Thompson Valley Boettcher Scholarship semifinalist Josie McCauley finds strength can be a weakness

 

Battling an eating disorder taught TVHS senior that it's OK not to be perfect

 

By Mike Brohard

Sports Editor

Posted:   01/15/2018 04:05:40 PM MST

The drive that helped Josie McCauley become a Boettcher Foundation scholarship semifinalist also led the Thompson Valley senior down the road to an eating disorder. (Mike Brohard)

The McCauleys will sit down to dinner as a family on Jan. 31, as they do every night. It's an admirable accomplishment really, considering Rod and Julie have three busy daughters.

That night will be a special dinner, marking the 18th birthday of their oldest daughter, Josie. It is the menu of her choosing, and she wants Mel's beans. It's basically a chili recipe they adopted as their own from Rod's days as a swimmer in Loveland Swim Club, when another swimmer brought it to a function, and his father loved the dish.

Since then, it's become a McCauley family staple.

It is Josie's favorite meal and the normal request on her birthday. Yet a year ago, the date and the meal became a major point of contention, making this one a very special occasion.

"That's huge. She just said she didn't want to celebrate her birthday at all," Julie recalled. "It was a terrible birthday. It wasn't really a birthday at all."

A strength can become a weakness, which Josie has come to understand all too clearly.

Being a perfectionist has made her one of the best students at Thompson Valley High School and also a Boettcher Scholarship semifinalist. She carries a 4.426 GPA through a load of advanced placement classes that range from literature to calculus to Spanish 5.

It pushed her as an athlete. She was honest with herself that she was never the best cross country runner the Eagles had, nor their best swimmer. But she wanted to be better.

 

In the classroom, all of her hard work was paying off, but she wasn't seeing the same results in competition. It wasn't that she had to be the best on the team, but she wanted to be better.

Never once did any of her coaches in either sport ever suggest anything about her weight, and why would they? She was a perfectly healthy young lady. Still, she thought maybe, just maybe, shedding a few pounds would shave a few seconds.

"It was just to be better at everything," Josie said.

 

"Maybe that would make me a better swimmer, because I've been trying so long and I'd always been just kinda mediocre. It seemed like there was a puzzle piece missing, and I had always been working hard. I didn't know what it was."

Lauren Smolar, the director of programs for the National Eating Disorder Association, said research reveals half of teenage girls will try dangerous weight-loss methods, from laxatives to skipping meals or even fasting. NEDA also acknowledges that female athletes in what are considered aesthetic sports are more prone to such behaviors.

For those closest to the person with the issue, it isn't always easy to see, and Josie knows she went to great lengths to hide her problem.

"I was putting on a face," was her description.

She cut back on her meals when people weren't watching, which was easy. The family dinners were tough, but gradually, in a way most folks wouldn't notice, she was eating less and less.

As her disorder started to really take hold, it affected her mental state and her taste. Food didn't taste good, and she no longer had the desire to eat.

"Although meals became contentious when we realized she wasn't getting what she thought, we didn't understand, we thought that she should just eat more," Julie said. "That's not how it works, and it's not how her mind was working at that time."

Family dinners were not the same happy place anymore, but the true issue hadn't kicked in to any of them yet. Smolar said the signs are often hardest for those closest to see.

"Eating disorders, part of their nature tends to be very complex, and some people, it's fairly common to see part of the disorder is the need to hide those symptoms to those that they are close to, to see they're struggling," Smolar said. "It can be very hard for people close to you, in particular because a large part of the disorder for people is to make sure it's secretive. It's not something they want to draw attention to. They will go to great lengths to make sure they're not getting other people involved."

Some of Josie's friends became concerned, and when they didn't get anywhere with her — she felt she had become a master of disguising it and refused to see an issue despite what the scale and her appearance told her — they went to teacher Jay Klagge.

Klagge and his wife, Jenny, have known the McCauleys for years, as their son, Tony, has attended school with Josie since kindergarten. What her friends told him triggered something he had started to suspect. He and his wife talked, then they called the McCauleys.

"It was difficult on the one hand, but on the other hand it wasn't," Jay said. "I could physically see that Josie not only had lost a significant amount of weight, but it was going beyond just simply losing a lot of weight and was kinda becoming a health issue. There really was no choice."

As it was, Josie had a physical scheduled the next week, and when her doctor diagnosed her with anorexia, Josie insisted she did not.

Looking back is the hard part, because she fought the truth so hard. She regrets things she said, the way she treated people. She shut herself off from family and friends, too, making it a family concern as she put up a series of roadblocks in their path.

"She's incredibly headstrong. She'd always been pushing the rope," Rod said. "It's why she's really successful at school. For something like this, it made it really challenging. What I didn't understand it's those kind of boys and girls who are prone to this. They're susceptible to it, because they're perfectionists. Trying to tell her what to eat was a challenge"

By February, with her heart rate down in the 30s, she was taken to Children's Hospital, and that's where things started to take hold for her, along with therapy. Over the course of five weeks of treatment at Children's, she started opening up to her mom, admitting she had faults, she had a problem.

Looking back is as draining emotionally for her as what she went through.

"I was very angry for a long time. I was just so, so mad," Josie said. "Sometimes sad, but mostly mad that it had happened, mad that I had let it happen, mad that it could happen to people, and that it had messed up my running and my swimming."

She missed five weeks of school, and during her stay at Children's Hospital, Julie remembers Josie receiving a rather personal letter from a prestigious school, one she felt served as a bit of a "beacon."

Josie was not going to let her eating disorder affect her education, though she's not sure how she pulled it off.

"I honestly don't know. I guess it was just an escape from that," Josie said. "That was such a messed up part of my life. Then I could come to school and be good at something at least.

"I felt like I wasn't trying that hard, but things were going well. I thought my teachers were being nice, and I confronted some of them."

