The National Association of Insurance Commissioners defines rehabilitation as “health care services that help a person keep, get back or improve skills and functioning for daily living that has been lost or impaired because a person was sick, hurt or disabled.”  In other words, Rehabilitation services are measures taken to promote optimum attainable levels of physical, cognitive, emotional, psychological, social, and economic usefulness, and thereafter to maintain the individual at the maximal functional level.  It is a service designed to restore, improve, or maximize the individual’s optimal level of functioning, self-care, self-responsibility, independence and quality of life and to minimize impairments, disabilities, and dysfunction caused by a serious and persistent mental or emotional disability

Rehabilitative services include, but are not limited to, physical therapy, occupational therapy, speech therapy, cognitive and behavioral therapy, recreational therapy, and music therapy. Rehabilitation services can positively impact the health status and functional ability of many individuals with medical conditions, including those living with brain injury, heart conditions, multiple sclerosis, stroke, spinal cord injuries, speech and hearing conditions, limb loss, and cerebral palsy.  In Psychtegrity. our coalition focuses on vocational services,  eating disorder recovery, or substance abuse recovery, a branch of therapy that aims to improve, restore, and maintain functional ability and quality of life.

Vocational Rehabilitation

The Vocational Rehabilitation (VR) Program helps eligible individuals with physical and/or mental disabilities obtain and/or maintain employment in a competitive integrated work site. Our team of VR professionals is ready to work with you to make employment a reality. We can assist with providing customized, individualized services including assessment for eligibility, career exploration, and planning for employment; disability management through counseling, therapies, treatments, or assistive devices; training to enhance skills using instruction and work experiences in work sites or through educational partnerships; job search assistance to help you find competitive integrated employment, and support once you are on the job

Drug and Alcohol Rehabilitation

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSA’s 2018 National Survey on Drug Use and Health (PDF | 1.6 MB) reports that approximately 20.3 million people aged 12 or older had a substance use disorder in the past year. The prescription opioids/heroin, drug, and alcohol addiction epidemic is affecting many individuals in the United States (U.S.). No one is immune. Per the U.S. Surgeon General report, more than 100 individuals die every day due to drug overdose. Only about 10 percent of people with a substance use disorder receive any type of specialty treatment. Further, over 40 percent of people with a substance use disorder also have a mental health condition, yet fewer than half (48.0 percent) receive treatment for either disorder. 

 

At Psychtegrity Behavioral Center, we use evidence-based practices and integrative therapies to help men and women take on the challenges of drug and alcohol addiction.  These treatments can help you transform the unhealthy lifestyle associated with addiction to active healthy habits. We will offer alumni aftercare groups along with onsite AA/smart recover/refuge recovery meetings to assist in the transition of our clients back to their communities. We will involve families in the treatment and assist and support them as they handle the care of their loved ones.  Overcoming an addiction to drugs or alcohol is an extensive process that will vary from patient to patient.  It is imperative to find a facility that will develop a personalized treatment plan built around your unique needs. Addiction is a unique and multi-faceted disease. We know that there is no “one-size-fits-all” approach to this problem. Our vastly educated and experienced team can help you find a treatment plan that works for you.

FAMILY INVOLVEMENT IS CRUCIAL FOR SUCCESSFUL SOBRIETY

Addiction and substance abuse are extremely difficult to talk about or bring up among family members. It is a scary time for the family members of an addict because they know the reality of overdose and the many other possibilities from drug and alcohol use. It is also overwhelming for the addict when they decide they need help. The decision to seek a treatment program and to change their life is a courageous step to take. There are so many difficult discussions the family members may want to approach or they may simply want to discuss how to best support the addict without enabling them.

 

When the addict is ready to seek a treatment program, family involvement is often crucial to the success and continued sobriety of the individual. The reality is that there have most likely been many altercations in the past because when an individual is addicted to a substance they do not think clearly. They say things they may not mean and do things they would normally know are wrong but will do anything they need to do in order to feel that high again.  Family counseling is a safe place to sort all of these significant issues out without fear of judgment or shame.  Family counselors are trained to navigate the hard conversations that need to take place between an addict and their family. Most of all, they can also help the family and addict resolve the problems that have been festering over the time of the drug or alcohol use.  A family counselor is able to help mediate the conversations to bring hope and reconciliation to everyone involved. The family counselor will also have resources to offer the parties involved. 

