Lower level movement: when restriction seeps into your every move.

low level movement and anorexia

This post on low level movement will most pertain to anorexia nervosa, or to people who are restricting their food intake in a way that it affects their physiology. This is because there is a physiological reason for lower level movement.

So what is lower level movement?

Well, it is a term used to describe a type of physical activity people with anorexia engage in. It often starts involuntarily without the person realising they are doing it but then the Voice takes over, the rules start and it becomes an activity the person feels compelled to do.

Compulsive exercise is well known in the eating disorder world and I shall write about this in more details in my next post. Briefly, however, it is when people engage in frequent, long and arduous exercise sessions. It can been seen as a form of purging, as it is often a way to compensate for the food eaten. It’s quite overt, you see people running, always in their gym wear, constantly at the pool etc.  Well think of lower level movement like this but hidden, like a workout under an invisibility cloak.

Lower level movement is sneakier that blatant compulsive exercise. It often goes unnoticed because people around you don’t see the extent to which you are moving. You are not wearing gym clothes, you are just being helpful, kind to the planet, a good dog owner etc.

Lower level movement encompasses different types of movement that you traditionally don’t think as exercise such as: walking, standing, or fidgeting.


Walking the dog is a good example. If you have a dog, you need to walk it, it’s only right for the animal to be comfortable and healthy, right? What I see though is people who walk their dog several (many) times a day, more than the dog really requires. It’s not just a decent walk and then a quick wee round the block. It’s getting up at the crack of dawn for a long walk, coming back home at lunch for another one by the beach, then one before dinner and one before bed. Before you know it your dog is exhausted because you have walked 10 miles.


Then there is walking the longer route, everywhere. This is certainly something that I did when I was a six former when I had to walk to and from the bus stop in time to get to school. I only ever went to quickest, and normal, route when I was with other people because I didn’t want to look weirder than I already was. Towards the end, I could engage in my crazy walking because I had no friend and there was no pretending I wasn’t weird, I was the anorexic vegetarian girl. Everyone knew this.

People wrapped up in lower level movement take AGES to shop. Most people with an eating disorder take ages to shop because they are scrutinising the labels but this takes another dimension. That’s because people will walk to the further shop possible and they may even visit several shops to check the different items they need to buy. Only then will they decide where they will buy the items from, possibly ending up in the first very shop. They will never just pop to the corner shop, they will go to the one that is three miles away at the bottom of that big hill. Conveniently, because it takes them so long to get there, they probably don’t have much time for lunch…

More walking

Another common feature of lower level movement is having rules about the route you take (always the same, or longer). Or, it’s having rules attached to how the walking is done: you have to go round the school grounds twice before you can walk home, for example. The result is the same, it’s about distance and it’s about not being deserving if you don’t comply with the rule.

I remember a language trip to Brighton when I was really ill actually (I looked a fragile twig on the cliffs of Eastbourne). I remember walking everywhere and not often buying a bus ticket because “it was cheaper”. It was, but the real reason was that every little step counted, I walked, walked and walked by myself when I was supposed to speak English, make friends and kiss boys.

People also walk whatever the weather “for the environment”…

Engaging in lower level movement means always taking the stairs even though lifts are available. It is racing people up the escalator (even though those people have no idea a race is taking place). It’s never siting on the tube – why sit when you can stand? It’s getting off the tube or bus several stops earlier, so you can walk the rest of the route home and “get some fresh air.”

Standing and fidgeting are also very common forms of lower level movement.

I see people, influencers or worst perhaps, health professionals, only ever using a standing desk because “it’s better for you.” They even go as far as installing a treadmill under their desk so it becomes a walking desk.

People watch TV standing, sometimes pacing around the room. I have had clients refusing to sit down for our sessions, constantly fidgeting instead.

Some people clean obsessively; people wrapped up in lower level movement never have a dirty house, it’s always immaculate. I saw a programme the other day when a lady was getting up every day at 4.30am to clean her place! She lives in a one bed flat on her own, how much cleaning could there possibly be?! Given other aspects of this woman I would be ready to bet that she is suffering with anorexia.

Certain persons sometimes go as far as picking jobs that mean you will stand and walk all day long: nursing, bar tending, harvesting, farming etc. The number of people I have seen working in the hospitality industry is unreal.

Moving to run away from ourselves

Moving is a way to distract you from the noise in your head and from the voice telling you are not good enough. It’s a way to fill the void and break the awkward silence between you and yourself, so you don’t ask yourself the important questions. So, yes, it is a way to run away from yourself. Eventually, movement is also a way to make it harder for you to eat. You don’t want to make crumbs while also cleaning the house, do you?

What matters isn’t what you do really because walking the dog, cleaning the house, not taking the bus are all valid things. What matters is how strongly you have to do those things. Anything that feels compulsive and that will induce guilt if you don’t do it is likely to be deleterious for your mental health.

The physiological side of lower level movement

One often assumes that lower level movement is just a sneaky way to burn calories but it isn’t just that and that’s what differentiates compulsive exercise from lower level movement. It is common for anorexia to start from compulsive exercise: people get caught up in the number game and need to go faster/further, to do better, and/or lose more weight. Lower level movement seems to be different in that it seems to be the consequence of under-eating. In fact it was already seen in the Starvation Study conducted by Ancel Keys: when starved the men started to fidget and want to move more.

On the surface of it, it makes no sense at all. If you don’t receive energy from food, why would you feel compelled to expand it through movement??

The answer to this is physiological. When someone loses weight due to a restricted diet, their level of leptin decreases. Leptin is a hormone directly related to the amount of fat we consume and store. If leptin is low because our diet is poor in fat and because we don’t have much body fat, it suggests to the body that it is starving. Evolutionary speaking, if we were starving we would have had to move to greener pastures, so low level of leptin therefore urges the person to move in order to find food.

Of course, evolution hadn’t anticipated mental health. It hadn’t anticipated that a person might “voluntarily” restrict their food intake even though they are surrounded by food. Nonetheless, the body responds in the same way and starts to move. Then comes the ED voice, recognising that this is a rather good idea to keep moving in the hope that more calories will be burnt.

How to get better

The only way to get better is by resting and eating.

The body needs rest to heal and it also needs food to rest.