That wasn't the case according to Klagge, who has had Josie in three of his classes over the years, noting her ability to read is one aspect that sets her apart, giving her an ability to digest complexity and broaden her academic understanding.

"She has always been pretty goal oriented. Where she sees herself five and 10 years from now, she didn't want to compromise any of that," Klagge said. "Part of that was probably good, too. Here I am, but I still have these things I can do, these things I can accomplish. She was able to do that, and I think that helped her."

The McCauleys are extremely appreciative of the staffs at Thompson Valley and Bill Reed (where a younger daughter was attending) for being helpful and understanding by still sending assignments and highlighting the correct work to be completed.

As amazed as he was to find out his daughter had an eating disorder, Rod marvels just as much to see the same personality trait carry her out of it and lead her academic pursuits.

"For her, that ability to focus, I don't have it," he said. "Watching her through the years, it's always been able to manifest itself in different ways. It's something that if applied incorrectly, it's disruptive. The other way, it's incredibly powerful."

It was a long road for her. The fact she couldn't correct the problem immediately was not to her liking. Her intake had to be gradual as not to trigger other issues, and even by prom, when she saw herself in the mirror, she was still brought to tears.

For her, that was about her darkest point in the process.

"I was around my lowest weight, and I knew how bad I looked," she said. "That was hard for me, to look in the mirror and know I looked terrible and unhealthy. I knew I was doing bad things, and I couldn't do it on my own."

That's a rather large step for a perfectionist to admit, and these days, Josie is starting to let go, bit by bit.

She received a B in calculus this past semester, a grade that would have enraged her before. She was OK with the mark. She does not deem being a valedictorian as an end-all, be-all goal for her anymore, either.

Then again, a girl who has watched surgery videos and shadowed a local surgeon with her eyes set on becoming a doctor herself one day, still doesn't want to see the letter become a regular.

At Children's Hospital, they set a range for her weight, including a specific target for her health. She has not only reached it, but put on a few more pounds, and she's beyond happy.

Striving to be that perfect person was always hard. When greeted, Josie always flashed a big smile, was personable and polite. Nothing, ever, could appear out of the ordinary. Now, Rod and Julie see a more honest version of their child, one who isn't always happy and isn't as reluctant to admit her day wasn't great.

She knows she is not the only one, and it pains her to know some of her fellow students are hurting for a multitude of reasons and feeling the need to hide their emotions as she once did. She lost a dear friend to suicide in her process, one who helped by sending Josie letters and playlists in the hospital.

A high school life isn't perfect, and that's the message she would share.

"It doesn't make a person less of a person. It's not a choice. No one sits down and says I want to have an eating disorder," she said. "No one would pick it for what it does to you, your family and your friends. Just pay attention to your friends, especially in light of all the things that have happened at our school. Be kind, be caring.

"It's OK for people to not be OK, to not be perfect. I wish I had been more open with it. It's OK to have something wrong with you, and it's OK for people to know that."

But Jan. 31, that will be a good day. It may be even more special, as the list of Boettcher semifinalists will be cut to finalists the day before.

Best of all, Mel's beans will be in the pot with a lemon icebox pie for dessert and the family sitting down to the table.

Now, her strength is leading her back in the right direction.

"They've said it's a tool you'll always have with you, and it's important not to use it," Josie said. "I was really good at having an eating disorder, but I was also really good recovering from one."

Mike Brohard: 970-635-3633, mbrohard@reporter-herald.com and twitter.com/mbrohard

Ford, Blue Jays prepare to tackle state meet

Oct 232, 2019

Parents ask state to warn Colorado teachers that nutrition lessons can be triggering to students prone to eating disorders

Experts say messages about food in the classroom could reinforce negative patterns

Dec 22, 2019

Two fathers concerned that their daughters’ school nutrition lessons may have contributed to health crises have asked the Colorado State Board of Education to warn the state’s teachers to be more careful when talking about food.

Doug Salg, whose daughter attends Roaring Fork High School in Carbondale, said she already had concerns about body image, but they grew worse after the students in her health class were instructed to track their calorie intake for two weeks on a smartphone app.

The teen subsequently spent 10 weeks in the eating disorder unit at Children’s Hospital Colorado to reach a healthy weight and learn ways to cope with negative emotions surrounding food, he said.

“That kicked it into high gear,” Salg said of the calorie tracking.

Kelsy Been, spokeswoman for the Roaring Fork School District, said the tracking project was meant to help reinforce the Colorado standards on caloric balance. It included a reflection component, where students were asked to consider if they were eating too much or too little, and whether they were getting enough from all food groups, she said.

District officials are going to talk to mental health specialists and determine whether they should change how they teach caloric balance, Been said.

“We want to be more aware of what we can do, so our students are learning about nutrition but are not put at risk,” she said.

A parent with a student in the Boulder Valley School District, who also spoke to the state board, said his daughter’s struggles intensified after a teacher made an offhand remark about the fat in food becoming fat in the body.

Medically inaccurate information like that can be a “final straw” for students who are vulnerable, even though the teacher meant no harm, the parent, who asked not to be publicly identified to protect his daughter’s privacy. The body stores any calories beyond its needs as fat, and our bodies need some fat stores for insulation and to protect our organs.

Randy Barber, spokesman for Boulder Valley, said the district reviewed records from nutrition classes at the student’s school, and all students were taught that a certain amount of fat is important to a healthy diet, though too much saturated fat can be a problem.

Salg said he thinks teachers are acting out of good intentions, but they may not be getting enough training about how to teach nutrition without harming vulnerable students. He said he met other parents with children in treatment for eating disorders who also reported unhelpful experiences, like having students line up to measure their body fat percentage in front of their classmates. The treatment team advised opting his daughter out of nutrition lessons in the future to avoid potential triggers, he said.

Jeremy Meyer, spokesman for the Colorado Department of Education, said staff members are reaching out to Children’s Hospital Colorado for guidance about eating disorders. The board then will be able to decide if it wants to send a letter to teachers, or perhaps add something to the standards, he said.