Eating Disorder Rehabilitation

We’ve all heard the term “eating disorder.” When most people hear this term, they picture someone who is severely underweight, malnourished (“anorexic”), and, most likely, a young woman.  While this may be partially true, there are many different types of eating disorders.  Eating disorders impact men, women, and children of all ages. Further, people with eating disorders do not always present as dangerously underweight.
 
An eating disorder is a treatable mental illness that includes a number of different symptoms, including extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders can have serious emotional and physical consequences.  In fact, those with anorexia, one of the most familiar eating disorders, have the highest mortality rate of any mental health disorder.

Anorexia Nervosa

Anorexia nervosa, oftentimes simply called anorexia, is a serious medical and mental health condition that can be life-threatening without treatment.  It is characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

 

Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities.  Although the disorder most frequently begins during adolescence, an increasing number of children and older adults are also being diagnosed with anorexia. You cannot tell if a person is struggling with anorexia by looking at them. A person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can also have anorexia, although they may be less likely to be diagnosed due to cultural prejudice against fat and obesity.

Anorexia often occurs alongside other mental illnesses, including depression, anxiety disorders, mood disorders, personality disorders, obsessive-compulsive disorders, and substance abuse.

WARNING SIGNS & SYMPTOMS OF ANOREXIA NERVOSA

Emotional and behavioral

  • Dramatic weight loss

  • Dresses in layers to hide weight loss or stay warm

  • Is preoccupied with weight, food, calories, fat grams, and dieting

  • Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

  • Makes frequent comments about feeling “fat” or overweight despite weight loss

  • Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy

  • Denies feeling hungry

  • Develops food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)

  • Cooks meals for others without eating

  • Consistently makes excuses to avoid mealtimes or situations involving food

  • Expresses a need to “burn off” calories taken in 

  • Maintains an excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury 

  • Withdraws from usual friends and activities and becomes more isolated, withdrawn, and secretive

  • Seems concerned about eating in public

  • Has limited social spontaneity

  • Resists or is unable to maintain a bodyweight appropriate for their age, height, and build 

  • Has intense fear of weight gain or being “fat,” even though underweight

  • Has disturbed experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight

  • Postpuberty female loses menstrual period

  • Feels ineffective

  • Has a strong need for control

  • Shows inflexible thinking

  • Has overly restrained initiative and emotional expression

Physical 

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

  • Difficulties concentrating

  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)

  • Dizziness

  • Fainting/syncope

  • Feeling cold all the time

  • Sleep problems

  • Menstrual irregularities—amenorrhea, irregular periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)

  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity

  • Dry skin

  • Dry and brittle nails

  • Swelling around the area of salivary glands

  • Fine hair on the body (lanugo)

  • Thinning of hair on the head; dry and brittle hair 

  • Cavities, or discoloration of teeth, from vomiting

  • Muscle weakness

  • Yellow skin (in context of eating large amounts of carrots)

  • Cold, mottled hands and feet or swelling of feet

  • Poor wound healing

  • Impaired immune functioning

Avoidant/restrictive food intake disorder (ARFID)

ARFID (avoidant/restrictive food intake disorder), previously known as Selective Eating Disorder, is an eating or feeding disturbance that is characterized by a persistent failure to meet appropriate nutritional and/or energy needs. This can lead to one or more of the following issues: Significant weight loss (or failure to achieve expected weight gain or faltering growth in a child), Significant nutritional deficiency, Dependence on oral nutritional supplements or enteral feeding (the delivery of a nutritionally complete feed, containing protein, carbohydrate, fat, water, minerals, and vitamins, directly into the stomach, duodenum or jejunum), and Marked interference with psychosocial functioning.

ARFID is often associated with a psychiatric co-morbidity, especially anxiety and obsessive-compulsive disorder. The true prevalence of ARFID is unknown, due in large part to a lack of understanding of the diagnosis. We do know that ARFID affects both genders and is more common in children and young adolescents; however, it can occur in late adolescence and adulthood as well. It’s not uncommon for a child, or even an adult, with ARFID to be considered a “picky eater” and to go undiagnosed when they really have a more serious eating disorder.

Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly and, in adults, to maintain basic body function. In children, this results in stalled weight gain and vertical growth; in adults, this results in weight loss. ARFID can also result in problems at school or work, due to difficulties eating with others and extended times needed to eat.

