"If I skip a day, I feel like i've absolutely failed": An exploration of lived experiences with compulsive exercise shared on social media

Abstract

Compulsive exercise affects as many as 85% of individuals with eating disorders. Compulsive exercise is characterized as excessive, rigid, driven, and obsessive. Exercise is used as a means to prevent negative consequences and avoid negative affect, but to the point that it interferes with daily activities and is maintained even despite injury, illness, or lack of enjoyment. Regardless of the high prevalence rate and negative impact that compulsive exercise has on eating disorder recovery, there is a lack of understanding around compulsive exercise, hindering prevention and treatment efforts. Exploring experiences with compulsive exercise shared online could provide a breadth of insight into compulsive exercise. Therefore, the purpose of this study was to explore experiences around compulsive exercise and eating disorders shared on social media. Social media posts from Reddit, Twitter, Instagram, and various forums with relevant key words were collected retrospectively for 12 months. A thematic analysis of 881 posts revealed five themes (and three subthemes). The themes include: (1) seeking control, but ultimately compulsive exercise takes hold, (2) burning off binges, but at what expense?, (3) recovery is a battle, but worth it, (4) is my exercise healthy?, and (5) frustration with comments about compulsive exercise. The experiences shared online revealed novel aspects of compulsive exercise, such as difficulty finding a healthy relationship with exercise during recovery. People online advocated for better treatment around compulsive exercise, and the need for improved awareness of compulsive exercise among healthcare providers and the public.