All Posts tagged exercise

Christmas Stress & Eating Disorders - Part 1

Christmas Stress & Eating Disorders – Part 1

Christmas can be an especially difficult time for all people who live with mental illness. For people with eating disorders (ED), the bells and whistles of Christmas and large family gatherings make the battle with food more visible to extended family and friends. Hypervigilance and high anxiety can easily lead to misunderstandings, judgement and conflict. Families may find themselves isolated at Christmas time, simply because hosting a Christmas lunch is extraordinarily difficult when someone with an eating disorder is sitting at the table.

The build up to Christmas typically involves increasing anxiety around traditional celebrations involving food. There may a heightened fear of putting on weight for people with anorexia, secret preparations and purging for people with bulimia nervosa or guilt, shame and trauma for people who have binge eating disorder. Afterwards there is the fallout of the festive season which can involve relapses, crash dieting, depression, isolation, even suicide. Naturally, this means that eating and drinking traditional Christmas fare strikes a morbid fear in the hearts and minds of many thousands of Australians.

It is estimated that there are over 913,000 people in Australia with eating disorders and the impact of an eating disorder is much like other significant mental illness –  the burden of illness falls firmly onto the shoulders of families and friends. This is particularly true in the case of eating disorders because there are so few hospital beds allocated for patients with eating disorders – The Butterfly Foundation estimate the nationwide bed allocation for people with ED is just twenty two. Twenty two beds across Australia allocated for people suffering from an often fatal mental illness. Needless to say, the waiting lists for these beds are sometimes years long (and very often years too late…).

  • Eating disorders can be fatal, in fact one in ten people with anorexia nervosa will not survive for more than 10 years after the onset of the illness.
  • In 2012 there were an estimated 1,863 deaths in Australia due to eating disorders (gender differences: 515 males, 1313 females).

Comorbidities such as anxiety, depression and suicidal ideation are common for people living with eating disorders. Suicide mortality rates in people with anorexia nervosa are one of the highest of all psychiatric illnesses with the risk of death by suicide in people with anorexia nervosa calculated as high as 57 to 58 times that of the same age and gender and populations.




5 Common Eating Disorder Triggers

So, what are some of the triggers someone with an eating disorder might be experiencing at this time of year?

Eating disorder triggers vary from person to person but common triggers include:

  • Emotional issues - Disordered eating is a way to cope with painful or distressing emotions (anger, sadness, frustration, helplessness)
  • Weight comments - “You look so much better now - how has your weight been?” or “Wow, you’re looking well!
  • Images - models, skinny people, pictures of food, recipes, cooking programs on TV
  • Eating with others - Some people who are living with ED report that eating with other people makes them feel like a “pig”. No matter how much is on their plate, it seems like much more that everyone else has.
  • Exercise promotion - When super fit models or personal trainers claim that “diet and fitness go hand-in-hand” it can be a trigger for people with ED. Over exercising is common in people living with anorexia and while the “Exercise to beat obesity” message is great for many people, it can be a dangerous trigger for ED sufferers.


Read more on Recognising the Warning Signs of Eating Disorders 


Coping with ED during the Festive Season

So, how can people with ED and their families prepare for this season of overindulgence?

  • Plan ahead: Identify a support person and talk to them about your fears and concerns. Ask them to be available for you or your family to contact in case you feel overwhelmed.
  • Be prepared for tensions to escalate around Christmas Day or before a party. Communicate as clearly and calmly as possible.
  • Take time out for yourself. Plan for your family to do something together that is relaxing and does not necessarily revolve around food. A walk on the beach or in the park, a swim, listening to music, playing a game together.
  • Avoid comments about appearance – try something like “It’s great to see you here” or “Lovely that you could make it today”
  • Set realistic New Year resolutions with healthy boundaries
  • Learn to set realistic goals for yourself and your family. If taking on too much is going to stress you out – say NO!
  • Say YES to a healthy body image

Remember, Christmas can be a tough time for many people. Christmas will never be a “perfect day”, so learn to relax about Christmas, lower the bar, and if things don’t turn out as planned, it isn’t the end of the world. Christmas is but one day. Tomorrow is another day and there are many more tomorrows to come…..




The Dangers of Unofficial Websites

It’s important to mention there are groups on the internet that actively encourage negative eating behaviours. Some people with ED use social media forums, blogs, photos and  “thinspiration” to encourage, laud and form an ED alliance where ED is discussed and where negative behaviours are reinforced. Initially, these sites were a kick against the system where censorship and punitive, conventional treatment methods were simply not working. The danger of such sites is that fasts, starvation, over-exercising and dangerous dysfunctional behaviour is very often celebrated and encouraged. People living with ED, their families and health professionals should be aware that these sites exist and form strategies around how to deal with insidious messages that encourage negative behaviours and practices and the emotions or behaviours that these messages may trigger.


