Let’s Talk About Disordered Eating
Why it matters and what we can do about it
Disordered eating can affect male and female runners alike. Photo: iStockPhoto.com
Adam Goucher has a lot of wisdom as a father, husband, Olympian, TransRockies finisher and motivational speaker. But in my opinion, his best piece of wisdom is his now famous quote, “Eat a bleeping Dorito.”
Adam was on a date with his girlfriend, who now goes by Kara Goucher (happy-ending spoiler), when he offered her some Doritos to hold off her pre-dinner hunger pangs. Kara refused and Adam responded, “Just eat a Dorito.” After Kara refused a second time Adam said, “Eat a bleeping Dorito.”
In a 2007 FloTrack video, Kara talks about this moment as the time she realized she was slipping into disordered eating as a collegiate runner. In the video she credits Adam and her mom with helping her overcome disordered eating.
She went on to compete in the 2008 Olympics in the 10K and the 2012 Olympics in the marathon while also giving birth to her son, Colt, in 2010. Although I doubt that Kara was fueling with Doritos for all of these accomplishments (except maybe the pregnancy), her success was certainly fueled by adequate nutrition.
Kara Goucher’s story had a happy ending. Unfortunately, many female—and male—runners with disordered eating or eating disorders do not share her story. Their running might succumb to stress fractures, performance drop-offs and fatigue, and the effects on the rest of their lives can be even more profound—hurting relationships, causing depression and sometimes even ending lives.
This article aims to talk about these issues openly and honestly, focusing on how we can support healthy habits (and fast, consistent running).
Disordered Eating and Eating Disorders
Counterintuitive as it may be, disordered eating is not the same thing as an eating disorder. An individual with an eating disorder has disordered eating, but not all individuals with disordered eating meet the criteria for an eating-disorder diagnosis.
Eating disorders are psychiatric illnesses. For individuals who suffer from them, food and thoughts about body weight become so pervasive that is difficult to have the energy to adequately focus on daily tasks.
Disordered eating, meanwhile, can involve abnormal thoughts about food and instances of restriction (or binges) that do not amount to a psychiatric illness. It is essential to recognize disordered-eating habits in order to avoid harmful impacts and the potential of developing a full-blown eating disorder.
Although our culture associates eating disorders with rail-thin women, individuals with disordered eating can be any size or gender. A runner with a normal BMI but disordered eating is still at a greater risk for stress fractures and overtraining than a runner with healthy eating habits.
Conversely, a runner who appears thin may not have disordered eating and may be at his or her ideal weight. Thus, it is important to understand the warning signs of disordered eating, while also being prudent with judgments of yourself and others.
Recognizing Disordered Eating
We live in a culture of fad diets and fad exercise philosophies. You can choose to be gluten-free, vegan, Paleo or even fruitarian. You can log 120 miles a week on Strava, do CrossFit until you pee blood or do hot yoga until your core temperature and skin texture resemble a Thanksgiving turkey.
Some of these actions have become socially acceptable. Heck, some have made champions. So how do we draw the line? When does disciplined eating morph into disordered eating, and when does disordered eating slip into a life-threatening disorder?
Unfortunately, there’s no Dorito litmus test to perfectly identify those at risk of disordered eating. However, clinicians recognize the following as some common red flags of both disordered eating and eating disorders:
- Frequent mirror checking or frequent weighing on a scale
- Self esteem that is highly based on body weight
- Fasting or skipping meals regularly
- Avoiding social events where food is being served
- Rigid and compulsive exercise routines
- Food rituals (cutting food into very small bites, eating food in a certain order)
- Waking up in the middle of the night hungry
- Difficulty concentrating while eating
If you talk honestly about these things with trail runners (men and women of all speeds and backgrounds), you’ll see a lot of these criteria floating around. The general link between running performance and body weight can create habits that we need to talk about openly to understand and confront head-on.
How Disordered Eating Impacts Performance
There are all kinds of infamous estimates about the amount runners can speed up by dropping weight.
You may have heard that losing a pound can save two seconds per mile. This formula is based primarily on having to carry less weight and how VO2 max (maximum aerobic capacity) is measured. For VO2 max, weight is in the denominator, so every other variable being equal, weight loss increases VO2 max.
However, not all variables remain equal in the real world.
First, trail running requires strength. There is individual variation in ideal body composition, but at a certain body weight, strength begins to diminish. Even for a person at a higher weight, energy deficits in training and racing can diminish strength.
Second, trails have hills, and hills increase impact forces. At a 9-percent downhill (relatively tame by trail standards), normal impact forces on the body increase by 54 percent. When multiplying those forces over a 50K trail race or a training week with 8,000 feet of vertical loss, it is evident that trail runners need to be resilient.
Disordered eating, even in the absence of weight loss, weakens musculoskeletal (MSK) strength, among other effects. Given the increased force on the MSK system while trail running, it is hard to successfully train and race with disordered eating without risking stress fractures and soft-tissue overuse injuries. Recovering from these injuries derails running consistency, which can hinder long-term performance.
Short-term running success may be possible with disordered eating, but a long career will be challenging. Stress fractures, as well as fatigue, overtraining and depression, play a role in this equation.
What to Do if You Think You Have These Symptoms
If you are worried you might have an eating disorder or disordered eating, get help and be honest. Visit a doctor and describe your habits openly.
No matter what, it’s important to talk about it and be unguarded. Stigma is totally unwarranted. These issues are common for runners, and confronting them head-on is the best way to get healthy or stay healthy long-term.
What We Can Do as a Trail-Running Community
Remember that you can encourage an individual with disordered eating to see a health-care professional, but it is not your job to be a health-care professional. However, it is possible to provide crucial support and understanding.
It can be difficult to talk about disordered eating with friends, teammates or loved ones. One strategy taught to doctors is to ask an open-ended question about life: “How are you doing?” “Are you stressed out by anything right now?”
If a plausible cause of disordered eating does not arise from these questions, you can transition to asking about running performance and health: “How is running going?” “Do you feel healthy?”
When posing these questions, refrain from commenting on body image or weight and avoid making judgments about eating behaviors. This conversation could take days or months to evolve or it may progress in minutes.
Although talking is the headline of this section, listening is the most important verb. You can make a big difference in someone’s life just by being a thoughtful listener.
The only way for us to squash the stigma (and possibly save running careers and even lives) is to practice consistent empathy, as individuals and as a unified community.
Putting It All Together
It can be tough to walk the line between eating healthily and disordered eating. Generally, it’s essential to talk about these issues in our community without judgment and convey the message that “strong lasts.”
Caloric deficits might be necessary for some runners who need to lose weight, but should never be accompanied by hard training and racing.
As for athletes who don’t need to lose weight, it is better to err on the side of over-fueling to avoid injuries. Think about healthy eating as benefitting performance, and ideal weight not as the lowest number but as the number at which a runner is strongest.
And eat a bleeping Dorito.
Megan Roche is a fourth-year Stanford Medical student, a four-time USATF trail national champion and a member of Nike Trail Elite and Team Clif Bar. Follow Megan’s training on Strava here and follow her on Twitter here.