When working with an exercise resistant individual, one must explore and resolve the source of the resistance, such as underlying anxiety, resentment, or anger. The goal of treatment is that the individual will be able to become physically active by choice, not coercion. It is important to begin by validating the resistance and even in some cases prescribing it, making statements such as:

• It is important that you can choose to not exercise.
  
• Resisting exercise serves a valuable function for you.
  
• Continuing not to exercise is one way for you to keep saying “no.”

Physically active by choice.

Well, I let myself sleep on Tuesday and Wednesday instead of exercising. I feel shame that I did that. I know that I need more sleep, but I think that I shouldn’t need that much sleep. I know that it’s not logical interpret things like this, but since others seem to thrive on 5 or 6 hours of sleep and there is so much societal pressure to sleep less and not to mention DH who sends me mixed messages about sleeping, I think that 8 to 10 hours per day is way too much.

So think of that as a mini-Thought Record.

Time/Location Tuesday & Wednesday morning & evening.
Situation/Trigger Not exercising while on travel
Thoughts See above paragraph.
Feelings/Urges Tired, guilty, ashamed, mixed-up, pressured, resentful, coerced
Distortions Social Comparison, Harsh Self Judgement, Mental Filter, Discount the Positives, Mind Reading, magnification, emotional reasoning, should, blame
Interpersonal Society, DH

Coping Statement: Excercise and sleep are both important. Sometimes I choose sleep, and sometimes I choose exercise.

Reference: Eating Disorders: Exercise Resistance in Women

A theme ran through the comments of the women studied that echoes the information in chapter 4, “Sociocultural Influences on Eating, Weight, and Shape.” Most of the women expressed that they felt extremely degraded and vulnerable by their direct experiences of being encouraged to exercise as a means to achieve an acceptable body. Instead of being encouraged to exercise for fun, exercise for these women was connected to body image, or the pursuit of an acceptable body.

“an acceptable body” says it all. It’s an extremely negative to find out that despite all your other vitures, you are unacceptable because of your body, something that one really has very little control over. I suppose you could argue that one shouldn’t (tsk, tsk, no shoulding) take it so absolutely, but remember, this is about people with eating disorders.

Many of the women’s stories included experiences of deep humiliation, public or otherwise, at being overweight and unable to achieve this illusive standard. Other women actually acquired a lean, thinner body and experienced unwanted sexual objectification by peers and adults. In a significant number of the women, rapes and other sexual abuse occurred after weight loss, and, for many, sexual abuse was connected to the onset of exercise resistance and binge eating.

deep humiliation: check
unwanted sexual objectification: check

I talked about the humiliation earlier. It started when I was so young. Why is it that people think they can modivate others by humiliating or shaming them? My husband does this to our son, and when I’ve talked to him about it, DH says that he thinks it’s a good thing. Sure, it doesn’t have anything to do with exercise, eating, or body image, but I think motivating a child thru positive reinforcement is the way to go and that shame and humiliation don’t make things better.

What woman hasn’t suffered unwanted sexual objectification? It has happened to me large, small, and in between from both men and women.

Many women are confused as they experience the desire to be thinner while at the same time feeling anger and resentment at what they have been told they have to do to achieve it, for example, exercise. For some, exercise resistance and weight gain may be symbolic boundaries, expressing a rebellious refusal to patronize a system in which the playing field for women is not about sports, or even achievement, but about sexual attractiveness to men—”We’ll play, you pose.” This system is one in which women and men equally participate and perpetuate. Women objectify one another and themselves right along with men.

Sure, I do feel anger and resentment at being told that I have to exercise so I can be thin, but what really pisses me off is that I’m told so often, now and in the past, that I must be thin, like it’s a moral or ethical thing. I won’t disagree that my weight now might be affecting my health; I’m like 80 pounds overweight. That’s a lot. But when I was 5 pounds “overweight” or even 30 pounds overweight, it shouldn’t (oh, no, another should) have been an issue! 30 pounds may seem like a lot to you, but I could still play volleyball. And 30 pounds overweight would be a lean, mean Jennifer at this point. Am I babbling?

