Eating for None
Eating Disorders Continue To Be a Complex Problem for Olympic Athletes
May is Mental Health Awareness Month and we have been pleased to share with you a series of special podcasts throughout the month on this topic. This week, one of our favorite guests returns, Dr. Kristin Keim. We first spoke with Dr. Kristin in 2019 and again during the COVID-19 pandemic in 2020. Dr. Kristin is back to update us on what new challenges elite athletes face in protecting their mental health. How are they navigating the post-pandemic world? How can Olympians manage the downside of social media? What should be done to protect the youngest athletes? Dr. Kristin has opinions!
Eating disorders are a major issue that persists in elite sports. We see it across sports, ages, and gender. We have spoken with Olympians Gracie Gold and Samantha Schultz about their experiences but there is so much more to this complex disorder. New diagnoses have been introduced that recognize different conditions affecting many athletes.
Orthorexia or Strict Diet?
Elite athletes often employ specific diets to perform at their best. Olympians also need to know where their food comes from to avoid inadvertent contamination of banned substances, like hormones used in meat production. Orthorexia is defined by the National Eating Disorders Association (NEDA) as “an obsession with proper or ‘healthful’ eating.” So what’s the difference between being responsibly careful and being sick? It really is a question of degree and consequences. Cutting out entire food groups, being inflexible with changes to diet, or refusing any kind of “cheat” food can all be signs of a problem. Feeling guilt, shame, or anger when eating “bad” foods can also be a concern. When eating healthy or pure start interfering with one’s ability to enjoy food or gets in the way of relationships, it is time to take a closer look.
In the RED-S
Relative Energy Deficiency in Sport (RED-S) first gained publicity when runner Mary Cain spoke out about her experience with Nike and disgraced coach Alberto Salazar. Cain went from being the most promising young distance runner in the US to being unable to function because she was starving herself. When an athlete burns more calories than she consumes, her body seeks energy stores wherever they can be found. The body depletes fat and muscle, then attacks organs. Over time, the athlete’s performance deteriorates. Coaches often think that a thinner runner will be faster. With RED-S, the opposite is true. A too-thin runner may not have the energy to perform. RED-S leads to an increased risk of bone fractures, infections, heart damage, and depression. RED-S can cause the body to metabolize food more slowly, making it more difficult for an athlete to maintain a very slim figure, often causing the athlete to eat even less.
Female Athlete Triad - Three Problems in One
The female athlete triad is a trio of symptoms used to diagnose RED-S. It consists of 1) disordered eating leading to low energy availability, 2) menstrual dysfunction, most often when a woman no longer gets a monthly period, and 3) decreased bone density. This is especially problematic in girls and young teenagers because their bodies are not done growing and may lead to lifelong consequences. In previous generations, female athletes not only expected to stop menstruating but were told by coaches that getting their periods meant they needed to train harder or lose more weight. We know now that the opposite is true.
Not Just a Problem for Women
Medical professionals know that eating disorders are not only a problem for women and girls but in recent years more male athletes have been willing to share their stories. Olympic medalists Adam Rippon and Brian Boitano have talked about the epidemic of “quiet starvation” among male figure skaters. Ski jumpers have long been told “fat don’t fly.” Weight-class based sports, like wrestling, are filled with horror stories of young men going to dangerous extremes, like purging, to “make weight.” Even power sports, like hockey, are not immune.
Easy to Overlook in Pursuit of Excellence
The same single-mindedness, discipline, and willingness to endure physical pain that makes champions also creates the perfect storm for developing eating disorders. It can be easy for top athletes to disguise a problem behind the screen of being careful or prudent about their diets. Judges in sports like figure skating, gymnastics, and diving praise competitors for a slender aesthetic. Sacrifice and deprivation are part of being an elite athlete so it is to apply that to all areas of one’s body.
What Is Being Done?
In February 2024, the International Federation of Sport Climbing (IFSC) issued new regulations regarding weight minimums for competitors. Climbers must provide details of their height, weight, heart rate, and blood pressure to national federations who can either issue a health certificate or require they go for more testing. Climbers need the certificate to compete in official IFSC events. Climbers have been fighting for years for their federation to do something to address the problem of RED-S within their community. These regulations are a tiny step but it is more than any other sport federation is doing.
What can we fans do? The easiest thing is to take weight and body image talk out of the conversation when discussing elite athletes. Too many fans are quick to throw around “fat” as an insult for bad performance. Recognize that many different body types can and should be valued in the Olympics.
Do You or Someone You Know Need Help?
Here are some trusted resources for information on eating disorders:
