It happened right before his eyes. “About a year ago, this girl enrolled in our gym with an obesity problem,” says fitness consultant Preetom Mukherjee Roy of Solace gym at Calcutta’s Sunny Park. “We put her on a weight-loss programme, which included a strict diet and exercise routine.” For a few months after that, according to Mukherjee Roy, everything was going great. “She was remarkably regular as far as working out was concerned and within a few months she achieved her ideal weight.” But the problem began later. Afraid of regaining weight, she went on an exercise overdrive and started working out like a maniac, dropping in at the gym at odd hours and exercising non-stop. “We warned her and told her to go easy but she refused to listen.” In another few months, reduced to skin and bones and always appearing exhausted, physically and mentally, she was diagnosed as underweight and was on the verge of collapse. Finally Mukherjee Roy gave her an ultimatum ? “either you stick to the exercise programme we prescribe for you or we will bar you from coming to the gym”.

What Mukherjee Roy was witnessing was a severe case of ‘activity anorexia’ (AA) ? a psycho-physiological condition characterised by a compulsive need to exercise to combat a deep-rooted fear of weight gain. And according to fitness experts around the world, the phenomenon ? closely related to anorexia nervosa (AN), another psychological disorder which manifests itself in physiological behavioural patterns such as an abnormal aversion to food ? is on the rise.

According to web-based health journal mama’shealth.com activity anorexia is estimated to occur in 75 per cent of all individuals who have anorexia nervosa. It goes on to report, “When a person has activity anorexia, he or she values exercise above all else. Food becomes secondary. When the food intake declines, the person attempts to compensate it by increased physical activity. And the vicious cycle continues.”

Throwing light on it as primarily a psychological disorder, consultant psychiatrist Dr Debashis Ray explains: “Often the problem sets in because of a traumatic incident or situation ? such as a rejection of some sort which may give birth to or set off feelings of low self-esteem. But the trigger can be virtually anything which results in a sense of inadequacy. Both men and women today are inundated with unrealistic ideas about what constitutes the ideal physical self. Like such eating disorders as anorexia and bulimia, the obsessive compulsive behavioural patterns of AA too indicate a deep-rooted drive to achieve perfection. Ironically, this backfires and the results are anything but symptomatic of perfection.”

Typically, a person afflicted with AA will go to absurd lengths to continue exercising. Points out fitness trainer Kunal Sarkar, “They rarely feel satisfied. While a daily exercise schedule should not exceed a certain number of minutes or hours depending on the weight loss target, body type, medical condition and other factors, a person with AA will want to keep going way beyond what is required or, more importantly, what is reasonable.” He refers to a case where a man, obsessed with body building, hit the gym as soon as it opened in the morning and refused to leave until it was closing time. “He was a college student who never attended class,” says Sarkar. “Nothing ? be it bad weather or ill health ? dissuaded him from attending the gym.” That obviously is undesirable.

Psychologists and physicians insist that AA is a serious disorder which unless diagnosed and treated can result in severe health complications in a person and, in extreme cases, can have fatal consequences. “Diagnosis and treatment are important in order to save the life of someone with activity anorexia,” confirms Mukherjee Roy. This includes recognising the symptoms of the problem and coming up with solutions.

In the case of the boy obsessed with body building, a frank chat initiated by Sarkar worked. Now he only works out for an hour or so a day, three to four times a week. For the AA-afflicted girl in Mukherjee Roy’s gym, it took an ultimatum for her to stop.

Experts point out that often nothing short of professional counselling is required. Family and friends, colleagues and classmates, all play a vital role in helping the diagnosis and treatment of AA. But they unanimously agree, it is only when the person himself or herself acknowledges it as a problem that the solution starts to work.

Words of advice for the activity anorexic

• According to fitness experts, the first step toward a solution is to make the person aware that there is a problem. “Be prepared for denials and stiff resistance,” warns Mukherjee Roy of Solace. “The AA-afflicted girl in our gym initially refused to see reason. We could all see how thin she was. She was sickly with her collar bones and ribs sticking out. But she was convinced that she was fat. But you should persevere in your attempt to convince the person afflicted.”

• If you feel that nothing is working, try and convince the person to seek counselling. Leave the rest to the counsellor.

• Of course, there is nothing like self-help. If you, yourself, feel that you have any of the symptoms of AA, you should immediately review your exercise schedule. Keep telling yourself that over-exercise is counter-productive. Internalise this. Engage your mind with other activities like reading, listening to music. Find ways to relax the mind.

Symptoms of activity anorexia

There is a thin line between being a fitness freak (FF) and an activity anorexic (AA)

• An FF exercises while the latter over-exercises. An FF exercises to live. An AA lives to exercise

• It is not unusual for an AA to bunk school or college or skip work to continue exercising

• Virtually nothing can separate an AA from his or her exercise schedule — be it illness, injury or intemperate weather

• Like people with anorexia nervosa, they feel that they are overweight, even when
they are not.