Exercise Almost Killed Her

June 15, 2006
by Ericka Souter, Marissa Wong
with Marc Zawel in Washington, D.C.

Peach Friedman’s exercise bulimia left her emaciated and in danger of heart failure — a fate that thousands of other young women could face as they struggle with this debilitating eating disorder.

Most of the time, when she has a rare free evening to herself — in between book-club meetings, her weekly French lessons and the master’s degree in creative writing that she’s finishing up at California College of the Arts — Peach Friedman likes to kick back alone at her Palo Alto, Calif., home. “I’ll bake cookies, watch TV or read, call my old friends back East,” says the Charlottesville, Va., native. But every now and again, she gets the urge to break out of her homebody shell. “I’m not necessarily a big ‘drink lots of cocktails and wear stilettos’ kind of girl,” Friedman admits. “But I do love an opportunity to put on a dress and some perfume and feel beautiful.”

A simple sentiment, but one that, up until about two years ago, Friedman, 26, couldn’t imagine ever expressing. In 2000, after breaking up with her longtime boyfriend and watching her parents separate, Friedman, then a college senior, felt as if her life were spiraling out of control. To regain it, she turned on herself, deciding that she was going to mold her body to match all the “perfect” images she saw in magazines and movies, no matter the consequences. “It was like an f-you to the world, getting skinny,” she says. “It was like saying, ‘Hey, you wanted thin? You wanted toned and conditioned? Here you go.'”

But what started out innocently enough — 30 minutes on the treadmill and the occasional yoga class — quickly grew into full- blown exercise bulimia, an eating disorder that doctors named less than a decade ago and that is marked by a purging of calories through an obsessive, life-threatening level of exercise; in fact, in severe cases, doctors resort to putting casts on the legs of sufferers in a desperate attempt to stop them from working out. Today the illness (which, like anorexia and bulimia, strikes mostly white, middle-class women in their late teens and early 20s) has become a serious problem at colleges, and campus fitness centers across the country are taking steps to address the problem — that is, when they can spot it. As Dr. Heather Hausenblas, director of the Exercise Psychology Laboratory at the University of Florida, explains, because American culture “glorifies people who exercise — it’s seen as a positive thing,” the disease remains difficult to diagnose. After all, when does a bit of healthy exercise cross the line into unhealthy?

It certainly was a while before anyone recognized that the 5’9” Friedman had a problem. Although she went from a fit 145 lbs. to a skeletal 100 lbs. in only three months, Friedman — who would start every day with a 10-mile run and end it with dance classes or swimming or more running, while limiting herself to as few as 800 calories — recalls that her peers responded positively to her ever- shrinking frame. “There is so much help and support to get thin,” she says. Such encouragement only fueled Friedman’s illness; she refused to let a morsel of food pass her lips without a punishing workout to cancel it out. As her problem worsened, Friedman became incapable of making it through a day without exercise; starting in December 2000, she ran 500 days in a row and — like many fellow sufferers — planned her entire life around her workouts, even refusing to go on vacation for fear there would be no place to exercise. By that time Friedman had stopped menstruating, suffered from bouts of nausea and was at risk for heart failure. But even with her life at risk, “I only thought about food and running,” she says. “My life was ruled by exercise.”

With more cases like Friedman’s cropping up (one expert estimates that up to 400,000 American women have exercise bulimia), colleges are taking action. At Boston College monitors are assigned to make sure no one uses a cardio machine for more than 40 minutes at a stretch; Georgetown, meanwhile, has a written policy requiring staff to report any suspicions of exercise bulimia to health services, and Miami University has suspended the membership of a student who exhibited signs of the illness. Mainstream gyms like Bally Total Fitness and Equinox are training staff to be on the lookout for over- exercising, while The Sports Club/LA asks applicants to fill out a health questionnaire–looking for, among other things, signs of exercise bulimia. “I see women work out two or three times a day and they do not look healthy,” says Brandon Sobotka, fitness director at a Chicago Bally. “I advise my staff to gain rapport with people obviously addicted and to be really gentle in pointing out that they might be working out too much.”

Even with this increased awareness, exercise bulimics find ways to get their fix. Experts in the field have copious anecdotes about college coeds who will work out in the morning, then come back to the gym later in the day wearing different clothes to try and sneak past staff monitors. Other exercise bulimics, barred from the gym, will sneak in workouts at odd hours and in odd places. Abby G., a 20-year-old DuPage college student and recovering exercise bulimic, recalls that after her worried mother canceled her gym membership, “I would get up in the middle of the night when my parents were asleep,” getting down to 101 lbs. on her 5’7” frame.