Unhealthy relationships with food

Colorado’s health education standards state that information should be medically accurate and developmentally appropriate, and that students should learn skills to help them make healthy choices throughout their lives. They include that children should learn what constitutes “healthy food” as early as preschool, with more specific topics like how to read nutrition labels, calorie balance and the drawbacks of restrictive diets covered later.

Dr. Ovidio Bermudez, senior medical director of child and adolescent services at Eating Recovery Center in Denver, said it’s not uncommon for young people in treatment for eating disorders to remember a comment from an authority figure — whether a teacher, a doctor or a parent — as an important factor in their illness.

It’s difficult to determine how much of a role specific events played for a person who already was vulnerable to an unhealthy relationship with food, but adults need to be aware of the messages they send, he said.

While eating disorders typically are associated with teenage girls, boys and people of all ages can develop them. Risk factors include a history of dieting, being teased about weight and mental struggles like anxiety or perfectionism, according to the National Eating Disorders Association.

Contrary to popular belief, eating disorders aren’t always about looks, Bermudez said — sometimes people get locked into increasingly rigid diet and exercise regimes, thinking they’re improving their health but actually harming it.

“When the path to health becomes very narrow, where you have to chisel yourself into health, it almost always backfires,” he said.

Setting an example

Jeana Cost, executive director of Denver Health’s ACUTE Center for Eating Disorders, said it’s also not uncommon for patients in their program to report that something they heard at school added to their concerns about their bodies.

She said she opted her own children out of body mass index screening at school, because kids may compare their numbers and become fixated on weight. Body mass index is a comparison of weight to height, which is used as a rough measure of how much fat a person has, though very muscular people also may have a high BMI.

Cost and Bermudez agreed it’s not always possible to tell which kid will react strongly to messages about food, so it’s important that all children hear positive messages about how food can fuel your body, rather than learning certain foods or body types are unhealthy. Focusing on numbers, like a person’s weight or the number of calories in certain foods, is especially unhelpful, they said.

Stacey Snelling, director of the nutrition education program at American University, said teachers should reinforce the idea of listening to your body for cues about when to eat and when to stop eating. It’s OK to discuss that some foods are more nutritious than others, but the focus needs to be on moderation, because telling vulnerable people that they should never have a certain food gives that food too much power, she said.

“I think banning any food is a trigger,” Snelling said. “We need to talk about how food supports health and growth.”

Yet schools aren’t solely responsible for the messages kids absorb about food, Bermudez and Cost noted. They urged parents to pay attention to how their children talk about food and their bodies, and to keep the focus on what their bodies can do, rather than how they look.

“You can set an example by not talking about good and bad foods, not talking about dieting, not talking about your own body shape or weight,” Cost said.

 

• When eating disorders pushed them near death, they found hope in Denver
• When some people don’t believe your eating disorder exists
• More men owning up to, getting help for eating disorders
• Denver becoming hub for treating eating disorders among both genders

 Florida Gators fire soccer coach Tony Amato after one season amid player complaints

April 27.2022

The Florida women's soccer program has parted ways with head coach Tony Amato, athletics director Scott Stricklin announced Wednesday.

The departure came after numerous players expressed concern about Amato's coaching style. WUFT reported the players specifically complained about Amato's approach to fitness, eating, weight and issues of body image.

Amato was hired last March to replace Becky Burleigh, who retired after 26 years. Stricklin said the complaints began in October, and he began addressing them with Amato on a regular basis.

Stricklin did not feel Amato had sufficiently changed his approach, so he was fired without cause. That means the school will have to pay the remaining five years of Amato's deal, which paid him $225,000 annually.

Tony Amato 'not a fit' for University of Florida

"I didn't see the progress that I felt we needed to see," Stricklin said. "That doesn't mean there wasn't an attempt. I just didn't see the progress we needed to see, the work on that."

Amato's departure is somewhat similar to that of former women's basketball coach Cam Newbauer. He was fired last year after players complained he was verbally abusive and created a toxic environment.

"This is more about not being a fit," Stricklin said of Amato. "And me not believing we could get to the point where it's going to be a fit than it was these things happening."

In his first season with the program, Amato went 4-12-4 after replacing Burleigh, who was the program's only coach. Amato came from Arizona, where he led the Wildcats to five NCAA Tournament berths and remains the winningest coach in program history.

A native of Levittown, Pennsylvania, Amato played soccer for Rollins College in Winter Park, and he would later coach at Rollins from 2003 until 2009.

More than a dozen players have decided to transfer

Stricklin would not comment on specific allegations against Amato, but WUFT reported that players complained about the coach's fitness-oriented approach. They said he commented about their weight and body shapes despite knowing some of the players had struggled with eating disorders.

After Newbauer's departure, the athletic department restructured its reporting process to make it easier for players to come forward with complaints. Amato issued a general apology to players during a team meeting on March 22, WUFT reported.

The problems persisted, however. Stricklin was asked Wednesday if he properly vetted Amato before hiring him.

"You can do all the background checks you want, you can do all the interviews," he said. "You can look at past experiences all you want. But until they're in your environment, interacting in this setting, you really don't know how that's going to work out. And so, certainly we're always trying to self evaluate and learn and grow and get better. But, you know, it's a bit of a inexact science."

Four players quit the soccer team and a Florida official said a dozen more have entered the transfer portal. The search for a coach who can more easily build relationships with players will begin immediately.

"Tony has a lot of good qualities," Stricklin said. "And ... another time and other location, he might be a really good fit for somebody. It just didn't work out from a fit standpoint."