 

ARFID vs. Anorexia

ARFID is often confused with Anorexia Nervosa because weight loss, limitations in the amount and/or types of food consumed, and nutritional deficiency are commonly shared symptoms between the two disorders. However, the primary difference between ARFID and anorexia is that ARFID does not involve any distress about body shape or size, or fears of fatness thus, lacks the drive for thinness that is so common for individuals with anorexia. 

WARNING SIGNS & SYMPTOMS OF ARFID

Behavioral and psychological 

  • Dramatic weight loss

  • Dresses in layers to hide weight loss or stay warm

  • Reports constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy

  • Reports consistent, vague gastrointestinal issues (“upset stomach”, feels full, etc.) around mealtimes that have no known cause

  • Dramatic restriction in types or amount of food eaten

  • Will only eat certain textures of food

  • Fears of choking or vomiting

  • Lack of appetite or interest in food

  • Limited range of preferred foods that become narrower over time (i.e., picky eating that progressively worsens).

  • Nobody image disturbance or fear of weight gain

Physical 

Because both anorexia and ARFID involve an inability to meet nutritional needs, both disorders have similar physical signs and medical consequences.

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

  • Menstrual irregularities—missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

  • Difficulties concentrating

  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)

  • Postpuberty female loses menstrual period

  • Dizziness

  • Fainting/syncope

  • Feeling cold all the time

  • Sleep problems

  • Dry skin

  • Dry and brittle nails

  • Fine hair on the body (lanugo)

  • Thinning of hair on the head; dry and brittle hair

  • Muscle weakness

  • Cold, mottled hands and feet or swelling of feet

  • Poor wound healing

  • Impaired immune functioning


Binge Eating Disorder?
Binge eating disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterward; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. It is the most common eating disorder in the United States.  Binge eating disorder (BED) is a widely misunderstood mental disorder — despite the fact that it affects millions of Americans. This illness has long been underdiagnosed or misdiagnosed.

Binge eating goes beyond feeling “stuffed” or overeating on occasion. With binge eating disorder, binges become a regular occurrence, feel out of control, and are followed by distress, shame, and embarrassment.

 

WARNING SIGNS & SYMPTOMS OF BINGE EATING DISORDER

Emotional and behavioral 

  • Evidence of binge eating, including the disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food.

  • Appears uncomfortable eating around others 

  • Any new practice with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

  • Fear of eating in public or with others

  • Steals or hoards food in strange places  

  • Creates lifestyle schedules or rituals to make time for binge sessions  

  • Withdraws from usual friends and activities 

  • Frequently diets  

  • Shows extreme concern with body weight and shape  

  • Frequent checking in the mirror for perceived flaws in appearance

  • Has secret recurring episodes of binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances); feels lack of control over ability to stop eating  

  • Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting

  • Developing food rituals (e.g., eating only a particular food or food group [e.g., condiments], excessive chewing, and not allowing foods to touch).

  • Eating alone out of embarrassment at the quantity of food being eaten

  • Feelings of disgust, depression, or guilt after overeating

  • Fluctuations in weight

  • Feelings of low self-esteem

Physical 

  • Noticeable fluctuations in weight, both up and down 

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.) 

  • Difficulties concentrating


Bulimia

Bulimia nervosa, better known as "bulimia", is an eating disorder characterized by patterns of bingeing (consuming a large amount of food in a short amount of time) and purging (eliminating calories consumed).

The most common forms of purging with bulimia include Vomiting, Laxative use, Diuretic use, and Excessive exercise.  Bulimia is a debilitating condition that is commonly accompanied by one or more serious mental health conditions like: Mood, anxiety and trauma-related disorders, substance abuse disorders and, obsessive-compulsive disorder.

Bulimia symptoms are generally accompanied by a negative body image in other words, people with bulimia often have an unhealthy relationship with their body size, weight, and shape. They also tend to have obsessive and intrusive thoughts about food and eating.

Many people with bulimia nervosa also struggle with co-occurring conditions, such as self-injury (cutting and other forms of self-harm without suicidal intention), substance abuse, impulsivity (risky sexual behaviors, shoplifting, etc.) and diabulimia (intentional misuse of insulin for type 1 diabetes).

