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1. What are some of the short and long-term side effects of being underweight and the ways people often go about getting their weight so low? Is it life-threatening?
In the short-term one will likely notice problems such as: weakness, fatigue, lightheadedness, inability to concentrate, lower pulse rate, increased emotion fluctuation and amenorrhea (cessation of menstrual cycle). Long-term this can lead to: bone mineral loss, premature osteoporosis where bones can weaken 2-3x faster than would be normal for that age, decrease sexual functioning, short and possible long-term reproductive damage, frequent over-use injuries, altered endocrine (hormone) function, growth of fine body hair on face and arms, extreme sensitivity to cold, difficulty swallowing, swollen glands, blood shoot eyes, damaged teeth and depression.
Yes, if taken to the extreme, this can be life-threatening or least threatening to your quality of life and life expectancy.
References: Nancy Clark’s “Sports Nutrition Guidebook” and Liz Applegate’s “Encyclopedia of Sports and Fitness Nutrition.”
2. Are these effects any more or less serious than being clinically overweight?
Interestingly enough there is some research to suggest that from mortality perspective it is healthier to be overweight and strong than to be underweight and weak. Just as someone who is legitimately overweight needs to work at getting back down to a healthy weight, one who is underweight needs to work on getting the body back up to a healthy weight.
3. If someone fears they are at risk of these side effects, what can they do to prevent them and return to a healthy weight?
They need to eat more healthy food and engage in some strength training to build lean muscle and get the body back up to a healthy weight. In some cases, body fat levels are too low (e.g. women under 10-15% body fat) may need to increase their body fat levels up to a healthy level where they resume a regular period.
4. Why is strength training important to someone who is recovering from an eating disorder/being clinically underweight?
Strength training is important for several reasons:
- It helps to rebuild lean muscle that is lost with extreme dieting. Lean muscle is an important part of being healthy weight.
- It helps to increase the metabolism. Extreme dieting and eating disorders lower the metabolism. When one returns to normal healthy eating, he/she has a tendency to gain extra body fat as the metabolism is slower. Strength training raises the metabolism and thus allows one to eat in a way that supplies daily nutritional requirements without the body fat gain.
- It helps to rebuild strength which is also low in those who are underweight and very low in those with eating disorders. Strength not only improves our ability to function safely and effectively in our everyday lives, but also improves our confidence and self-esteem.
- It builds bones. As mentioned previously, bone density loss is a common problem with eating disorders, extreme dieting and those that are underweight. The stress of resistance training builds not only the muscles but the bones as well. In conjunction with proper nutrition, weight training can assist individual recovery from an eating disorder with rebuilding bone density.
5. We know exercise is good, but we also know it is possible to take it too far, what is compulsive exercise and what are some signs we can look for in ourselves to be sure we don’t head down that road?
Compulsive exercise is taking a good thing to a bad extreme for the wrong reasons. In identifying a compulsive exercise disorder, ask yourself the following questions:
- What is my purpose in exercising?
- How much time do I spend exercising?
- What important high-priorities (e.g. family) have been sacrificed for extra time to exercise?
- How much of my thought life is focused on exercise and how my body looks?
- Am I able to appreciate the positive changes that exercise has had on me or am I constantly craving further physical changes?
- Am I exercising to make healthy improvements in my body or am I secretly wishing to have someone else’s body?
It is very hard to put numbers on compulsive exercise in the same way it would be hard to say that eating a certain level of calories means you have an eating disorder. We are all different and should therefore expect that there can be differences in the amount of exercise we can safely and effectively do without it becoming compulsive. However, to give you a general guideline for the average person (i.e. not an elite athlete, bodybuilder, etc): 3 to 4 days a week of intense training for about an hour.
In addition to this, I recommend that people get daily physical activity but that additional activity from the intense training previously mentioned would ideally be non-structured activities. These can be things such as: yard work, housework, sports, recreational activities, dance, and playing with your children.
6. Can ‘exercising too much’ hurt rather than help? How so?
Exercise is good, but too much is not good. Exercise puts stress on our body and, if this stress is in excess of what our body can handle and recover from, it will make us weaker. Excessive exercise can lead to problems such as: decreased physical fitness and performance, muscle loss, fatigue, suppressed immune system, increased risk for illnesses, joints and tendons overuse injuries, shin splints, low back pain, depression, sleep disorders and many more.
7. What advice would you give someone who is struggling with compulsive exercise?
Treat this like you would any other compulsive disorder. A professional counsellor can be very helpful in this situation to work through the underlying psychological issues. If necessary, hire a trainer to help you establish a realistic exercise program and healthy/appropriate fitness goals.
In addition to this, invite close family or friends to be accountability partners who are willing to check up on you regularly and help you watch for relapses.
8. Any last words?
Despite what the media would have us believe, I don’t believe there is one ultimate standard of human beauty. Speaking as a guy, I have had many guys express to me their tastes in women and they are as different as the number of different women out there. I think there are a lot more people out there than we realize who have attractions to people that are not what the media tells us is beautiful. I believe God not only makes us all differently but also creates in us attractions that are just as unique. Let’s embrace that!
Andrew Heming works at Trinity Western University as an assistant professor and a strength and conditioning coach and performance nutrition consultant for Trinity Western’s Spartan Athletics. Andrew has a Master’s degree in Exercise Science and certifications in strength and conditioning, personal training and performance nutrition.
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It is so interesting that being underweight can be as bad, if not worse than, being overweight. It is a fact so rarely put out there!!