EATING DISORDERS WITH FEMALE ENDURANCE ATHLETES

Article By: Penny Sparks

The most serious side effect from the pressures females face in their athletic careers is eating disorders. Eating disorders have risen drastically in the last ten years, especially among young female athletes. Athletes obviously have to perform publicly in highly competitive situations, but this is something that, for the most part, they enjoy. But too much outside pressure can lead to many negatives, including eating disorders. One reason female endurance athletes are so susceptible to eating disorders is that they are lead to believe that there is only one body type that will be successful - the 12 year old look. Therefore, they must have very low body weight in order to be competitive.
Eating disorders, however, are not that simple. It is far more complicated than just wanting to be thin. "Anorexia nervosa is much more than just a diet gone awry and the sufferer more than an obstinate, skinny person refusing to eat. It is a complex problem with intricate roots that often begins as a creative and reasonable solution to difficult circumstances, and is thus a way to cope." When pressures become too much or get distorted they can lead to psychological issues that can be life threatening.

To make matters worse, many athletes have A-type personalities. The very traits that make them so successful in the first place, perfectionism, high achievement expectations, self-disciplined, competitive and driven characteristics are also associated with eating disorders. These young women expect a lot from themselves and they are willing to put in the time, the work, and the sacrifice to get what they want. They don't mind sacrificing much to accomplish their goals. They are take-charge, driven, disciplined young women, evidenced by the things they willingly give up for their sport and the hard work they do day in and day out. They feel empowered by being in control of their life and accomplishing their goals.

Unfortunately, that A-type personality can sometimes be a double-edge sword for some of them. Their need for control and perfectionism can lead many down a dangerous path. When they feel like things are getting out of their control they feel desperate and insecure. In order to try to get the feeling of control back, they sometimes resort to desperate measures such as not eating. The ironic thing about these young achievers is the control they do have over themselves. They would not or could not accomplish the things they have without having self-control. They were in control but they didn't realize it or came to believe they no longer had it because of too much pressure, whether from within or outside of themselves. The control they were desperately seeking is totally lost in their eating disorder.

Eating disorders have nothing to do with food per se, but with the need of feeling in control or the need of controlling something they feel will harm or has harmed their performance level, entering into womanhood, or too much outside pressure from coaches or parents. For whatever reason, emotional and/or psychological, they feel desperate in their need to control this aspect of their life. Sadly, eating disorders have the opposite effect--they lose the very control they so desperately want and need. The very thing they desperately needed during this period of their life is now in control of them. They no longer have the control they once had.

There are huge demands placed on young athletes today. They are expected to specialize at a very young age, leading many to heartbreak as the sport they excelled at as a prepubescent youth no longer holds for the now young-adult athlete. Their strengths and abilities shifted. What once worked well for them as a child is no longer working for them as a young adult. Their new body is better suited for another sport than the one they specialized in when just a child. But since they specialized so young they were never given the chance to know if they possibly could have been better suited for other sports as well. This specializing as children can be very limiting as young adults.
They are also expected to perform at a high level at a very young age, and perform a lot. Society hates losers, and they know it! It is not good enough to be their best--they must be the best, especially if they are gifted, and have already had success. They know they are not being judged on the effort of their performance, but on the outcome of their performance. We live in a society where it no longer matters how or what you have done to be successful, only that you be successful. The end, not the means, is what is important. And to many young athletes this spells disaster. If you don't believe me, take some time to go around and be a spectator at sport competitions and listen to the parents and coaches. It's scary!

We must educate ourselves in all aspects of youth coaching and competing, especially eating disorders. The warning signs are sometimes subtle, but can easily be spotted if the coach or parent is aware and educated. Here are some of the warning signs that an athlete may be feeling too pressured in their sport -- performance stagnates or drops, they lose the love for their sport they once had, they start making excuses for poor performances, they never feel good before competition, they harbor anger or resentment towards their coach or parent/s and sometimes both. Their running goals lessen dramatically or they no longer talk about running in their future. They do not want to discus running at all with either their coach or parent, especially when it personally involves them. They resent advice or constructive criticism, and are overly sensitive in issues regarding their sport. They have reached a point where the reason for participating in their sport no longer exists, or they no longer find joy and fulfillment in their sport. They are at a point where they feel their sport is serving everyone but themselves. If your child or athlete has reached this point, it is best for the parent or coach to take a giant step back and really look at the situation honestly, closely and clearly. Ask yourself if you are too close, expecting and pushing too much.

It is vital that you let them be the captain of their ship, that they are in control of their sport, and that they have the right to succeed or not. It is their success or their failure, and as young adults they need our support and guidance in sport and life, but not our pushing and control. They need to have both success and failure to learn and to grow into healthy sound adults. They need to experience and learn to handle all what sport throws at them. They are valuable lessons in life and if we interfere in that process we are hurting them in the long run. Our well-meaning intentions can actually hurt the future success of their sport career.

Parents and coaches must wear many hats and figuring out which one to wear is not easy at times. Coaching and parenting athletes can be very stressful, very complicated, very demanding, but learning when to step forward and when to step back is vital for the health and welfare of our young athletes. Coaches truly walk tight ropes at times, but if we stay attuned to our athletes we will learn and know better how to deal with the complexities of athletes and their sport. If we don't learn to read the warning signs of an athlete feeling too much pressure we can unintentionally push them into quitting their sport, or worse, into an eating disorder to try and gain some control of their life.

Eating disorders are a deadly epidemic that is rising among our wonderful athletes, especially our females. The three most common eating disorders found in athletes are anorexia nervosa, bulimia nervosa, and compulsive exercise. Anorexia is self-starvation, bulimia is eating large quantities of food then purging, and compulsive exercise is doing more exercise than is needed for quality performance. All three disorders could have life threatening consequences.

"Anorexia nervosa has a multitude of medical complications ranging from mild to severe. In fact, it is believed that 5-20% of anorexics die, usually from complications associated with self-starvation, such as: heart, kidney, or multiple organ failure, or illnesses like pneumonia, which may be due to an inability to fight infection-all ultimately due to the anorexia. Studies show that the longer one has anorexia, the higher the mortality rate."

