Sarah's Story

Note: this transcript has been edited for clarity, grammar, and flow.

Steph: Hello, I’m Steph Boulet, and you’re listening to the Inside Out Institute Podcast. This episode is all about exercise and healing your relationship with it.

Exercise is often seen as a virtue in our society. But for people with an eating disorder, it can become quite the opposite. It can turn excessive and compulsive, to the point where it takes over your life and becomes dangerous for your health.

In fact, for many people with an eating disorder, exercise is actually of greater concern than food. To delve into this, I’m talking today to Sarah King, an exercise physiologist and health coach who helps people with disordered relationships with exercise.

We discuss:

• How to safely exercise in eating disorder recovery
• How to know when you’re overdoing it and what to do about it
• The role of social media in shaping our beliefs about exercise

This episode is a little different because Sarah is not only our expert guest, but she also has her own lived experience of overcoming an eating disorder, which she very generously shares with us.

Sarah: The thing that kind of kicked it off for me was a really unhealthy relationship. The person I was with would often make comments about my body, comparing me to what he believed was the ideal.

I was so young, so impressionable, and all I wanted was to be liked. So I thought, Right, well, this is how I’ll be liked and accepted.

At first, I masked it by telling myself, I’m just going to the gym and I’m just being healthy. But eventually, it spiralled out of control. I couldn’t live without exercise. It became compulsive, and my behaviours became more restrictive.

I reached a point where I was really unwell, but as many people with an eating disorder would understand, I was also in denial. At first, I didn’t want to get help. So for many years, I went through semi-recovery. I saw a psychologist, a psychiatrist, and a dietitian, and I definitely made progress.

But then, it hit a point where my best friend said to me: You can’t keep living like this. That was a turning point. I ended the bad relationship, and I realised: I don’t want my life to be completely ruled by thoughts about food, exercise, and my body.

So I went headfirst into recovery. I had to unlearn all the unhelpful messages I had absorbed. And, essentially, I had to do the opposite of what my eating disorder wanted in order to get better. And that took years.

It doesn’t take long to develop an eating disorder, but it takes a long time to recover from one. Going through an intensive outpatient program was really helpful for me. The group dynamic, hearing how other people were struggling, helped me realise that I wasn’t alone.

Eating disorders and mental illness, in general, can be such isolating experiences.

Being surrounded by others who were fighting for the same recovery that I wanted really propelled me forward. That, combined with having a really supportive family, helped me over time. My inner monologue started to shift. And when I regained some weight, something flipped in my brain.

It gave me space to step back and think, Whoa. I can’t believe that I thought all those disordered thoughts were my reality. Because they weren’t. That was just the eating disorder part of my brain. When I was able to access more of my logical brain, that’s when I started making real progress in my recovery because my mind was finally clear.

You almost feel like you’re trapped in a prison cell with an eating disorder. Recovery is about slowly breaking free. And there’s a grieving process to that, which sounds really odd, but it makes sense. Your eating disorder has been part of you for so long, so you’re not just letting go of harmful behaviours - you’re also rediscovering who you are without it.

It’s a massive self-discovery process.

Steph: Hey, just a quick question—do you work in fitness?

Did you know that fitness professionals can play a really important role in identifying eating disorders early and helping clients move toward recovery?

Inside Out’s e-learning course will teach you how to do just that. It’s accredited by Fitness Australia for two CECs.

Head to Fitness Australia or the Inside Out website to find out more.

The course is called Eating Disorder Red Flags: Decision-Making and Communication for At-Risk Clients.

You’re listening to the Inside Out Institute Podcast: rethinking eating disorders from the inside out.

Steph: In your role as an exercise physiologist, you often help people with eating disorders. What’s that like?

Sarah: Yeah, sure. When I went through recovery, there was really no information about what was okay and what was too much in terms of exercise. We know that during recovery, healing your relationship with food and your body is essential, but for a lot of people, there’s also an exercise component.

It usually falls into one of two categories:

1. Over-exercising: where movement is compulsive, excessive, or used as compensation.
2. Resentment towards exercise: where it’s only ever been associated with weight loss or earning food, and once that mindset is challenged, exercise is abandoned altogether.

My goal is to take those two extremes and help people find their happy balance in the middle. That’s really the challenge because it looks different for everyone. A big part of my role is listening to people’s experiences and understanding what they’re struggling with.