Useful Links

More tips for coping with Christmas: Eating Disorders Victoria

The Butterfly Foundation Support for Australians experiencing eating disorders

NEDC National Eating Disorders Collaboration 

Derwent House NSW 








Paying the Price: The economic and social impact of eating disorders in Australia. Butterfly Report, 2012. Download The Butterfly Report 

American Association of Suicidology. Suicide and Eating Disorders. Downloaded from LIFE

Eating Disorders Victoria

Eating Disorders Victoria Helpline: 1300 550 326

National Eating Disorders Collaboration NEDC


Five Reasons why Exercise Improves your Mental Health

Five Reasons why Exercise Improves your Mental Health

By guest blogger Susan Whitby - MClinSc (Lifestyle Medicine), Grad Dip (Biological Anthropology), BA.

With 20% of Australians suffering from a mental illness in the past 12 months1 and the cost to the Australia economy teetering around $20 billion2 it’s well worth paying attention to the body of research supporting exercise as a valid treatment option for those suffering a mental illness.

Now who am I to be saying this? Well yes, I’m a personal trainer, so of course I think that exercise is great! But let me share something with you. For many years I suffered from deep depression and crippling anxiety to the point that I was self-harming. After many years and many relapses, I spent years researching how exercise has the potential to reduce the symptoms of anxiety and depression.

Medical Practitioners are at the coalface when it comes to helping those with mental health issues. 70.8% of mental health sufferers present to a General Practitioner.3

Health professionals are in a perfect position to share this information. Sure, compliance may be an issue but there will also be people who take on board the messages gleaned from this research.


Here are five reasons why exercise could be an important part of a treatment program for your patients:

1. Regular exercise reduces inflammation in the body. Pro-inflammatory cytokines TNF- α are suppressed by regular exercise.4

2. Moderate intensity exercise has the potential to create a state of ‘flow’, a well-used Positive Psychology strategy for reducing the symptoms of depression.5

3. Exercise releases ‘happy hormones’. 5-HT is synthesised and metabolised immediately after a one hour bout of exercise.6

4. Exercise promotes a healthy and functioning brain by way of neurogenesis (synthesis of new neurons), the same as anti-depressant medication.7

5. Exercise increases self-efficacy. Mastering an exercise type is important in recovering self-esteem and rebuilding confidence.6

The type of exercise really doesn’t matter. Cardiovascular exercise works well for some while resistance training is preferable to others. What is important is that this information is shared. It could save millions of dollars and just as many lives.



  1. Mental Health Council of Australia. Fact Sheet – Statistics from the 2007 National Survey of Mental Health and Wellbeing.
  2. Australian Bureau of Statistics (2007) Mental Health. Gender Indicators. ABS Cat No. 4125.0. Canberra ABS.
  3. Australian Bureau of Statistics (2007). National Survey of Mental Health and Wellbeing: Summary of Results. ABS Cat No. 4326.0. Canberra ABS.
  4. Petersen AMW, Pederson BK. The anti-inflammatory effect of exercise. Journal of Applied Physiology 2005;98: 1154-1162.
  5. Dey S, Singh RH, Dey PK. Exercise Training: Significance of regional alterations in serotonin metabolism of rat brain in relation to antidepressant effect of exercise. Physiology and Behaviour 1992;52(6):1095-1099.
  6. Black Dog Institute. Fact Sheet - Exercise and Depression
  7. Ernst C, Olson AK, Pinel JPJ, Lam RW, Christie BR. Antidepressant effects of exercise: Evidence for an adult-neurogenesis hypothesis? Journal of Psychiatry and Neuroscience 2006;31(2):84:92.


Useful Links



Unravelling the link between diabetes and heart disease

Unravelling the link between diabetes and heart disease

What if everyone in Australia were to visit a dietitian….?

e-GPS are pleased to have as our guest blogger this week: Accredited Practising Dietitian, Sally Marchinibox of veggies

It’s a frightening statistic that three in five people with diabetes die of cardiovascular disease. However, this doesn’t need to be the case.  Managing the condition correctly will be of benefit and this includes a healthy diet and regular exercise.

If you’re wondering why it is that diabetes and cardiovascular disease are so closely linked, Diabetes Australia explains:  “People with type 2 diabetes often have ‘abnormal’ levels of blood fats (cholesterol and triglycerides). Not only are the blood fat levels different to those of a person without diabetes, the cholesterol also tends to ‘behave’ differently. This is a contributing factor in the up to six-fold increase in atherosclerosis that people with diabetes experience.”

If everybody in Australia were to have a visit with an Accredited Practising Dietitian (APD) or Accredited Nutritionist (AN) to have ‘healthy’ explained in a personalised format, it is possible that the rates of these conditions could be significantly reduced.  This is because an APD/AN would help you to find the best way to avoid them by tailoring an approach that follows the Australian Dietary Guidelines.

In a nutshell, the guidelines recommend a wide variety of nutritious foods including plenty of a variety of coloured vegetables and legumes, whole fruits, mostly wholegrain cereal foods, lean protein sources, reduced fat dairy produce and choosing to drink plenty of water. They also talk about foods that should be limited including foods high in saturated fat (fats from animal origin plus coconut and palm oils), added salt, added sugars and alcohol.