Health complications from anorexia include malnutrition, abnormal heart rhythms, amenorrhoea (interruption of the menstrual cycle in females), osteoporosis (a decrease of bone mass), liver and kidney damage, hypoglycemia, low body temperature, muscle cramps and weakness - due to electrolyte imbalances, loss of hair on head, low blood pressure, sleeping disorders, destroyed body protein, decreased potassium level, constipation, high cholesterol, etc. Signs and symptoms of anorexia are excessive weight loss-15% below normal for age, height, and body type, always thinking about food, calories, and body weight, wearing layered or baggy clothing, mood swings, avoiding activities that involve food, complaining of always being cold, distorted body image, absence of at least three consecutive menstrual cycles, or if the athlete has not started menstruating at all by the age of 15 or 16.

Health complications from bulimia include laceration of the oral cavity (injury due to self-induced vomiting), esophageal inflammation (acid from vomiting may cause the tears in the esophagus), dental erosion (acid from vomiting erodes the dental enamel), cardiac arrest, dehydration, and electrolyte imbalance. Signs and symptoms of bulimia are excessive weight loss or gain, being overly concerned with one's weight, visiting the bathroom after meals, depression, excessive dieting, followed by binge eating, and always criticizing one's body.

Compulsive exercise warning signs are numerous--forcing exercise when tired or not feeling well, never exercises for fun or to relieve stress. Every time they exercise they go as fast or hard as they can. They experience severe stress and anxiety if they miss a workout. They miss family obligations and social events because they have to exercise. They calculate how much exercise to do based on how much they have eaten, would rather exercise than get together with friends, cannot relax because they think they are not burning calories, and worry that they will gain weight if they miss a workout.

All three disorders will require someone close to the athlete to recognize these warning signs. Identifying athletes with an eating disorder is not easy. They are often secretive or blame their eating and exercise regiment on their training goals, and they are leaner then the non-athlete due to their sport when healthy and normal, but they have crossed that thin line into self-starvation. Many will resent interference because they feel you don't understand them or their needs. They feel you are attacking the very thing that is making them feel good about themselves. They feel they are finally in control and you want to take that away from them. As a coach or parent you must get them professional help. Unless you are a certified nutritionist, psychologist and doctor you are not qualified to treat them. They need your love, support, understanding, encouragement, and patience but they most definitely need professional help.

As coaches if you suspect you have an athlete that is anorexic or walking the thin line of anorexia nervosa you must deal with it promptly. A few athletic programs are now implementing standards that require medical clearances specifically for eating disorders; a required amount of calories to be consumed daily for participation; bone density testing; nutrition counseling, and, if necessary, counseling from a licensed therapist who is familiar with eating disorders. It is imperative for recovery that an athlete with an eating disorder restores their body weight as soon as possible. The longer they have an eating disorder, the harder and longer the recovery phase. It is also highly suggested that the athlete's whole family be involved in their therapy.

Be patient with the recovery process because you must remember they did not get to this point overnight and they will not heal overnight.

Eating disorders are serious and can become life threatening. For more information, contact: Anorexia Nervosa and Related Eating Disorders, Inc.: (541) 344-1144.

National Association of Anorexia Nervosa and Associated Disorders: (847) 831-3438.

I am aware that there are many reasons for eating disorders; however, I only addressed eating disorders in regards to the female endurance athletes.

 

Striving for the ‘Perfect Running Body’

A Personal Account by Emily Giannotti

My story would probably have to start when I first started running cross-country in the eighth grade. I was an “OK” runner, but became even better when I moved to the varsity team my freshman year. I won my league, my district and placed 27th at states. The following track season also gave me a great year in the distance events. Little did I know, however, that a big problem had been growing behind all of this.

While my love for running and competition grew, unfortunately, so did the pressure I put on myself to develop the “perfect” running body (which I finally learned did not even exist). I started limiting what I ate and eventually dropped to about 110 pounds on my tall 5’6’’ frame. Although I didn’t become full on anorexic, I looked horrible, sick and tired all of the time, and I obviously weighed too little for my big-boned body. In addition to my deteriorating relationship with food, I hadn’t gotten my period for over a year. I ignored all of this and even my doctor, though, certain that it would all help my performance. I wanted to be a better runner!

All of this carried into the beginning of my sophomore cross-country season, but fortunately, although I didn’t like it at the time, my bad habits came to a screeching halt. One summer day before a fun run, my dad stopped me in the car. Being an orthopedic surgeon, I had talked to him before about my problems but insisted I was fine. He obviously saw right through that and gave me a brief but serious talk about the female athlete triad. He explained what it was and told me that he thought I had it. He also told me that if I continued with my ways, my running career would be over very soon. That fact alone changed my habits from that point on. I wouldn’t be the same without running!

That very night at dinner, I ate a lot more than I normally would have. Mentally, it was very hard. While it felt good to finally be able to feel full, I felt like I would become fat and slow if I ate that way all of the time. I persisted, however, thinking of how much running meant to me. Eventually, I saw a doctor for nutrition, my period started and I got back up to a healthy weight.

My efforts to get on the right track were encouraged even more when I had a shin splint scare right before my sophomore track season. Luckily, it passed for the most part, but could have been much worse without my eating changes.

Today, I feel very proud to have overcome the challenges I have faced, mainly the false mentality I had developed that skinnier was better. I still have instances today where I struggle to eat more food. However, instead of focusing on limiting the amount of food I eat, I try to take in plenty of calories and improve the quality of my food choices. I believe that I am on my way to my best cross-country season yet (but I don’t want to jinx anything)!

For other girls that are purposefully struggling with the triad, I would like to say that you are taking the wrong path. Although, it might improve your short-term racing, you could be done running even before next year. It is very unhealthy and obviously not the way our bodies were intended to work. I encourage anyone with the condition to seek help immediately. Trust me, you won’t slow down!

