Purging through exercise – One man’s personal experience with bulimia

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Luke O’Neil

Bulimia is arguably the most well-known eating disorder, likely because of the visceral imagery it brings to mind. It forces us to envision young, dangerously frail women purging through vomiting or other means like laxatives in the isolation of an otherwise quiet bathroom.

While this is often the case with bulimia, the eating disorder doesn’t always look like you’re imagining. Not only is there a significant chance a person with bulimia might be male, but they also may use other ways to “control” their weight that are less obviously dangerous. In fact, their “purging” may take the form of something that looks healthy without context.

Luke O’Neil, contributer for men’s news and lifestyle website Esquire, doesn’t match any of the “typical” characteristics of eating disorders. Standing six foot tall and weighing over 180 pounds, O’Neil is far from frail. His frame can be imposing, especially with his muscular frame, thick beard, and intense eyes.

But, when O’Neil looks at himself, he sees something very different.

“I see a fat piece of s–t, and then I think to myself that it’s time to punish my body for letting me down,” Luke writes in a recent article about his experience discovering he lives with a condition commonly called “exercise bulimia.”

The condition is a form of bulimia that until recently has gone unrecognized. Instead of the hallmark behaviors of bulimia, like vomiting, exercise bulimia manifests itself through compulsive exercise as a form of purging.

“Exercise bulimia manifests itself in different ways — from excessive exercise to compensate for calories consumed, to starving oneself but continuing to exercise, to an all-consuming obsession with exercise to the point of serious self-harm, as in my case at the moment,” he writes.

“In all cases, the results can be debilitating, both mentally — emotional distress when you’re unable to exercise sufficiently — and physically — bone density loss from lack of nutrition, joint pain, constant muscle soreness, recurring injuries, and persistent fatigue.”

For O’Neil the condition takes the shape of compulsive exercise. By his own estimate, he believes he goes to the gym at least 360 days in the year.

Like many people with eating disorders, Luke initially saw his exercise behaviors as “admirable, a point of pride.” But, over time, the condition placed friction in his personal life and started to lead to more dangerous behaviors. He would miss once-in-a-lifetime opportunities on vacations abroad to make sure he found time in a gym – no matter where he was in the world.

“There was the time I found myself lifting weights alone in the fitness room of a middle school in the Scottish Highlands, looking like a deranged bench-press pervert, in lieu of a whisky tasting at a distillery,” he recalls. Not content with that, he says he later went running through the hills of Scotland until his phone died and he was left lost in a foreign land.

Now, healing from a back injury, he still can’t shake the behaviors.

“Today, I will run and lift weights, despite instructions from my doctors to take it easy this year,” he writes. “will run until my knees ache and my back stiffens, and I will manage the ensuing pain with too much Advil. Being skinny, even with back pain, feels a lot better than being chubby. And then, once I feel I have earned it, I will eat a large meal, thereby resetting the cycle of guilt, and begin the process all over again tomorrow.”

Even after coming to terms with the condition, O’Neil has found it hard to openly talk about his experiences. “As someone who has no problem sharing all manner of personal information about himself online every day, and who certainly doesn’t consider himself one to conform to outdated gender stereotypes, writing this—even in an email to my editors—felt embarrassing in a way I was unfamiliar with.”

Healthy habit or dangerous compulsion?

His embarrassment and hesitance to open up are far from uncommon. The vast majority of men living with eating disorders agree that one of the biggest hurdles between getting help is overcoming the stigma of having a “women’s issue.”

Andrew Walen, a spokesperson for the National Eating Disorders Association, founder of the Body Image Therapy Center, and author of Man Up to Eating Disorders, says men with eating disorders fear being feminized by their condition.

“The general cultural understanding is that to speak up about an eating disorder is to feel like you have an un-masculine disease,” Walen told O’Neil.

“People might think, ‘I’m a man and I struggle with these insecurities and self-esteem and self-worth issues, and I put a lot of onus on my body to give me that self-esteem, so does that make me a narcissist or an egomaniac?'” Walen says. “No, it makes you someone who has a brain disease that is actually a lot more common than most people are willing to admit. I think it’s harder for guys to say we have a feminine-normalized issue, just from our culture saying man up.”

Additionally, our culture often praises signs of eating disorders because working out is generally a healthy behavior.

Luke O’Neil is regularly congratulated for his compulsive need to exercise, even when it would normally be inappropriate. While family members would be concerned about a young women disappearing to the bathroom after every meal, no one bats an eye when O’Neil disappears from family dinners to run lap in an effort to compensate for the food he ate.

“I often joke when I’m talking about my issues—drinking too much, smoking cigarettes, spending way too much time online—that at least I’m also addicted to the gym. And most people agree.”

Jennifer Rollin, a psychotherapist and eating disorder specialist based in Maryland, explains that most people simply don’t understand that too much of a good thing can be a bad thing. “It’s not something to admire,” she says. “Men are often praised for spending more time at the gym, but you would never praise an alcoholic for sitting at the bar.”

With more voices speaking up, this might eventually change. O’Neil personally hopes he is helping lead the charge to make more people aware of exercise bulimia and recognize the signs. “You’re not alone, and it’s OK to talk about,” he writes.

“You’re not going to die from the embarrassment. Your eating disorder, on the other hand, might do the trick if you let it.”

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