Counting Every Step

Grace, 29, a marketing executive in Manchester, started jogging to feel better after a breakup. Soon she was running twice a day, even with a sore knee, and logging every calorie. If she misses a run she feels anxious an…

Grace, 29, a marketing executive in Manchester, started jogging to feel better after a breakup. Soon she was running twice a day, even with a sore knee, and logging every calorie. If she misses a run she feels anxious and guilty, and she skips meals to compensate.

Her friends notice that she turns down dinners and brunches, and that she seems tired and cold. She sleeps badly, wakes early to run, and her periods have become irregular. She says, "I am just being healthy," but her eyes show worry.

One evening her flatmate, Sana, says calmly, "I miss you at dinner. I am worried about how hard you are pushing yourself." Grace becomes defensive, then tearful. She admits that exercise is no longer enjoyment but a rule she cannot break.

Sana does not argue about weight or food. She stays with her, and a week later goes with her to the doctor. The doctor explains that movement should serve wellbeing, and that rigid rules around food and exercise can signal a problem needing professional support. Grace begins gentle, shared walks and regular meals with a therapist's guidance, and slowly the running becomes something she chooses rather than something she fears.

How to recognise it

• Exercise done despite pain, illness or fatigue, with intense guilt if missed.

• Strict food rules, skipped meals, avoiding social meals.

• Tiredness, feeling cold, irregular periods, frequent injuries.

• Mood tied to weight, shape or exercise.

• Secretiveness and defensiveness when asked about it.

What this story explains

Movement supports mental health in moderation, but over-exercise and food restriction can become unhealthy and may be linked with an eating disorder.

Probable root causes

• Emotional pain turned into control over body and food.

• Perfectionism and low self-esteem.

• Social media and cultural pressure about body shape.

• Under-eating, which affects mood and thinking.

What to do

1. Express care without commenting on body or weight.

2. Encourage regular meals and rest days.

3. Suggest a medical check, as the body may be under strain.

4. Offer to accompany her to appointments.

5. Help shift exercise to enjoyable, social activity.

6. Stay in touch even if she pulls away.

Whom to consult

• Family doctor for a physical check and referral.

• Clinical psychologist or counsellor experienced in eating concerns.

• Dietitian with the doctor's guidance; emergency service or hospital if she faints, has chest pain or severe weakness.

Do and don’t

How to behave and communicate

• Use "I" statements: "I am worried because you seem exhausted."

• Keep the tone calm and kind, never accusing.

• Listen to her feelings rather than debating food.

• Say: "You are more than your body. I am here."