Eating Disorders - frustrated with adults not stepping in

Thank you very much for posting these; good to see positive stories of recognition and recovery.

There have been some excellent posts on this thread pointing out the coach's role/response to an athlete's eating disorder. While coaching a Co-ed program for over thirty years, I had my share of high school runners with ED. The suggestion of reporting to the school nurse only works if your school has a nurse, not a health clerk. Unfortunately, far too often the root of ED and body image are far too complex for my expertise and that of a health clerk. My first suggestion is to make sure all your runners know that their worth as a person is not tied to their performance. Secondly, have referral information available for parents that come to you for advice concerning their child's ED issues. Lastly, those posts that innapropriately singled out a particular HS runner need to be deleted.

My high school teammate struggled with ED for 25 years. She passed away a few years ago because she was never able to overcome it. High school was the early 2000s and most of us really had no idea what was going on. Didn't understand why she couldn't just eat. It seemed so simple. Now it's pretty clear how much this was truly a mental illness. Maybe we didn't know better because we were just kids, but it does seem like there has been massive improvement in this area over the last 20 years.

Another one of my college teammates is now recovered and considered a voice in this space. I'm glad she's doing so much better. At the same time though, she had so many people telling her she needed to change something, and yet she never did until she hit her own mental breaking point.

I think that's the hardest part of ED and many other mental illnesses. As an outsider you have to accept that you can only do so much. You can support, plead, beg all you want. Until the individual decides they want a different path you cannot truly "help" them. You can support and encourage which goes a long way, but it's their own battle to fight, and that's a tough reality.

We’ve gone over this, creep. She’s been riddled with injuries the last several years, and she’s nowhere close to the level she was at before that.

Six things on a serious note:

1. You're right—there should be more folks focusing on this. I think it is changing, but it often seems the change is happening far too slowly. Still, this is better than where it used to be.

2. TLDR; don't underestimate how difficult it is to help the ED sufferer recognize the issue and treat it. On a "support team" side, there are truly a number of factors in play. Even if someone is knowledgeable about the signs, and can see the issues, often the ED sufferer is in denial, or outright obstinance, about it being a problem. Some will even recognize it is a problem, but are willing to exchange what they think are short-term gains for long term risks. Moreover, well-meaning folks trying to help often approach it poorly (every ED sufferer is different, and how to reach them differs) and even those who do not often get pushed away by the athlete if they persist. Watching friends and loved ones suffering from addictions or disorders is truly difficult, and hard to navigate for more than just the sufferer.

3. Focus on body weight is terrible. Weight is a poor substitute for a myriad of relevant factors—it summarizes a bunch of different things down into one number, and using that number as a gage is foolish. BMI has the same issues. To a degree, even VO2Max measurements have the same problem—it is a summary of factors, and not what you should be focusing on (velocity at VO2Max, that's different).

4. For endurance, the high carb revolution is coming. Balancing macro nutrients and micro nutrients is coming. Elite endurance athletes already do this. The Peleton in a major cycling race? They fuel sooooo much. Major marathoners, swimmers, skiers, triathletes, etc—all have been trending towards more and better fueling, and taking down records more and more often. It's just got to trickle down.

5. High school, and to some extent college, is the bottom of the spear. They lag, badly. Many high school coaches—who often don't have much training—are stuck 10-20 years back in time on what worked then. Under-fueling—especially dangerous for high school girls going through puberty, but also for the boys—was more common. Plus, high school schedules and stresses can make it genuinely difficult to get the fuel you need. I'm not sure who—USATF, state entities, USOPC, someone?—can bring a focus to this, and maybe help educate or even mandate more focus on fueling, but that might help a lot of folks.

6. Finally, you do see more body types in both the men and women's side of things than you used to see. Does this mean fueling is no longer an issue? No. But, look back at World Champs and US Trials one to two decades ago, and compare it to now. The folks at the front vary more greatly, and each have their strengths and weaknesses, than they used to vary IMHO. This is because every runner is different, and every body has a different peak shape and form for different types of efforts. Trying to make everything the same was always foolish, but then again if you're having to balance a team of dozens or hundreds I guess there is a reversion to a mean rather than the exceptionalism of the individual.

