Advice on how to deal with a possible eating disorders of a teammate

I have no expertise here, but this is a very important thread. Thanks for starting the conversation.

Should this be a registered users only thread?

Wanted to through some question for the experts. Is there a hierarchy on who to contact first (Parents, Coach, AD, School Nurse). Maybe it would be different for HS vs College, how to help if the athlete is older (22+). When its best to have this conversation with your athletes (all of them at once, regardless of whether anybody has an issue) and how to approach it (food is fuel).

So what advice do you all have on how to deal with such a situation?

Eating disorders are not something to be taken lightly, not at its start not at any weight/gender/etc. Nobody should struggle with the lifelong lasting implications that an eating disorder can leave someone with.

My advice? Share this information with a trusted adult who can make the appropriate judgement call and decision moving forward. If it is a teammate, that coach is obligated by law to notify a professional like a school counselor of the situation because it is considered life threatening and and endangerment to his/herself. That counselor and the other school authorities will then make the appropriate phone calls, contacts, and referrals necessary to deal with the situation. Then, it gets moved to a professional and the parents who can handle the situation. Hopefully it is early on in the situation and this hasn't been an an ongoing problem; eating disorders are a result of a need to control a situation and usually aren't born out of dissatisfaction with body image. But, when you lose yourself and get a warped perception of what you're worth that one thing you can control (food) becomes the weapon of choice in dealing with all of life's stresses.

Very few make it out alone and unassisted, a team of passionate health experts can help you get a better immediate physical recovery but the psychological relationship with food is something that needs to be more deeply looked into. With that, you have to figure out ways to handle and deal with stress and control in other ways that aren't abnormal or unhealthy food restrictions/binges/purges. Remember that a healthy body doesn't just produce a healthy athlete, but it produces a happy human. You can live to see your friends, family, kids, and anyone else grow up and physically move. If your bones are destroyed and your hunger cues obliterated from abuse, how can you ever grow physically able enough to see the small beautiful things in life?

My advice besides getting a team, letting someone who can HELP know what's going on, is to let what will happen happen with regards to athletics. They can't do their other passions and hobbies either if they're immobile or dead. What's worse? Having that guilt on your hands or having the confidence to speak up to protect someone?

For the person dealing with the eating disorder. Seek help. If you won't, ignore the scale and calories. Try to stick to a routine with eating like you do your training. That control of routine can replace the control of ignoring your body's nutritional needs. Make it the same goal you had before to continue with your eating disorder to nourish your body. And lastly, force yourself to have 1 thing you wouldn't normally consume once a week. I did this in recovery and it taught me a lot. A mountain dew at a Friday night football game, a snickers bar at the gas station, a slice of pizza after dinner because friends were still hungry. This taught me that life goes on, I don't have to control it all all the time, and that I didn't magically lose my athletic ability, I didn't spontaneously become obese, and I was still the same person people could love.

I have no advice on eating disorders.

But here is the solution before it gets to an eating disorder: Learn to cook basic meals!

I’m not above practicing and doling out advice on avoiding processed foods myself, but processed food phobia is overrated. Most food ingredients even if inscrutable to most lay people (e.g., soy lecithin) are not known to be harmful. We also can’t point to systematic controlled trials comparing people consuming more or less processed foods in part because the word “processed” doesn’t even have a concrete universally agreed upon meaning. (Of course some processed ingredients, e.g., trans fats, are known to be harmful through scientific studies.)

I enjoy cooking and do silly things like buying frozen Ezekiel bread or bread fresh from the bakery because they only contain flour, water, salt, and yeast, but do so knowing that it is in good part for psychological feel-good benefit.

I feel like this should have been a stickies thread 20 years ago. Better late than never.

If you are struggling with an eating disorder, you need to talk to a mental health professional. If you’re a minor, you can ask for a referral from your pediatrician. A trusted school counselor may be able to help you find one. Your parents may be able to help you find one.

Your life will be better and your athletic performance will be better, if you take the first step of asking for help. This goes not only for eating disorders, but for depression, anxiety, OCD and other physical or psychological challenges. The hardest part is realizing you need help and asking for it.

I would not task a HS kid with anything other than letting an adult know what is going on and just being a good supportive friend. The physical and psychological issues underlying EDs are very complicated. Each person with an ED can have very different issues and require complicated integrated care from MDs, psychs and RDs who specialize in EDs. Tasking a HS kid with any kind of intervention is not a good idea as even well intentioned actions could backfire and make matters worse. Outcomes for people with EDs are betting when they have lots of family support. So, unconditional love and support from friends at school is really the best thing that kids can do for friends with EDs. Everything else is just too complicated.