What do you healthy people do to fill up your time if you aren’t obsessing over things like this? Not the overall issue of shoulding people to exercise, but the issue of how it affects me. Well, not me, altho I do think you-all should be obsessed with; I’m the center of the universe, after all. But obsessing on yourself.

Back on topic.

When someone comments on how the culture of thin is oppressing women, this is what I think they are talking about. It has certainly worked to destroy my self-esteeme. And while I am an extreme example, I know only a handful of women who are truly comfortable with their bodies.

Part 6. coming soon
Reference: Eating Disorders: Exercise Resistance in Women

THE MEANING OF EXERCISE RESISTANCE

To better understand exercise resistance, we can borrow from our understanding of how weight loss diets have affected eating behavior. We know that weight loss diets are a key aspect in the historical mistreatment of overweight individuals, in many cases actually contributing to binge eating, which increases over time. Responses from the women surveyed support the view that exercise resistance may be an unexpected, unconscious backlash against the current cultural emphasis on slimness and the overfocus on the symptom; for example, the weight, instead of the inner psychodynamic issues.

Blah, blah, blah, yawn.

QUESTIONS TO ASK THE INDIVIDUAL WITH EXERCISE RESISTANCE

1. What feelings and associations emerge for you at hearing the term exercise? Why?
   
2. When did being physically active change for you from “playing” as a child to “exercise”? When did it shift from something natural, an activity you did spontaneously (for example, from an internal drive), to something you felt you should do?
   
3. Has physical activity ever been something that you did to control your weight? If so, how was that for you, and how has it affected your motivation to exercise?
   
4. How did your exercise attitudes change during and after puberty?
   
5. Does being physically active relate in any way to your sexuality? If so, how?
   

Item 1. SHOULD I should exercise more. It’s good for me, so I should exercise. It will lessen the chances of me getting diabetes, so I should exercise. It will lessen the chances of me getting heart disease, so I should exercise. It will help me lose weight, so I should exercise. Sould, should, should, ….

Item 2. Very early. I remember being in 1st or 2nd grade and having to do unpleasant things like run (boring) around the quarter mile track, chair pushups, and situps. OTOH, I enjoyed playing volleyball well beyond college, and I enjoy swimming still.

Item 3. Of course. In fact a news article just came out that said if people with the obesity gene would just exercise for 3-4 hours per day, they would not be obese. Sure, 3-4 hours/day. Should, SHOULD, SHOULD. I resent it. It’s not fair. See item 1.

Item 4. Puberty – that would be when my mother started to tell me that I would get fat if I didn’t exercise. Or she told me that I was fat, and I should exercise. Having large breasts also tended to make exercise unpleasant.

Item 5. I don’t think it does. … Well … It seems that I traded my mom for my DH. He is now on my case to exercise more.

Part 5, coming soon.

Reference: Eating Disorders: Exercise Resistance in Women

RISK FACTORS FOR DEVELOPING EXERCISE RESISTANCE

1. A history of sexual abuse of any kind at any age.
   
2. A history of three or more weight loss diets.
   
3. Exercise used as a component of a weight loss regimen.
   
4. A larger body size as a boundary or defense against unwanted sexual attention or sexual intimacy (be it conscious or unconscious).
   
5. Parents who forced or overencouraged exercise, especially if the exercise was to compensate for perceived, or actual, overweight in the child.
   
6. Early puberty or development of large breasts and/or early significant weight gain.
   

Well, these are going to be fun. What?

Item 1. I was surprised to see this on the list. It had never occurred to me that the two would be related.

Item 2. I rather doubt I can count the number of weight loss diets that I have been on. I think I’ve been on one for the majority of my teen and adult life.

Item 3. Of course.

Item 4. I wonder. It’s possible, so it would be unconscious.

