\" class=\"related-content__link\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"\"> <\/p>\n<div class=\"related-content__card--image bg-tan\" :style=\"{ backgroundImage: 'url(' + post.image_url + ')' }\"> <img :src=\"https:\/\/www.wellandgood.com\/eating-disorder-treatment-exercise\/post.image_url\" :alt=\"post.title\"\/> <\/div>\n<p> <\/a>  <\/div>\n<\/p><\/div>\n<p> <\/related-content> <\/div>\n<\/p><\/div>\n<h2><strong>Why eating disorder treatment centers restrict movement<\/strong><\/h2>\n<p>What\u2019s behind providers\u2019 insistence on not allowing patients to move? Psychiatrist <a href=\"https:\/\/withinhealth.com\/team-members\/wendy-oliver-pyatt\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/withinhealth.com\/team-members\/wendy-oliver-pyatt\">Wendy Oliver-Pyatt, MD, FAED, CEDS<\/a>, founder of several eating disorder treatment centers, including <a href=\"https:\/\/withinhealth.com\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/withinhealth.com\/\">Within Health<\/a>, explains that for some patients, a period of rest may be needed if their body needs time to heal from disordered behaviors. Those with restrictive eating disorders may truly not be fueling their bodies enough to allow for anything strenuous. Some patients may also need time off from movement for psychological reasons, if they feel like they <em>need<\/em> to exercise to burn calories.<\/p>\n<p>Fanelli adds that another major concern for centers is liability. Providers don\u2019t want to be responsible for a patient passing out or injuring themselves, for instance, so they ban movement to reduce the chances of this happening.<\/p>\n<p>But instead of being upfront about these fears, she says centers sometimes shift blame onto the patient. \u201cProviders often couch their fears that come with the perceived physical fragility of all eating disorder clients in a catch-all \u2018that\u2019s your eating disorder talking\u2019 accusation so that they don\u2019t have to take accountability for what\u2019s actually their own anxiety,\u201d Fanelli says.<\/p>\n<p>As a patient, I can\u2019t help but feel like this kind of policy is created for providers\u2019 own self-preservation. Rather than treating patients as individuals with different needs and choosing what\u2019s best for each person at each step of their recovery, a blanket ban against movement seems to serve the center itself most of all.<\/p>\n<h2><strong>The effects of not being allowed to move during recovery<\/strong><\/h2>\n<p>Personally, having the choice to move my body completely removed from my coping skills toolbox left me feeling powerless. And it instilled an intense need to feel in control of my body\u2014which ironically is the reason many patients wind up in treatment.<\/p>\n<p>Compounding the frustration of not being able to move was a lack of any timeline for when I might be able to do so. \u201cWhen the person has no indication of when they\u2019re going to be able to move again or it\u2019s contingent on their compliance with a protocol of some sort, that lack of agency can activate emotions that have nowhere to go,\u201d Fanelli says.<\/p>\n<p>I found that this rigidity around movement actually reinforced a harmful myth that many patients already believe: that food and exercise are directly correlated. Fanelli notes that patients who begin treatment with rigid rules about food can end up with a new set of rules, this time about movement. \u201cIt just becomes another control mechanism,\u201d she says. \u201cIs that really recovery?\u201d<\/p>\n<p>In contrast, when I\u2019m not in treatment, joyful movement has been a key part of my recovery. Instead of restricting or purging away my anxious thoughts, I\u2019ll go for a quick walk down the street, enjoying not only the benefits of stretching my legs, but also fresh air and nature.<\/p>\n<h2><strong>A better way forward<\/strong><\/h2>\n<p>It&#8217;s a natural human impulse to desire some kind of physical activity. And I honestly believe that not being allowed to move my body the way it craved removed my autonomy in a way that was not only not helpful, but actually harmful.<\/p>\n<p>Fortunately, not all eating disorder treatment centers follow this policy. There are some centers that actively embrace the benefits of movement through dance or movement therapy to help patients reconnect with their bodies. \u201cWe can get back to the basics of feeling safe in moving our body,\u201d says Erica Hornthal, a dance therapist in Chicago. Hornthal says this process isn\u2019t about <a href=\"https:\/\/www.wellandgood.com\/what-is-body-neutrality\/\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.wellandgood.com\/what-is-body-neutrality\/\">body positivity<\/a> and how the body looks, but focuses on how it <em>feels<\/em> to be in the body, something eating disorder survivors often struggle with.<\/p>\n<p>\u201cAllowing ourselves to take up space and notice how our body moves helps us reclaim ourselves on the road to recovery,\u201d says Hornthal, who helps clients do this through practices like guided imagery, movement meditation, and creative techniques like mirroring (where the therapist will mirror the client\u2019s movements to externalize what they\u2019re feeling in their body). \u201cIt\u2019s like rebuilding a friendship with someone who has hurt us, and working to repair that connection.\u201d<\/p>\n<p>Fanelli adds that yoga can also be a helpful transition exercise. Not only does the practice encourage a mindful connection to the body, it takes the focus off reaching numerical goals, which patients often struggle with in more intense workouts, like running or high-intensity interval training.<\/p>\n<p>Dr. Oliver-Pyatt says the key is to create a \u201cparadigm shift\u201d so that patients see exercise as self-care instead of something they <em>have<\/em> to do to burn calories. \u201cYou want to do it not out of fear, but because you want to move your body,\u201d Dr. Oliver-Pyatt says.<\/p>\n<p>At Within Health, Dr. Oliver-Pyatt says patients begin to move gradually and with support of a provider. And if they\u2019re not quite ready yet, providers will determine <em>when<\/em> to incorporate it into a patient\u2019s recovery plan and let clients know that even if they can\u2019t exercise at the moment, they will be able to eventually.<\/p>\n<p>With any steps in the recovery process, I strongly believe\u2014and Dr. Oliver-Pyatt agrees\u2014that the client should be included in the process. <span style=\"font-weight: 400;\">\u201cIf you don\u2019t have that relationship, they won\u2019t share with you what\u2019s actually going on,\u201d she says. <\/span>When it comes to movement, having someone listen to my concerns around not being able to move while in treatment would have been instrumental in learning to trust not only my body, but also my voice.<\/p>\n<p>\u201cPatients may not have ever learned how to trust their body, and that you can eat without compensatory activity,\u201d Dr. Oliver-Pyatt says. \u201cBut if people don\u2019t learn that while in treatment, they may never learn it all their life.\u201d<\/p>\n<\/p><\/div>\n<div data-type=\"_mgwidget\" data-widget-id=\"1675549\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n\n","protected":false},"excerpt":{"rendered":"<p>I was standing by the window when a voice interrupted. \u201cYou need to have a seat.\u201d A therapeutic assistant at the residential eating disorder treatment center where I was then a patient stood nearby, glaring at me. I had been standing while talking on the phone with my mom, when the staff member interrupted. I &hellip;<\/p>\n","protected":false},"author":3,"featured_media":5033,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-5032","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/5032","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5032"}],"version-history":[{"count":0,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/5032\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/media\/5033"}],"wp:attachment":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5032"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5032"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5032"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}