* * *

Many of you may be aware of such issues as amenorrhea, oligomenorrhea and the female athlete triad…but I suspect that to many female high school athletes this is a foreign language. You see, amenorrhea is the absence of menses (your period) and can be caused by strenuous exercise like in the case of Emily. Oligomennorhea is scant or little menses and is also associated with the hormone changes that occur in female runners. One study shows that 49% of amenorrheic runners had stress fractures. The constant weight bearing exercise involved with running along with hormone imbalances associated with missed menstruation may be increasing your chances of getting stress fractures. It’s true that adequate calcium, vitamin D and the right shoes are extremely important in stress fracture prevention, but don’t forget about underlying issues.

Emily recognized that her shin splints may be associated with her menstrual irregularities…what is causing your boney pains? These problems may also be linked to a third problem common amongst female distance runners. Disordered eating. Anorexia and bulimia are common in sports which have a “thin ideal body image”. Not everyone who has an eating disorder starves themselves or induces vomiting, the most commonly accepted definitions of these disorders. Instead, an eating disorder may be associated with vigorous exercise in order to prevent weight gain. Together, menstrual dysfunctions, osteoporosis and disordered eating make up the female athlete triad. Athletes may look “normal” for their sport and still have 1, 2 or all 3 of these conditions. Take Emily’s advice and seek help if you think you may be affected by the triad.

 

Eating Disorders in Long Distance Runners

Running. For some, this word in itself brings thoughts of agony, something that should only be done if absolutely necessary. For others however, running is a form of pleasure or escape, a source of great strength and empowerment. The sport of running can take a variety of forms, from track sprints to a leisure jog to the marathon.

While participation in sports and engaging in regular physical activity, such as running, has many numerous health benefits, there are concerns about certain sports that make an individual more susceptible to developing an eating disorder.

Long Distance Runners are Vulnerable to Eating Disorders

People who participate in long-distance running are among those athletes who are more vulnerable to developing an eating disorder. Long distance running, or endurance running, can be classified as a form of continuous running over distances of at least 3.1 miles [1].

The most common types of long distance running include:

• Cross country running
• Track running
• Road running

Training for long distance running events, such as a cross-country race or a marathon, often involves rigorous training schedules and activities.

A Potential Breeding Ground for Eating Disorders

Long distance running is often connected with a stigma that lower body weight will have a positive effect on sporting performance, such as by enhancing speed on a course or in a race. While research has not supported this theory, this myth strongly circulates among long distance runners, from the high school level athlete to the Olympian.

The pressure of sports performance and competition involved with long distance running can be a breeding ground for eating disorders. If other factors are involved, such as social pressures, low body image/self-esteem, or biological susceptibility, the risk for developing an eating disorder can be increased.

Research has shown that both female and male athletes are at greatest risk for developing an eating disorder in sports where leanness confers a competitive advantage, such as long distance running [2].

Rationalizing the Weight-Loss

Long distance athletes who fall into the trap of thinking that weight loss will aid performance, may be encouraged to further perpetuate weight loss, engaging in disordered eating behaviors, such as restriction certain foods, extreme exercise, fasting, or purging.

These behaviors can quickly spiral out of control, progressing rapidly to an eating disorder such as Anorexia or Bulimia.

Long distance running is unique in the sense that it is a sport performed in isolation.

Performance is completely hinged on the individual that is running, thus increasing the demands and drive for perfectionism that an athlete may experience.

The nature of long distance running is one that can become completely agreeable with an eating disorder; however, this can be missed among coaches and parents, as behaviors may be mistaken for the demand of the sport.

The Role of Parents, Coaches and Loved Ones

Early intervention can play a tremendous role in recovery, preventing an athlete from experiencing many of the dangerous consequences that result from having an eating disorder. If you are a parent, coach, or loved one of a long distance athlete, it is important to be aware of these risk factors, which may indicate early signs of an eating disorder.

Signs to Look For:

• Increased isolation
• More frequent occurrences of injuries, such as sprains or muscle strains
• Decreased concentration, coordination, and energy
• Increased fatigue, low energy
• Decreased social interaction with coaches and teammates
• Preoccupation with food
• Physical complaints, such as light-headedness, muscle aches, dizziness
• Prolonging training beyond what is required for sport
• Continued training, even when sick or injured

Because eating disorders among athletes and long-distance runners can result in dangerous consequences to both health and performance, early identification and diagnosis is crucial for appropriate intervention. The Preparticipation Physical Examination (PPE) monograph is a questionnaire screening tool used to identify potential disordered eating behaviors among athletes.

Use of a questionnaire like this among sports medicine providers and coaches can be an important tool in evaluating disordered eating and diagnosing eating disorders when interacting with athletes and active persons.

A Proper Balance of Nutrition, Rest and Exercise is Best

These warning signs are red flags that may reveal that an athlete is struggling. For an athlete with early indicators of an eating disorder, long distance running may serve as the ideal portal from which the disease can continue to develop. While with any sport, there is the potential for positive benefits, there also exist extreme measures, which can lead to a vicious cycle of an eating disorder.

Running great distances, whether as a recreational activity or a competitive sport, can be a beneficial outlet for channeling physical and emotional energy. It is also an activity that requires a proper balance of moderation, rest, and nutrition in order for those benefits to be reaped.

If an eating disorder is identified in a long-distance runner, specialized care should be sought with an experienced multidisciplinary team, including a physician, mental health professional, athletic trainer, and dietitian. Sports medicine physicians can help determine the best course of action for an athlete, such as if a temporary break is needed for adequate healing and treatment and/or clearance for a return to long-distance running.

 

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About the authors: Jacquelyn Ekern, MS, LPC founded Eating Disorder Hope in 2005, driven by a profound desire to help those struggling with anorexia, bulimia and binge-eating disorder. This passion resulted from her battle with, and recovery from, an eating disorder. As president, Jacquelyn manages Ekern Enterprises, Inc. and the Eating Disorder Hope website. In addition, she is a fully licensed therapist with a closed private counseling practice specializing in the treatment of eating disorders.