Running media...Milesplit, Dyestat, etc. keep glorifying these athletes short term success despite the obvious problems that go along with it. That kind of attention is very desirable by many girls and they see what it takes to achieve it. They may be relatively new to the sport and haven't been warned of any of the dangers or watched long enough to see those way too thin athletes fall apart and end their career after only a year or two of success. Coaches and the media are way too irresponsible with this subject because they like winning. It will only happen more often if we keep glorifying this kind of "success".

I hope one of AP is not one of the girls from the class of 22 you’re referring to! Because the success to nothing in college pipeline was true for her until fortunately recently!

Good for her- she’s really gotten it together and is running amazingly, after known pretty bad struggles in high school and injuries/silence for a few years in college.

It's easier said than done.

You ask why don't all these athletic people do something. As a former coach, I'll ask you this - What about the parents? They must see it as well. They are around them way more than a coach.

For better or for worse, coach a mentor of physical wellness and in most cases the most consistent mentor that athletes will be around in high school or college. Given how teens tend to isolate themselves from their parents, coach may be the adult they're willingly around the most in a given week. What teacher or prof or counselor will they see daily for most of the year for four or more years? It stinks that the system has disempowered them from taking a hard line. My family has a strong background in education and for a few years after college I was contemplating the path to college coaching. Glad I found a better career opportunity. I do appreciate reading the first-hand accounts here, it's truly elucidating.

It’s a very tricky thing. The main reason these girls are as good as they are just because they’re super thin. If they put on weight, they would be slower. I don’t know why it has to be a disease can’t they just be restrictors trying to be at the perfect racing weight? ?

Why can’t after they quit the sport and then also start eating “normal” again?

all sports offensive lineman eat a lot. Once they quit the sport they lose some weight wrestler starting themselves because they wanna be light in the lower weight class.

I think it's an extremely difficult issue to tackle at any level. I was a male D1 runner and it happened to me without me even realizing anything was going on (until a few years later). I never had the right build to be a distance runner, had a good amount of talent at mid distance but not quite elite speed. This left me convinced I could be an elite distance runner if I could get down to distance runner weight. A large portion of my identity and self worth was based on running fast and I knew for a fact I didn't have the build to succeed as a distance runner and the twisted part is that I was right. I legitimately thought I looked fat at times when I weighed 20 pounds less than I do today (and I'm not exactly fat today). I ended up dropping around 10 pounds and ran fast and felt like I could handle greater volume in training and my threshold and other longer workouts felt like a breeze. A girl I was seeing actually said something about me looking too thin and I laughed it off because it was working so well. I wasn't mature enough to accept that there were advantages and disadvantages to being built the way I am and the best course of action would have been to maximize my strengths and accept my weaknesses.

What happened next was repeated illness and injury that derailed the rest of my college career. I will always regret this and think I could have been a pretty good mid-d runner if I had trusted that my training would work over time and not tried to turn myself into something I wasn't. After all, wouldn't every distance runner be better if they could have a mid-d runner's muscle/speed and every mid-d runner be better if they had the weight and build of a distance runner?

This all led to a real feeling of failure and made me want to sit around and drink beer and eat fast food as often as possible after graduation. Over time I found a healthy medium but that experience haunted me in a lot of ways.

My experience was a small fraction of what I'm sure many other experience but it was complicated and not something I could handle myself. I also don't think it's something a coach could be expected to notice happening, especially for men (based on stereotypes and expectations). I think my HS coach could have guided me through this based on our relationship but a D1 college coach simply doesn't have the time with recruiting, coaching and travel expectations (especially in a smaller program). I think this happens a lot more than most of us would expect. Especially since social media has picked up, even fast HS runners getting NIL deals and sponsorships, it seems to me that today's runners are bombarded with broken records and other the successes of others every time they open their phone. I hope they are able to realize that most of us hit a ceiling at some point and have some really unhappy times in this sport.

If they put on a healthy amount of weight and take a long-term approach to training and performance, they can be much faster in adulthood. It's not worth sacrificing their health and all future prospects for 1 or 2 years of high school glory. The female athletes competing in the professional ranks don't look like this.

Unfortunately, some of the Puma Elite women do or used to. One of them won the OT marathon in this apparent state.

What do you expect those sites to do? Begin picking and choosing who they think has a problem and curtail their coverage of those specific individuals? So for a given invitational/championship meet they'd have totally one-sided coverage of the boy winner and ignore the girl?

+2

American football causes CTE

Elite distance running sometimes causes bone density issues and eating disorders if taken too far to the extreme

Also running high mileage outdoors in daylight and not wearing sunscreen causes early skin aging