Eventually, such behavior results not only in physical changes but personality changes as well. When Friedman returned home to Charlottesville during her Christmas break from Naropa University during her senior year in 2000, her appearance was disturbing. “She was wearing a dress that exposed most of her upper torso,” recalls family friend Samantha Lane, 32. “I fixated on the clear shape of each vertebra along her spine. Her eyes were sunken in a hollowed face. She looked like a skeleton.” Equally upsetting to Friedman’s friends and family was her emotional state. Usually fun-loving and easygoing, “Peach’s eyes had grown defensive and more quiet,” says high school friend Laura Pederson, now 26. Adds Friedman’s sister Victoria, 17: “I had always looked up to her as my big sister, but all of a sudden, she was mean.”

For Friedman’s mother, Chris, 54, who owns an exercise studio and is herself a recovered anorexic, Friedman’s condition was a painful reminder of the past. “I felt responsible at times for her being that way,” she says. “I spent many anguished nights feeling guilty and plain worried about her safety and health.” With the support of her mother and father Daniel, 54, a financial adviser, Friedman decided not to return to school and moved back home to participate in individual and group therapy, as well as weekly meetings with a local dietitian, Kate Bruno. (While visits to the physician were covered by insurance, the costs for Friedman’s therapy and nutritional counseling were not.) Still, embracing recovery was a challenge; a year into treatment Friedman wrote in her journal, “How is an egg and cheese bagel justifiable on a lazy stomach?”

It would take three years of treatment before Friedman felt healthy enough to move to Palo Alto and pursue her master’s. (She had finished her college degree from home in Charlottesville in May 2001.) Today she weighs a healthy 165 lbs. and works as a personal trainer — which might sound to some like an alcoholic going to work as a bartender. But experts say Friedman’s career choice is not an unusual one. “Typically, you teach yourself so much about the field during recovery and you learn to value and respect your body,” says Bruno. “So it then becomes very compelling to want to help others do the same thing.”

That’s exactly what Friedman, who sees a therapist weekly to keep her on track, hopes to accomplish. Still feeling the effects of her illness— she so abused her joints that she has frequent pain and because of her history must pay more for health insurance–she hopes to spare other young women a similar fate. “I want to spread the message of healthy body image,” she explains, “to show women how to use their bodies in a way that feels good and take the focus off the way their body looks.”

Which is the approach she takes to her own workouts, which today are limited to no more than 60 minutes, six days a week, and can range from a hike with friends to swimming at her local YMCA. Although Friedman, whose food favorites include ice cream and Mexican, admits she has moments when her recovery is tested — “I’ll see someone who’s really cut and be like, ‘Oh, I can do that!'” — she counteracts such thoughts by reminding herself that nothing feels better than being healthy. “It’s not a constant battle anymore,” she says. “I know my body, and I know what feels good, and that’s what I follow.”

As with other eating disorders, exercise bulimics take extreme measures to minimize calories. But they don’t do so by starving themselves (like anorexics) or throwing up (bulimics); instead they keep track of every calorie they consume — and then make sure that they burn off at least that many, if not more. “Sufferers use exercise as their form of purging,” says Dr. Heather Hausenblas, who has written dozens of articles on exercise dependency. “It becomes their drug. If they can’t exercise, they will experience withdrawal symptoms and become anxious and depressed.” That was the case for recovering exercise bulimic Cody Ruple, 23, of Saginaw, Texas, a program director at a YMCA, who continued running 13 miles a day despite stress fractures in her hip. “I had everything taped,” Ruple recalls. “My hips hurt, my feet hurt, but I would just take bottles of Advil. Nothing could keep me from running. It was this incredible driving force.”

In an industry with unrelenting pressure to be thin, Jamie-Lynn Sigler succumbed to exercise bulimia

At 16, the Sopranos star “only thought in extremes,” she recalls. “Either burn everything you eat — or don’t, and be obese.” Still, it wasn’t until she dropped to less than 100 lbs. that Sigler sought help. Today, at 24, she’s is a spokeswoman for the National Eating Disorders Association, reaching out to women on college campuses. “I see firsthand how widespread this problem is,” she says.

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