This is a tough situation to be in.
First of all, for the teammate, do not feel guilty about whatever you decide to do, whatever happens to your friend is NOT your fault. I would recommend an anonymous note to the coach or school nurse, this will not only fulfill your duty as a bystander, but it will also relieve your pressure about it. If the problem is that obvious, chances are that the kid's parents already know about it, and if they aren't taking action, there isn't anything you can do about it, just try to be there for your friend, and make sure to focus on your own mental health.
For the athlete, number one is to recognize that you have an eating disorder, you can't solve a problem without acknowledging it. Once you acknowledge it, you can start taking action. I highly recommend getting help from a therapist/psychologist, because it is very had to deal with these issues on your own. I've seen kids who have insisted that they can deal with these kinds of issues on their own, but the problem is that this behavior is ingrained, and when they get stressed out/upset, that kind of behavior is what they immediately go back to for comfort. So, please get help from a professional, because they will ensure that you are making progress and not ignoring the issue. And don't worry too much about your weight, if you are fueling your body properly and you gain a bit of weight, that's okay, that's just where your body needs to be to properly function and develop.
Hope this was helpful and good luck!

I would talk to both the coach and maybe also the school nurse and counselor. at least one of the two.

depending on how you describe it to the coach, the message might not come across as very clear. some people are very good communicators, and others not so much. A nurse or counselor might have better follow up questions to get the full scope of the situation. Hopefully all of these adults would eventually get in a room and come up with a plan moving forward.

I also think a parent could miss this. teenagers are hyper busy and sometimes the relationships between parents and kids of this age are strange to say the least. A kid not wanting to eat around their parents could just be passed off as moody teen behavior. I think the signs could be there, without the pieces actually being put together. there is just so much running around these days. missing the forest for the trees type of thing.

In running, paradoxically eating disorders do not immediately correlate in a reduction in performance, whereas a direct correlation between intake and performance is more noticeable in, for example, weight lifting. Eventually, the physical effects of an eating disorder will negatively impact recovery, training, and result in muscular atrophy and poor performance outcomes...but this can take a while. As coaches, teammates, and parents, we should never surmise something about someone's physical health based on their running performance, as times are not an indicator what is occurring in the body on a biological level. If overall muscle mass decreases in accordance with overall body mass, individuals can sometimes get away with losing significant amounts of weight while still maintaining impressive times. Moreover, the physical effects of malnutrition often manifest before any noticeable weight loss occurs, including a decrease in resting heart rate and blood pressure. For instance, athletes I have coached with eating disorders often have bradycardia during medical evaluations. This is not a result of increased fitness, but atrophy of the heart muscle caused by malnutrition. Given the seriousness of this matter, it is a conversation that should not be taken lightly and should not be brushed aside with a series of passive-aggressive remarks made by lets run lurkers. Thank you for making this forum so we can continue the conversation in a professional, respectable manner.

NATIONAL EATING DISORDERS HELPLINE
Toll-Free Phone Number: 1-800-931-2237
For 24/7 crisis support, text 'NEDA' to 741741

My HS athletic flagged me for an eating disorder after my third stress fracture in two years. He left a voicemail for the orthopedist (in hindsight this sounds like a HIPAA violation). The doc brought it up but my mom categorically denied that there was an issue and it was dropped. Because I was a minor I was never 1:1 with the doctor.

Went to college, promptly got another stress fracture, and got flagged by a team doctor resident who soft pedaled and encouraged me to talk his sports dietitian friend. She did NOT soft pedal and helped me get the help I needed. Things got worse before they got better and I remember a conversation with my college coach a decade later where I got benched and nearly kicked off the team.

The conversation is totally different when dealing with a minor, especially if parents don't want to see it. For HSers, a school psychologist or social worker can help.

It's sad that a teenager even has to bring this up! Mental health education should be a part of training the entire team.

I was hospitalized with anorexia in my teens, had to quit track as a result. If you are worried about a teammate, tell your coach. If you are a coach, talk to the school and the parents. If you're a struggling athlete, please ask someone for help. I went too far and will never be able to run fast again probably because of how much damage I did to my body. I also had to do a year of high school online (long before covid) because I was in the hospital getting fed through my nose. Not fun! I've graduated college since and it still affects me. Please get help for your friends while they can help themselves, starvation takes a serious toll on the brain as well which makes recovery that much harder. And all of you, take care of yourselves.

You have the rest of your life to run! You can recover and run well again (if that's what you want to do). Speaking from experience.

A lot of great insight here. Thanks on behalf of everyone this helps.