However, these guidelines were developed for healthy people. People who already have diabetes or are in a high risk group for diabetes should also minimise highly-refined starches (for example white bread, crackers, savoury snacks) and eat fewer highly-refined starchy vegetables such as potato or corn chips, or crisps. These high-glycemic index carbohydrates are linked to higher risk of cardiovascular disease, diabetes and some cancers, and sit alongside saturated fats (animal fats plus coconut and palm oils) and sodium as the main dietary contributors to cardiovascular disease.

Evidence is growing that people with diabetes should enjoy a diet based on nutrition-dense and low-glycemic index carbohydrates, lean proteins and should include mono- and poly-unsaturated fats (a Mediterranean-style diet) for improved diabetes control and minimised cardiovascular disease risk.

If you would like to learn more about how these ideas relate to your own circumstances, to understand portion sizes and to find ideas to make your diet more satisfying and rewarding, then arrange to see an APD/AN. You can find one near you through


Diabetes Australia - Eating Well

Glycaemic Index - University of Sydney

Diabetes info for under 25s

Marchini Nutrition


A Shared Voice - Australian Diabetes Council 



General Practice Solutions

Living with Diabetes and Coeliac Disease


I’m in pain, I don’t want to exercise!

I’m in pain, I don’t want to exercise!

Since writing his post in 2013, there has been an exciting development in the world of pain.

NSW Health and the NSW Agency  for Clinical Innovation launched their new user-friendly Chronic Pain ToolKit - The Pain Management Network.

Take a look at the website then read on…


I’m in Pain I don’t want to exercise

Let’s face it, the last thing you feel like doing when you have pain, is exercise. It’s more likely that you will listen to your body, and those around you, and rest the injury until you feel able to continue your normal activities. Many people who have experienced a sports injury or another type of acute pain, may be advised by their medical professional to rest for a brief period, perhaps take over-the-counter pain medication, and once they can move freely again to continue their normal activity. Others may avoid all activity, take strong pain medication and rest until the pain has gone completely. Everyone experiences pain differently depending on their past history of pain, culture, beliefs, mood and ability to cope.

But what if the pain doesn’t go away?

People who experience long-term pain (known as chronic or persistent pain), often become disabled by their pain. Chronic pain can stop people doing the things they are used to and can restrict normal daily activities and enjoyable leisure time.  Of course, this can lead to feelings of helplessness, frustration, anxiety and may result in an increased sense of isolation.

Exercise and chronic pain

Many people who experience chronic pain tend to arrange their lives to avoid activity as much as possible. They give up their usual activities and become less fit. If you are experiencing chronic pain, it is likely that your doctor will have several treatment suggestions. When a team of health professionals are involved, it’s called a multidisciplinary approach. Gentle exercise forms an important part of this approach and studies have shown that exercise goes a long way to help managing chronic pain.

But how do I start?

Exercise helps by improving strength and fitness, increasing confidence and allowing you to gradually return to productive, enjoyable activities. Before starting an exercise program, it is advisable to consult a medical professional. You may be afraid that exercising will cause further injury and more pain. Talk to your doctor about how you are feeling. They may suggest seeing a psychologist with chronic pain experience who can help you manage the fear and anxiety that is often associated with chronic pain.

Setting your exercise goals When you start exercising, keep in mind some realistic and achievable goals. Realistic goals for an exercise program might be:

  • Increased flexibility
  • Increased strength
  • Improved fitness level
  • Improved endurance.

Even though improving your flexibility, strength and endurance may help to reduce pain levels, it is more realistic to work towards improving your ability to function from day-to-day, rather than use pain relief as a goal. Be SMART  When you set goals, make them SMART goals:

  • Specific - State exactly what your goal is, eg; I want to run in the local 2 km Run for Cancer Research
  • Measurable - How will you achieve your goal? Perhaps you could start by walking for 20 minutes three times a week. Then, in two weeks, build up to running for 2 minutes during the walk. Increase the run by 1 minute every time you go out for your walk.
  • Achievable - Set goals you know you can achieve. There’s nothing worse than setting unachievable goals eg; I am going to do the corporate triathlon next month and then, if you don’t achieve the goal, feeling as if you have failed.
  • Relevant - Is this something you really want to do? Is it a worthwhile goal to set for yourself?
  • Time-bound - Have a definite time frame for your goal. For example; In three months, my goal is to build up to running 2 km for the local Run for Cancer Research.

Exercise programs usually consist of the following components:

  • Warm-up and Stretching
  • Strengthening - Body core and large muscles
  • Aerobic fitness
  • Warm down

Of course, if you have chronic pain, it is best to get back into exercise gradually. Always consult your doctor or medical professional for an exercise plan or get a referral to see an exercise physiologist or physiotherapist. Most importantly, pace yourself, be kind to yourself and don’t overdo it.


Nicholas M, Molloy A, Tonkin L, Beeston L. (2000) Manage Your Pain: Practical and Positive ways of Adapting to Chronic Pain. ABC Books, Sydney, Australia.

Meyer, Paul J (2003). “What would you do if you knew you couldn’t fail? Creating S.M.A.R.T. Goals”. Attitude Is Everything: If You Want to Succeed Above and Beyond. Meyer Resource Group, Incorporated.



Pain Management Network 

Pain Australia


Body In