If someone is engaging in over-exercise or compulsive exercise, whether to compensate for food, to cope with stress, or simply to make it through the day, we work on getting to the root of that belief.

Where did that story come from? And how can we start changing it?

So part of the process is changing behaviours - looking at what their exercise routine currently is and seeing how we can adjust it to break rigidity, whether that’s reducing intensity, frequency, or duration.

The goal is to reduce harm and build a healthier, more flexible relationship with movement.

Steph: So how do we know if we’re exercising in a healthy way? And where does it cross the line into being compulsive or excessive?

Sarah: I think if you can’t take a break or you feel a lot of guilt and shame around resting your body, then you’re probably not in the best place with it. But that doesn’t mean you can’t exercise at all. It just means there’s some work to be done in repairing that relationship.

If you look at the research, there are so many different opinions. Some studies suggest that exercising more than six hours a week is obsessive, while anything under that isn’t. But it’s not really about the amount; it’s about the intention behind it.

We do know that any amount of exercise, when paired with inadequate nutrition, can be harmful regardless of body size.

Sarah: Yes, and I think when your internal health starts to take a hit because of what you're doing physically, that’s when it crosses the line from healthy to unhealthy.

Steph: And what are the consequences of continuing to exercise excessively - beyond what your body is able to sustain?

Sarah: I mean, there’s a myriad of different consequences. I’ll go through a few of the most common. The first one is injuries. Injuries and illness are really, really common if you’re over-exercising because you’re not giving your body enough time to rest and recover.

People often think you get fitter or stronger in the gym, but that’s not actually what happens. Exercise breaks down muscle tissue. It's the time after exercise, in the next 24 hours or so, when your body rebuilds. If you're resting properly and fueling yourself well, that’s when you actually get stronger and improve cardiovascular fitness.

But if you’re not doing that, if you’re under-fuelling or never letting your body rest, you’re constantly breaking yourself down. Then there’s the hormonal impact. For men, it can cause lower testosterone levels. For women, it can lead to loss of their period (hypothalamic amenorrhoea), which is a huge red flag that the body isn’t getting enough energy to function properly.

And then there’s the social impact, which I think is one that often gets overlooked. Exercise can start to take priority over everything else: your social life, your friendships, important life moments. You might start missing out on birthdays, dinners, or trips because they don’t fit into your workout schedule. And at some point, you have to ask yourself:

Do I want to get to the end of my life and realise I missed out on making amazing memories just because I thought exercise was the most important thing?

Steph: When exercise is such a big part of your identity, and you have to remove or reduce it, how do you find yourself again?

I know you’ve had personal experience with this - how do you figure out who you are without fitness?

Sarah: Yes! That’s a big question. And it’s something a lot of people struggle with, because it’s not just about reducing exercise, it’s about figuring out who you are without it.

I always say to people: Exercise is a great thing but we want to get it to a point where it’s like brushing your teeth.

You brush your teeth every day to keep them healthy, but you’re not obsessed with it. You don’t think about it all the time. You don’t wake up worrying about whether you brushed well enough or if you need to do more later in the day. You just wake up, have breakfast, brush your teeth, and move on with your day.

That’s what we want exercise to feel like; something that’s part of your routine, but not something that consumes your thoughts.

In recovery, the first step is to minimise harm and give people a different internal dialogue when those negative, eating disorder-driven thoughts come up around exercise.

And then, over time, as you start bringing other things into your life, exercise naturally becomes a smaller part of your world. That’s the bigger picture of recovery - realising that your life wheel has so many different components. If you’ve been focusing only on exercise, food, and body image, the question becomes:

How can we start putting the other components of the wheel back in?

Because once you do that, once you start exploring new interests, relationships, and experiences, exercise naturally finds its place.

It’s still there, but it’s no longer the defining part of who you are. It just becomes something you do for health and enjoyment rather than something you need in order to feel okay.

Steph: What are the common concerns or themes you hear from your clients? And what’s your message to those concerns?

Sarah: A lot of the themes that come up are around pressure - this feeling that they have to maintain a certain level of fitness because of expectations from the outside world.

Steph: Are we talking social pressures? Social media?

Sarah: Yeah, social media is a big one. But also, a lot of it comes from public health messages which, while well-intended, can sometimes create fear or pressure.

Steph: You mean things like 30 minutes of exercise a day?