WARNING SIGNS & SYMPTOMS OF BULIMIA NERVOSA

Emotional and behavioral 

  • In general, behaviors and attitudes indicate that weight loss, dieting, and control of food are becoming primary concerns 

  • Evidence of binge eating, including the disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food  

  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics 

  • Appears uncomfortable eating around others 

  • Develops food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch) 

  • Skips meals or takes small portions of food at regular meals 

  • Disappears after eating, often to the bathroom

  • Any new practice with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

  • Fear of eating in public or with others

  • Steals or hoards food in strange places  

  • Drinks excessive amounts of water or non-caloric beverages  

  • Uses excessive amounts of mouthwash, mints, and gum  

  • Hides body with baggy clothes  

  • Maintains excessive, rigid exercise regimen – despite the weather, fatigue, illness, or injury—due to the need to “burn off ” calories  

  • Shows unusual swelling of the cheeks or jaw area  

  • Has calluses on the back of the hands and knuckles from self- induced vomiting 

  • Teeth are discolored, stained  

  • Creates lifestyle schedules or rituals to make time for binge-and-purge sessions  

  • Withdraws from usual friends and activities 

  • Looks bloated from fluid retention  

  • Frequently diets  

  • Shows extreme concern with body weight and shape  

  • Frequent checking in the mirror for perceived flaws in appearance

  • Has secret recurring episodes of binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances); feels lack of control over the ability to stop eating  

  • Purges after a binge (e.g. self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, fasting)  

  • Extreme mood swings

Physical 

  • Noticeable fluctuations in weight, both up and down 

  • Bodyweight is typically within the normal weight range; may be overweight

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.) 

  • Difficulties concentrating 

  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate) 

  • Dizziness 

  • Fainting/syncope 

  • Feeling cold all the time 

  • Sleep problems 

  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)

  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity 

  • Dry skin 

  • Dry and brittle nails 

  • Swelling around the area of salivary glands 

  • Fine hair on the body 

  • Thinning of hair on the head; dry and brittle hair (lanugo) 

  • Cavities, or discoloration of teeth, from vomiting 

  • Muscle weakness 

  • Yellow skin (in context of eating large amounts of carrots) 

  • Cold, mottled hands and feet or swelling of feet 

  • Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period) 

  • Poor wound healing 

  • Impaired immune functioning​


Compulsive Overeating

Compulsive overeating is a term that is used to describe loss-of-control eating behaviors.  Compulsive overeating includes, but is not limited to, the following behaviors night eating, eating past satiety (continuing to eat even when you feel full), impulsive eating, and other compulsive food behaviors like hiding food or eating food out of the garbage.

There are many reasons behind loss-of-control eating behaviors like these. Some individuals may eat out of boredom. Compulsive overeating may simply be a mindless habit for others. For many individuals, compulsive overeating is a coping mechanism that helps one avoid underlying emotional issues. This can include depression, anxiety, or trauma-related distress.

​Compulsive eating can be a symptom of bulimia nervosa or binge eating disorder, or it can occur independently.


Compulsive overeating commonly results in weight gain which can lead to obesity, metabolic syndrome, and other weight-related medical concerns. It can also be associated with body image problems.  Those struggling with overeating who are of normal and higher weight don’t often see themselves as having an eating disorder. They tend to minimize maladaptive overeating and instead attribute their failed weight loss and food issues to moral failing (“I am a bad dieter” or “I have no willpower”). Once they learn about the diagnostic criteria for various overeating disorders, they often recognize behaviors that have been evident since childhood.

Compulsive eating is a subdividision of Binge Eating Disorder.

Orthorexia

Orthorexia was coined in 1998 and means an obsession with proper or ‘healthful’ eating. Although being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself, people with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.

Without formal diagnostic criteria, it’s difficult to get an estimate on precisely how many people have orthorexia, and whether it’s a stand-alone eating disorder, a type of existing eating disorders like anorexia, or a form of obsessive-compulsive disorder. Studies have shown that many individuals with orthorexia also have obsessive-compulsive disorder. 

Like anorexia, orthorexia involves a restriction of the amount and variety of foods eaten, making malnutrition likely. Therefore, the two disorders share many of the same physical consequences. 

WARNING SIGNS & SYMPTOMS OF ORTHOREXIA

  • Compulsive checking of ingredient lists and nutritional labels

  • An increase in concern about the health of ingredients

  • Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)

  • An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’

  • Unusual interest in the health of what others are eating

  • Spending hours per day thinking about what food might be served at upcoming events

  • Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available

  • Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram

  • Body image concerns may or may not be present

 
Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a body image disorder characterized by obsessive thoughts related to body size, shape, or weight. Negative thoughts may be focused on a single body part or the entire body. BDD has a number of serious effects on one's life, including severe emotional distress, problems with daily functioning (a refusal to go out or to be seen in photos) and extreme efforts to “fix” the real or perceived flaw (diet, exercise, plastic surgery, camouflaging with clothes, makeup, wigs, etc.)