Jacquelyn has a Bachelor of Science in Human Services degree from The University of Phoenix and a Masters degree in Counseling/Psychology, from Capella University. She has extensive experience in the eating disorder field including advanced education in psychology, participation and contributions to additional eating disorder groups, symposiums, and professional associations. She is a member of the National Eating Disorder Association (NEDA), Academy of Eating Disorders (AED), the Eating Disorders Coalition (EDC) and the International Association of Eating Disorder Professionals (iaedp).

Jacquelyn enjoys art, working out, walking her golden retriever “Cowgirl”, reading, painting and time with family.
Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without support from our generous sponsors.

Crystal Karges, MS, RDN, IBCLC is a Contributing Writer for Eating Disorder Hope.

Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing,

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH and nutrition private practice.

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References:

[1] Grine, Frederick E. et al (October 2006). The First Humans – Origin and Early Evolution of the Genus Homo. Stonybrook University. Retrieved on 2013-04-11.
[2]: Sundgot-Borgen J, et al. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med 2004;14:25–32.
[3]: Bernhardt DT, et al. American Academy of Family Physicians, American Academy of Pediatrics. PPE: preparticipation physical evaluation. 4th edn. Elk Grove Village, IL: American Academy of Pediatrics, 2010.

 

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on June 14, 2017.
Edited And Updated By: Crystal Karges, MS, RDN, IBCLC.
Reviewed By: Jacquelyn Ekern, MS, LPC on June 14, 2017.
Published on EatingDisorderHope.com

Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without the support from our generous sponsors.

In a ‘Lighter Equals Faster’ Culture, Runners Must Combat a Culture of Disordered Eating - Columbia Daily Spectator (columbiaspectator.com)

The epidemic in women’s distance running and what it did to me – Lane 9 Project

How Coaches Can Address Disordered Eating - Runner's World (runnersworld.com)

What I Learned as a Collegiate Runner Majoring in Dietetics (Guest Post by Maggie Farrell) Part 1 – Running in Silence

 

What the Stopwatch Doesn't Tell
Coaches are central in identifying eating disorders among athletes, sometimes
before they arrive on a campus

