When we talk about sport in all its forms, it is often to salute effort or performance and to enhance the physical, psychological or social benefits of sports. But, if it is indisputable that, very often, moving is beneficial for the body and the mind, the fact remains that as soon as the subject of eating disorders (TCA) is addressed, the subject of sport is often thorny. Indeed, it can be used in a logic of compensation when the TCA preexist or be a trigger for these disorders.
Supervised physical activity, a well-being vector
Introducing physical activity as part of the management of people who live with an eating disorder is quite new. “It only became a healing asset of healing in the last five to ten years. Until then, she was seen as a bane, something dangerous ”says Doctor Bruno Rocher, psychiatrist and addictologist at the Nantes (Loire-Atlantique) University Hospital and head of the Barbara area, ambulatory hospital center in addictology.
Setting that you do not manage anorexia or bulimia by associating the three pillars that are thoughts, emotions and cognitions, Bruno Rocher points out that one cannot do without a body approach. This is the reason why the Barbara space has set up workshops of French Savate, dance or walking for its patients with TCA. “These are physically engaging activities that are ways to reconnect to your body and regain consciousness”comments the psychiatrist.
And in fact, in many respects, reconnecting with the movement can be very beneficial, in particular to resolve muscle tensions, to find and feel bodily sensations, to reclaim your body, to channel stress, or even to better accept food intake. And that’s really something great! But you have to see that these activities take place in a therapeutic setting. We are talking about supervised physical exercises that do not benefit from all the people who live with an eating disorder.
A risk of compensation
However, for some of these people, there may be a risk of leaning towards compensation mechanisms, for example by eating a little more and adopting an excessive and/or problematic sporting practice to counterbalance it and thus avoid gaining weight (or even continue to lose). “It’s about questioning the intentionspecifies Céline Durand, behavioral dietician specializing in eating behaviors. If a patient tells me that he or she had a big week, that she was stressed, that she went to run and that it relaxed her, everything is fine. But if the person told me that he ate Bolognese spaghetti, that it made him feel guilty and that he went to run to eliminate, I think it is a troubled practice. And this, especially since the person will adopt this type of behavior when he is tired and his body tells him to rest. ”
If it is not uncommon to meet on social networks people who claim that they have emerged from a disorder of eating behavior by the practice of running, triathlon or even swimming, it is difficult to know if they are fully restored or if they have replaced problematic behavior by another … Especially since if general opinion stigmatizes people with TCA, it tends to overvaluize those who practice problematic.
“You are never well placed yourself to judge, to know if you really got out of TCA or notexplains Bruno Rocher. And then, you have to give yourself a little time and hindsight compared to this question. This is why the support is so important. The outside gaze makes it possible to verify that sporting activity contributes to appeasement, that the food inputs and exit and the energy expenditure is “OK” and that the person has not returned to dependence on physical exercise.
The psychiatrist and addictologist adds: “Some people have the impression of getting better because they have greater control of their bodies thanks to physical activity. But nutritionally, they are still going as badly. Or else, they come to maintain a psychic or behavioral dependence on sport, because it comes to clog a breach, a difficulty. ”
“I had moved my anorexia to an addiction to fitness”
“I suffered from anorexia for a few yearstestifies Angèle, 35 years old. When I gained weight, I signed up alone in a gym. I started with very softstretching, a little bicycle two-three times a week. It did me a lot of good. Then, encouraged by the coaches, I started to come more regularly, sometimes up to twice a day, and to go to more intense practices. The advantage is that I allowed myself to eat a little more. I had “the right” since I compensated by burning calories by sport. I started to become anxious if I had to miss a session, to go there even if I had a cold or even a fever, even if friends offered to go out in place. I had to hurt myself severely so that I understand that everything was not going round and that I had moved my anorexia to an addiction to fitness. ”
There are sometimes only a few steps between anorexia to Bigorexia – ADDICTION IN SPORT – which is defined by the Center for Studies and Research in Psychopathology and Health (CERPPS) in Toulouse as “An irrepressible and compulsive need to regularly and intensively practice one or more physical and sporting activities with a view to obtaining immediate gratifications, despite long -term negative consequences on physical, psychological and social health”.
Thus, the person concerned thinks every day of his “dose” of sport, gradually increases it to maintain an effect, fails to stop, even if they are injured or is sick. It no longer experiences pleasure but a need, a necessity and it feels irritability and anxiety if it is put to forced rest. In addition, his life is organized around sports activities and his social life is affected. And there, it is a question of becoming aware of it – which is not obvious, as sports is valued – and to be helped, which is not always easy either.
“You have to be able to become the person to realize that their use of sport may not be suitable, including self-observation exercises from behavioral therapiesindicates Céline Durand. It will be for her to observe her needs to play sports, to wonder what her thoughts, her intentions, if she feels obliged to go there, if she goes there because she wants or because she considers she has eaten too much … All these observation exercises allow the person to step back from his practice and to regain his freedom. “
When sport is a gateway to TCA
But, if eating disorders can lead to a troubled practice of sport, it can also lead to TCA. We think of course of professional athletes and sportsmen. “Entry into a high -level sports diet is something quite commonreports Bruno Rocher. Weight constraint exists in judokas, dancers, swimmers or even people who are rowing. These are sports that are very restrictive from a point of view of the body image and where there can be strong discrimination linked to weight. The beautiful values of surpassing oneself can also do a lot of damage. ”
Céline Durand confirms: “Sometimes, having to weigh yourself regularly, to have a lot of looks at your body induced at the start of food restrictions only the life of competition. And gradually, some sportsmen and sports people learn to control their short and medium term weight, which can cause eating behavior disorders. ”
“Faced with satisfaction or appeasement felt by body control and weight loss, some young girls have returned to food restrictions.”
But it is not only the pros which are affected by this shift. When we talk about the subject, the example that leads to many psychiatrists, psychologists and dietitians, it was the young women who started to move in front of their screen during confinement. “There was a clear increase in TCA among young people in the West after the period of health restrictionsexhibits Céline Durand. In a context where there was a great general anxiety, a loss of landmarks and habits, many young people, especially young women, spent many hours in front of idealized bodies, influencers preparing fruit salads between two fitness training sessions. ”
Bruno Rocher Shares this opinion: “In the clinic, we see many young girls who tell us that they needed to spend themselves because they were stuck at home. This need has changed in need to control their body and afraid of gaining weight. They then started to do a lot of sport through YouTube applications and videos. And faced with the satisfaction or appeasement felt by body control and weight loss, they have returned to food restrictions. ”
Restrictions which are one of the signs of identifying a food behavior disorder that begins and to which can be added:
- A great concern for food and the number of calories;
- A rapid decrease or increase in the amount absorbed;
- Increased water consumption;
- Pretexts or excuses to avoid eating with other people (“I have already eaten”, “I am not hungry”, “I will eat later”)
- A social withdrawal;
- Large concerns for weight and physical appearance;
- Significant and rapid weight fluctuations (socket or loss);
- Mood changes.
Because it is very difficult for the person concerned to become aware of their troubled relationship to food, it is important that those around him recognize the alert signals and can approach the subject with subtlety and benevolence.
