Ok With Pain, But Not With Gain

Eating disorder symptom of over exercise linked to potential for suicide attempt

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Exercise is important for health, but over-exercise may be a symptom of a deeper problem. Those with eating disorders that also over-exercise may be battling deeper troubles.

In a recent study, researchers used four separate experiments to determine whether over-exercising was associated with suicide risk in people with bulimia.

These results showed that over-exercise was linked to pain insensitivity, which was linked to the capability for a suicide attempt.

"Seek help for eating disorder symptoms."

April R. Smith, PhD, from the Department of Psychology at Miami University in Oxford, OH, worked with a team of psychologists and psychiatrists to investigate over-exercise in people with eating disorders.

Bulimia nervosa is characterized by episodes of binge eating followed by excessive measures to rid the body of the additional calories, such as vomiting, laxative abuse, fasting or over-exercise.

According to the authors, roughly one-third of people with bulimia nervosa attempt to commit suicide at least once during their lifetime.

For this study, the researchers did four separate experimental studies to determine the risks of suicide in women who used over-exercising to counteract the excess calories consumed during an eating binge.

In the first study, 204 women between the ages of 18-57 were recruited from eating disorder clinics. Only 71 percent of the group meet the full clinical criteria for a bulimia nervosa diagnosis, while the remaining 29 percent only met the criteria for partial bulimia nervosa.

Between 1-84 episodes of over-exercising in the past 28 days was reported by 60 percent of the group. In this group, 14 percent said they had made at least one suicide attempt.

The researchers found that women who reported over-exercising were more likely to have made a suicide attempt than women who reported vomiting, laxative abuse or fasting.

In the second study, 171 undergraduate students, 80 percent female, from a large southeastern university filled out two questionnaires 3-4 weeks apart from one another.

The questionnaires asked students about their bulimia nervosa symptoms. Questions about each person’s fears or lack of fears and pain tolerance were also asked. Answers to questions about fear and pain tolerance were used to assess each person’s capacity to commit suicide.

The results of the second study confirmed the results of the first study in that over-exercise was predictive of a person’s capacity to commit suicide. This study did not ask participants whether they had made a suicide attempt in the past.

“Although most, if not all, types of disordered eating behaviors are likely to result in some level of discomfort and pain, it appears that over-exercise may be a particularly potent way to increase pain and reduce fearlessness about death,” said the authors.

In the third study, 437 undergraduates from a large northern university, 57 percent female, filled out questionnaires to assess eating disorder symptoms and over-exercising habits.

Among the students, 27 reported vomiting, 16 percent reported taking diet pills, laxatives or diuretics, and 48 percent reported 24-hour fasting periods.

Each student participated in a pain tolerance exercise involving a computerized heat sensor.

The researchers found that students who reported over-exercising had greater insensitivity to pain. The researchers said that pain insensitivity was found in students with greater capacity to commit suicide.

In the fourth study, 512 undergraduates from a large southeastern university, 80 percent female, filled out online questionnaires.

The questions were designed to assess each student’s over-exercise habits, capacity to commit suicide and actual suicide attempts.

The results showed that people that showed the capacity to commit suicide were more likely to make a suicide attempt compared to people that did not show the capacity to commit suicide.

The results showed that over-exercising habits were more common in people that had made a suicide attempt compared to those that had not made an attempt.

“Overall, the results of four studies converge to suggest that over-exercise is related to suicide attempts through its association with pain insensitivity and the acquired capability for suicide,” concluded the authors.

This study was published in April in Psychiatry Research. No outside funding sources were declared. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 16, 2013
Last Updated:
December 30, 2013