By ERIN STROUT
When Michael Whittlesey recruits for the University of North Carolina at Chapel Hill, he
is scouting for more than the nation's top runners — he looks for female high-school
athletes who are happy, healthy, and fit. It is a more difficult job than many people may
assume.
Lurking behind the championships, trophies, and academic achievements of many top
female athletes is a devastating battle with eating disorders — not a new problem, but one
that has changed the way coaches talk to their teams about weight and nutrition. The
illnesses, which are often difficult to detect, can throw an entire team into a tailspin.
The issue has become so prevalent, dangerous, and potentially disruptive that coaches
like Mr. Whittlesey, North Carolina's cross-country and assistant track-and-field coach,
have learned to spot the symptoms well before they decide which runners to sign to
scholarships.
"An eating disorder can threaten a girl's long-term health or even cause death," Mr.
Whittlesey says. "You can't pick out every person, but you can learn to see the warning
signs."
Increasing numbers of college coaches are dealing with athletes' eating disorders, and the
problem is particularly acute in sports like running, where a lean physique and unusually
small frame can enhance performance. One 2002 study showed that almost half of female
college athletes exhibited symptoms of eating disorders, such as fear of being too heavy
or feeling pressure to achieve a certain weight.
Anorexia (self starvation and excessive weight loss) and bulimia (binge eating, followed
by self-induced vomiting or excessive use of laxatives) are thought to be both
psychologically and biologically based, triggered by emotional and cultural factors. The
stress of the transition into college life, competing on the collegiate level, keeping up
academically, and adapting to a new social scene can exacerbate the illnesses.
While eating disorders are nothing new, coaches are increasingly finding themselves on
the front lines of identifying the athletes at risk, and dealing frequently with the aftermath
of their diagnosis as essential support for the students' return to good health.
"If any coach says they don't deal with an eating disorder at least once in a season,
they've got their head in the sand," says Ron Helmer, director of track and field and
cross-country at Georgetown University. "Every year there are at least one or two
conversations with people on the fringe."
Danger Ahead
Victoria Jackson was one such high-achieving recruit with troubled eating habits. When
Mr. Whittlesey first met Ms. Jackson, during her junior year of high school, in 1998, he
saw a "solid, healthy runner" who was on the brink of peaking nationally. A year later,
she didn't disappoint, taking second at the national high-school cross-country
championships, maintaining stellar grades, and compiling a laundry list of extracurricular
activities.
Soon after Ms. Jackson committed to North Carolina, Mr. Whittlesey noticed a change in
her. "She went from a really happy kid to melancholy," he says. "It was like talking to
two different people on the phone, and I started to suspect something was wrong."
A few months before Ms. Jackson arrived in Chapel Hill, Mr. Whittlesey saw her at a
track meet in Los Angeles, where she was a shadow of the runner he had recruited. His
concern led him to meet with her parents and alert sports-medicine physicians at North
Carolina that potential problems might arise when Ms. Jackson moved to the campus.
As Mr. Whittlesey suspected, his star recruit came to North Carolina too thin, frail, and
sick to compete. But Ms. Jackson, who had battled anorexia for much of her young life,
worked with the university's doctors and was determined to return to competition. Unlike
many victims of eating disorders, she didn't try to conceal her problem. She gained
enough weight that year to run the conference and national championship meets, as well
as compete during indoor track season, but she later regressed.
By her sophomore year, the 5-foot-6 athlete weighed just 85 pounds.
While doctor-patient confidentiality laws protect athletes from having their doctors tell
coaches about their health conditions, Ms. Jackson allowed her physicians to discuss her
illness with Mr. Whittlesey.
"It was clear that running was a stressor to her and part of the reason for her anorexia,"
the coach says. "We decided that she could not compete anymore. It was time for her to
take care of her life instead."
Early Detection
Like Ms. Jackson, many girls struggle with eating disorders before college. Research
shows that about 40 percent of newly identified cases of anorexia are in females ages 15
to 19, making it important for coaches to learn the symptoms so they spot them during
the recruiting process.
No system is perfect, but coaches have learned that looking beyond the record-breaking
times and collection of medals is imperative. Seeing an athlete with an overly thin, prepubescent-looking body leads college coaches to search for other signs of eating
disorders, like excessive body-hair growth, abnormally dry and yellowing skin, thinning
hair, brittle or discolored nails, and drastic mood swings. Many coaches ask members of
their teams to hang out with recruits and report back any questionable behavior during
meals, such as picking at their food instead of eating it or consistently going to the
bathroom after eating.
Some coaches, including Mr. Helmer, say that high-school parents and coaches should
more closely monitor young athletes to prevent negative eating habits, which can become
amplified when women leave home for college.
Mr. Helmer watches how recruits interact with their coaches, parents, and teammates. He
asks if an athlete tends to over-train against her coach's wishes, or if she shuts herself off
from socializing with friends in favor of extra training or schoolwork.
"You can't recruit with blinders on," the Georgetown coach says. "You can find out how
they deal with it, and if a great runner is in denial — if her parents and coaches are in
denial — I stay away, because I know it's not worth it."
Clearly, prescreening does not always work, and a big concern for coaches is quickly
identifying athletes with eating disorders before other team members start emulating their
negative eating habits. Many runners who lose weight initially experience a spike in
performance, tempting teammates to mimic the habits that are producing enviable results.
In that way, coaches say, eating disorders can be "contagious."
Ian Solaf, head women's cross-country coach at the University of Portland, tries to
prevent that from happening by setting expectations for his athletes from the beginning,
emphasizing that the two most important aspects of success are training hard and eating
healthy. He talks about nutrition in the context of how it fuels performance, and stresses
that eating the right foods — and enough of them — is essential to competing at a high
level.
"I try to get in their heads early and make them understand that you can't eat 500 calories
a day and expect to go to meets," he says. "It's hard as a coach, but if you let somebody
run who you know is not fueling themselves properly, you send a message to the team
and usually end up with problems."
Subtle Signs
Coaches were not always so enlightened about the influence they could have on the
women they coached. In sports like distance running, rowing, or gymnastics, where low
body weight is advantageous, weigh-ins used to be the norm, and athletes were often told
to maintain a certain number on the scale.
A 2003 survey of 2,800 coaches of female athletes, conducted by the National Collegiate
Athletic Association, found that two-thirds of female coaches and 80 percent of male
coaches did not understand that the disruption of regular menstrual cycles — called
amenorrhea — is a sign of an eating disorder.
In response, the American College of Sports Medicine and the NCAA started educating
coaches about what is called the "female athlete triad," which connects the symptoms of
disordered eating, amenorrhea, and osteoporosis.
An athlete who has one component of the triad should be screened for the others. For
example, an athlete who struggles with stress fractures should be asked if she misses her
menstrual cycle. The two symptoms combined means the athlete should be screened for
anorexia or bulimia.
Dena Evans, former head women's cross-country coach at Stanford University and a
former competitive distance runner, says she believes that the more uniformity there is in
dealing with eating disorders, such as awareness about the female athlete triad, the more
likely it is that coaches will successfully help athletes overcome them.
As a coach, Ms. Evans says she found it important to be observant of the red flags, even
when an athlete was successful.
"If you see a subtle uptick in exercise in order to do better, you see a change in body size,
you know they've missed a period — it's the small signs of what may grow into larger
problems," she says. "All of us in life get to places we didn't intend to get to, but it helps
to have people around athletes who can see the subtle changes, not just the success they
are achieving."
A Strong Finish
At North Carolina, Mr. Whittlesey took Ms. Jackson out of the game, but his willingness
to put her on a medical redshirt allowed her to return to competition as a graduate
student.
In her last two years at North Carolina, Ms. Jackson did not run a step. She surrounded
herself with support from her counselor, physician, nutritionist, boyfriend, and family.
She decided that anorexia was a childhood disorder and an element of her past.
Ms. Jackson says that Mr. Whittlesey's forethought was instrumental in allowing her to
focus on her health and created a turning point in her life.
"He understood that I wanted to pursue graduate studies and I wanted to run," she says.
"His decision saved my career and my life."
After she finished her undergraduate degree at North Carolina, she enrolled at Arizona
State University. She chose Arizona State not because of its running program but because
the university offered the faculty expertise she needed to complete a doctorate in
American Indian history. With two years of eligibility remaining, and having gained 35
pounds, she decided to give running another try. This time she focused on a healthy
lifestyle, and not on performance.
But she is clearly still setting high expectations on the track. Last June, Ms. Jackson won
the national title in the outdoor 10,000-meter NCAA track-and-field championship.
Wearing the maroon-and gold Arizona State colors, she crossed the final finish line of her
collegiate running career happy, healthy, and with her hands held high, which was
perhaps a bigger accomplishment than winning the title itself.
TIPS FOR IDENTIFYING EATING DISORDERS
Understand the "female athlete triad." The triad comprises involves eating disorders,
amenorrhea (menstrual irrregularity), and osteoporosis. The triad usually begins with
disordered eating patterns, which lead to disrupted menstrual cycles and injuries such as
stress fractures.
Know the symptoms. Some physical signs of eating disorders include dehydration,
gastrointestinal problems, intolerance to cold, significant weight loss, and dental and gum
problems. Behavioral and psychological symptoms include excessive exercise, difficulty
concentrating, anxiety, depression, and excessive time spent in the bathroom.
Tread carefully. The initial contact with an athlete who may have an eating disorder is
crucial and should be done privately and without criticism by a person in authority who
has a good relationship with the athlete. Referrals should be made to health-care
specialists immediately. Source: NCAA

Male Eating Disorders – Running in Silence