The exact cause of BDD is not known. One theory suggests that there are problems with certain neurotransmitters (chemicals that help nerve cells in the brain send messages to each other). BDD often occurs in people with other mental health disorders, such as major depression and anxiety, which helps support this theory.

Other factors that might influence the development of or trigger BDD include the experience of traumatic events or emotional conflict during childhood, low self-esteem, parents and others who were critical of the person's appearance and pressure from peers and a society that equates physical appearance with beauty and value

WARNING SIGNS & SYMPTOMS OF BODY DYSMORPHIC DISORDER

  • Preoccupation with one or more defects or flaws in physical appearance that cannot be seen by others or that appear slight to others

  • Engaging in repetitive and time-consuming behaviors, such as looking in a mirror, picking at the skin, and trying to hide or cover up the defect

  • Constantly asking for reassurance that the defect is not visible or too obvious

  • Having problems at work or school or in relationships because the person cannot stop focusing on the defect

  • Feeling self-conscious and not wanting to go out in public, or feeling anxious when around other people

  • Repeatedly consulting with medical specialists, such as plastic surgeons or dermatologists, to find ways to improve his or her appearance

 
Pica

Pica is an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value, such as hair, dirt, and paint chips.  It is unclear how many people are affected by pica. It most likely is more prevalent in developing countries.  Pica can affect children, adolescents, and adults of any gender.​  Pica can be associated with intellectual disability, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder.  Pica often occurs with other mental health disorders associated with impaired functioning (e.g., intellectual disability, autism spectrum disorder, schizophrenia). 

 

Iron-deficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. In these individuals, pica is a sign that the body is trying to correct a significant nutrient deficiency. Treating this deficiency with medication or vitamins often resolves the problems.​

WARNING SIGNS & SYMPTOMS OF PICA

  • The persistent eating, over a period of at least one month, of substances that are not food and do not provide nutritional value.

  • The ingestion of the substance(s) is not a part of culturally supported or socially normative practice (e.g., some cultures promote eating clay as part of a medicinal practice).

  • Typical substances ingested tend to vary with age and availability. They may include paper, soap, cloth, hair, string, wool, soil, chalk, talcum powder, paint, gum, metal, pebbles, charcoal, ash, clay, starch, or ice. 

  • The eating of these substances must be developmentally inappropriate. In children under two years of age, mouthing objects—or putting small objects in their mouth—is a normal part of development, allowing the child to explore their senses. Mouthing may sometimes result in ingestion. In order to exclude developmentally normal mouthing, children under two years of age should not be diagnosed with pica.

  • Generally, those with pica are not averse to ingesting food. 

Compulsive Exercise

Compulsive exercise is not a recognized clinical diagnosis in the DSM-5, but many people struggle with symptoms associated with this term. If you are concerned about your or a loved one's relationship with exercise, please speak with a treatment professional.

WARNING SIGNS & SYMPTOMS OF COMPULSIVE EXERCISE

  • Exercise that significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications

  • Intense anxiety, depression, irritability, feelings of guilt, and/or distress if unable to exercise

  • Maintains excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury

  • Discomfort with rest or inactivity

  • Exercise used to manage emotions

  • Exercise as a means of purging (needing to “get rid of” or “burn off” calories)

  • Exercise as permission to eat

  • Exercise that is secretive or hidden

  • Feeling as though you are not good enough, fast enough or not pushing hard enough during a period of exercise; overtraining

  • Withdrawal from friends and family

HEALTH CONSEQUENCES OF COMPULSIVE EXERCISE

  • Bone density loss (osteopenia or osteoporosis) 

  • Loss of menstrual cycle (in women)

  • Female Athlete Triad (in women)

  • Relative Energy Deficiency in Sport (RED-S)

  • Persistent muscle soreness

  • Chronic bone & joint pain

  • Increased incidence of injury (overuse injuries, stress fractures, etc.)

  • Persistent fatigue and sluggishness

  • Altered resting heart rate

  • Increased frequency of illness & upper respiratory infections

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