Sarah: More like the 10,000 steps a day messaging. A lot of people get caught up in the idea that if they don’t hit that number, they’re being lazy or unhealthy. And that’s simply not true. Health is so much more nuanced than a step count. In fact, the 10,000 steps rule doesn’t even have that much scientific grounding. We actually know that the number is a lot lower than that.

It’s the same with fitness guidelines. A lot of my work involves helping people detox their social media feeds. I tell my clients: Every time you log onto social media, it’s like opening a magazine. You can either fill that magazine with things that make you feel bad about yourself (things that reinforce negative beliefs) or you can fill it with things that make you feel good.

And that doesn’t just have to be fitness-related content.

Steph: Yeah, like puppies and funny memes.

Sarah: Exactly! Or interior design, travel, art - anything that sparks joy.

Because if all you see on your feed is content about bodies, fitness, exercise, and food, that’s what your mind will constantly be focused on. And I think, as a society, we already focus on those things way too much.

At the end of the day, your health doesn’t define who you are. It’s a small part of your overall being. It’s what helps give you the energy and vitality to do the things you actually care about. But we’ve made it the centre of everything when it doesn’t have to be.

Steph: Just to give this some context ... At what point in recovery is it healthy to start reintroducing exercise?

Sarah: If we’re looking at medical reasons for not including exercise in recovery, being underweight is definitely one of them.

But it’s not just about weight. We need to look at the bigger picture.

Even if someone isn’t medically underweight, behaviours like purging or severe restriction can create electrolyte imbalances and energy deficiencies. Adding exercise on top of that can put a huge strain on the body.

Steph: So it’s not just about weight. It’s about overall health?

Sarah: Exactly. If someone is already in an energy deficit, adding exercise into the mix can be dangerous. It’s just not a good combination.

But on the flip side, some people in recovery actually need to take a solid break from exercise - mentally as well as physically.

And for those people, I always say: You are allowed to take a break.

I took a full year off exercise during my recovery because I needed to prove to myself that I could live without it and be okay.

So, both options (taking a break or reintroducing movement slowly) are completely fine. The key is making sure that when you do start exercising again, you:

• Feel mentally ready
• Are physically well-nourished
• Have a strong treatment team behind you

And you shouldn’t do it alone.

If you have a dietitian, they can help make sure your meal plan supports your activity. If you have a psychologist, they can help you navigate your mindset around exercise. Even if it’s just for a few sessions, having someone to hold you accountable is important.

Let them guide you on what’s a safe and appropriate amount of movement for your stage of recovery.

Steph: So it’s almost like prescribed exercise?

Sarah: Exactly.

Steph: And when someone is ready to reintroduce movement, how do they do it in a healthy way?

Sarah: Well, my advice is always individualised, but there are a few key things I look at. The first is preferences. We need to move away from compulsive behaviours.

If someone used to run excessively or obsess over gym classes, we might press pause on those and try something different.

Instead of running, maybe we start with walking. Instead of intense gym workouts, maybe we try gentle movement with a friend. And accountability is key.

Can you tell someone your plan so that you’re not making those decisions in isolation?

The goal is to remove those old eating disorder ties so we avoid fixating on steps, calories, or rigid timeframes.

If I’m working with someone in a gym setting, I try to make movement fun - more about strength and function, rather than aesthetics or numbers.

The ultimate goal is to have people move their bodies in a way that makes them feel good. And I think the best test of whether you’re doing that is:

How do you feel after?

If you leave a workout feeling better, both mentally and physically, that’s a good sign.

Steph: So not thrashing yourself every time?

Sarah: Exactly.

If you finish exercising and feel like you need a nap, you’re probably pushing it too hard.

Sarah: Yeah, it’s about filling up your cup rather than draining it further.

Because while physical activity has so many benefits, it’s also a stress on your body. So if you’re already going through a stressful period, whether it’s work, family, or personal struggles, you need to take that into account.

Maybe a high-intensity spin class isn’t the best idea today.

Steph: Right - maybe today is a day for something more relaxing, like a swim in the ocean?

Sarah: Exactly!

Steph: We’ve talked a lot about compulsive exercise and over-exercise. What about the people on the opposite end of the spectrum - those who have no motivation to exercise, either because of past negative experiences or because they’ve never exercised at all?

Sarah: That’s such a great question. First of all, if you’re in a place where you hate exercise because it felt like something you had to do, then you need to give yourself the time to take a break.