Item 5. I remember my mother telling me that I had better do after school sports if I didn’t take phys ed during school. The implied or what was “or you’ll get fat(ter)”.

I also remember sitting with one of my brothers, looking at a high school yearbook. He couldn’t find me on the volleyball team. When I pointed myself out to him, he said, “My GOD! You were anorexic.”

That’s not what my parents were telling me, and I’m sure I thought I was fat at the time.

Item 6. Early puberty – I was 10 years old. It was awful. Elementary schools are not set up for girls who have periods. I wasn’t allowed tampons, and the pads in those days were enormous. It was messy, and I was so uncomfortable with cramps and with the general messy, smelly, sticky feeling. I think I’ll let Chunguita stay home for the first two days, especially if she’s 10.

Development of large breasts – oh yeah. That’s me. I think I was a C cup in 6th grade.

Sheesh, no wonder I suffer exercise resistance. Not that I’m going to use that as an excuse or even dwell on it. I’m a CBT true-believer. But it’s nice to know that there’s more to it (or maybe it’s not even that) than my being lazy.

Part 4, coming soon.

Reference: Eating Disorders: Exercise Resistance in Women

Underactivity or physical passivity appears to offer a sense of control over body and feelings, just as disordered eating and over-exercise do. Exercise resistance may simply be another component in the menu of options from which men and women find themselves suffering in this time of epidemic eating and body image problems. If we are to begin to look at exercise resistance as a separate syndrome worthy of specialized understanding and treatment, here are some factors to consider.

WHAT DIFFERENTIATES THE EXERCISE RESISTANT INDIVIDUAL FROM SOMEONE WITH SIMPLE LOW MOTIVATION OR POOR EXERCISE HABITS?

1. The individual strongly resists any suggestion to become more physically active (barring any physical impairments and given several workable options).

2. The individual reacts with anger, resentment, or anxiety to any suggestion to become more physically active.

3. The individual describes experiencing moderate to severe anxiety during physical activity.
   

Item 1. most certainly applies to me. I have an endless supply of reasons for why I can’t exercise. The ones that are really hard for me to deal with are the ones that could be physical impairments. For example, I have a weak knee. It causes me pain pretty much whenever I do anything but not consistently. It’s unstable and weak, but nothing is structurally wrong. To make matters worse or give me a better excuse (I’m not sure which), I fell on it a few years ago. After tripping over my own feet and to avoid hitting my head on a table, I landed with my full weight on my bad knee. It swelled up like a grapefruit, but there was no structural damage. It healed, and in 6 months, I was able to do stuff again. Then I fell again and landed on my knee. This time, it didn’t get better. I used the same therapy regime that I have used since I was a teenager. After a year of that, I decided to see the doc, who sent me to physical therapy, where I learned that doing leg extensions where probably aggravating my knee. The PT showed me how to strengthen the stabilizing muscles w/o leg extensions, and because my improvement had been so rapid, I cancelled the follow-up PT appointment.

Improvement does not mean that the pain was gone. I exercise with pain (another behavior that might be part of an exercise/eating disorder). So sometimes I exercise with pain, sometimes I use the pain as an excuse to not exercise, but since the pain indicates weakness, not aggravation of the injury, it’s not a good excuse (in my mind). And either way, I torment myself about it.

And this is only one way that I torment myself over (not) exercising w/regards to resisting exercise. I could probably go on and on about not having time.

What was my point? I forget. Now there is the benefit of an eating disorder! I can take any issue and turn it into a swirl of thoughts about eating/exercising/being fat/etc. and not actually deal with anything.

Item 2. True. Resentment an Anxiety, for sure. Anger probably follows pretty quick.

My usual response is “Why the fuck don’t you think I exercise?”

Hm. That indicates anger.

The anxiety is usually around not having time or finding a block of time when I can freely exercise.

Item 3. I do not experience anxiety when exercising.

Part 3.

Reference: Eating Disorders: Exercise Resistance in Women