It’s okay to say: I’m not ready yet. A lot of people don’t want to be in their body because they feel uncomfortable. They might think they’re too unfit to go to the gym, or that they don’t belong in those spaces.

And to that, I always say: Wherever you are right now is the right time to start.

It doesn’t matter your age, background, body size; exercise is about finding what makes you feel good.

One of the best ways to shift your mindset is to focus on goals that aren’t aesthetic-based.

For example, if you’ve got a holiday coming up that involves a lot of walking, that can be your motivation - starting small and building up your stamina so you can enjoy it. Eventually, you’ll find what makes you feel energised and happy.

Steph: And also realising that exercise doesn’t have to happen in a gym!

Sarah: 100%! There are so many different ways to move: YouTube workouts, online classes, social activities...

Steph: Yeah, group activities are such a great alternative to just pounding away on a treadmill.

Sarah: Exactly! If you can bring a social element into movement, it’s often so much better for both your body and your mind.

It takes the focus off what you look like and onto just enjoying the moment.

A lot of people worry about being watched or judged when they exercise, but the truth is, everyone is way too wrapped up in their own world to be paying attention to you. And if you’re in a group setting, you can just let yourself be, interact, and actually enjoy the experience.

Steph: Plus, being outdoors and getting fresh air helps too!

Sarah: Absolutely. And if you’re someone who prefers indoor movement, try to find a really inclusive space. For example, yoga studios often don’t have mirrors, which can help if you struggle with body image.

There are also women-only gyms or gyms with diverse communities that can make you feel more comfortable. And one thing I’m super passionate about is making sure fitness instructors are mindful of their language.

If you’re in a spin class or a weight-training session, and the instructor is constantly talking about “toning” certain body parts or “burning off” calories, that can reinforce really harmful messages.

If you ever hear that kind of language, don’t be afraid to speak up and say:

"Hey, that’s actually really unhelpful."

Because when trainers use those phrases, they’re reinforcing the idea that exercise is only about weight and shape, when in reality, it’s about so much more.

Steph: What about body image tips?

Because during recovery, your body changes a lot. How can someone cope with that?

Sarah: From personal experience, I found that part really challenging.

And honestly, there’s no magic pill that makes it easier. But over time, you realise that body image isn’t stored in your fat cells - it’s stored in your brain cells. It’s about changing your mindset, not changing your body.

If you’re struggling, the healthiest thing you can do is:

• Distance yourself from people who constantly talk negatively about their bodies.
• Unfollow social media accounts that make you feel bad about yourself.
• Make yourself comfortable - don’t force yourself into clothes that don’t fit or don’t make you feel good.

Even people without eating disorders have bad body image days. So on those days, be kind to yourself. Clean out your wardrobe and get rid of clothes that no longer serve you. And remind yourself: Every single person’s body changes over time. That’s normal.

Your body size doesn’t define you, and the more you take your focus off your body and onto other things, the more peace you’ll find.

Steph: Before we wrap up, what’s your message to anyone out there struggling with disordered eating, eating disorders, or obsessive exercise?

Sarah: Whatever stage you’re at, you deserve help.

I think one of the biggest things that holds people back is this belief that they’re not sick enough to ask for support. But the truth is, the sooner you reach out for help, the better your outcomes will be. That’s why I speak out about this - because raising awareness is so important.

I want people to know that they matter and that they can get through this.

Steph: Thanks for listening. You can find Sarah on Instagram at @sarahlizking or visit her website, sarahlizking.com.

She also hosts the Holistic Health Radio podcast - definitely check it out!

Did you know that Inside Out, in collaboration with Fitness Australia, has developed guidelines for eating disorders in the fitness industry?

The National Eating Disorder Recommendations for the Fitness Industry give gym instructors and fitness professionals guidance on spotting warning signs of an eating disorder and the best ways to help.

• eLearning: ‘Red Flags’: Decision Making and Communication for At-risk Clients in the Fitness Industry. Click here to learn more.
• InsideOut x Fitness Australia guidelines for eating disorders in the fitness industry
• For more information about Inside Out, visit insideoutinstitute.org.au.

Catch you next time!

If you or a loved one needs support, visit www.insideout.org.au or call the National Eating Disorders Helpline at Butterfly on 1800 ED HOPE (1800 334 673).