Lean Dreams: Eating Disorders on NCAA Teams
Posted May 15th, 2007 at 9:43 AM by Adam Jacobs
Section: News & Results, Nutrition, Healthy Eating, SoundOFF, Columns, Health & Fitness, Injury & Rehab, Exercise, Weight Loss
We see her running at cross-country and track meets every season; we watch her as she propels her thin arms and legs, conspicuous ribs, hollow cheeks and eyes, bulging veins and concave stomach forward. The visible markers on her body shout that something is not right, as her drive for perfection pushes her towards a dangerous dance with death.
The prominence of professional sports in America places athletes on the highest pedestal of celebrity, praise and respect. This cultural phenomenon gets replicated in college athletics in the form of big time Division I athletic programs. Often times, these programs incite the same excitement and feverish fandom as professional sports do - sometimes even more so because of the appeal of an athlete’s amateur status to the American imagination, and the almost cultish following of the universities that these athletes represent. Without question, the enormous pressure to excel and win in NCAA Division I programs creates serious issues concerning the physical well being of its athletes.
Because of their dedication and discipline, athletes often tread on the boundary between healthy and unhealthy physical habits. When one thinks of nutrition and Division I sports, the concept of anorexia does not seem logical; however, a growing number of female Division I athletes face this serious and potentially fatal problem.
We’ve all heard of anorexia nervosa—a physical and mental disorder in which a person is so afraid of becoming overweight that he or she does not consume enough calories to maintain a healthy lifestyle or sustain his or her athletic training. Studies show that disordered eating, including anorexia and bulimia, strikes at least one-third of all female collegiate athletes.(1) For years eating disorders have fueled the dark underbelly of our sport –most athletes and coaches know they exist, but few of them willingly engage in an open and honest public discussion about them.
Sports like swimming, cycling, and running, where participants are deemed “naturally skinny,” potentially mask this serious disorder; an athlete’s already strict diet and workout regime makes it harder to detect and diagnose an eating disorder. A joint study by the Anorexia Centre at Huddinge Hospital in Stockholm and the Swedish Sports Federation found that “the main causes of anorexia in elite sport were high levels of physical activity, including heavy training, in combination with difficulties in eating enough food to meet the energy requirement of this activity”.(2) In sports that demand high caloric outputs, like running, a lack of nutrition often results in unhealthy weight loss.
One Division I athlete I interviewed, who chose to remain anonymous, spotted eating disorders amongst her teammates during her freshman year. In an interview she observed,
“We’d go to the dinning hall together and you’d see what people eat, or they don’t. Plus, one of the girls told me one of our teammates was quitting because she was bulimic and another was ‘redshirting’ because she was anorexic.”
(Note: The term “redshirt” refers to student-athletes who do not compete in their sport for an entire academic year; many athletes continue to practice with their teams and they use that year of eligibility to compete for a fifth year.)
Statistics reveal the sobering reality of eating disorders among female athletes. In a 2002 study, Katherine Beals, a competitive athlete and Associate Professor of Nutrition at the University of Utah in Salt Lake City, interviewed 425 female subjects and found that 43 percent “were terrified of being or becoming too heavy, and 55% reported experiencing pressure to achieve or maintain a certain weight”. Given this reality, it is not surprising that between 2-3 percent of all female college athletes meet the diagnostic criteria for a full-blown eating disorder.
The Division I runner interviewed above highlights the significance of these statistics. Like the female athletes behind these numbers, she admitted to feeling pressure to stay skinny:
“I feel like cross-country is a very competitive and individual sport. But also, I think there’s an ideal cross-country runner that people expect you to look like.” In sports like distance running that emphasize weight and body aesthetics, the pressure of this stereotypical or ideal body image drives many women into the pit of sports anorexia, or “anorexia athletica.”
While anorexia athletica functions like anorexia nervosa and compulsive over-exercising, its main trigger can be traced to the competitive nature and body weight expectations of specific sports. So in sports that emphasize weight control and leanness as key factors in winning, where does coaching and NCAA responsibility come into play?
Unfortunately, only a handful of schools have stepped in to fill the void; the leader among these schools is the University of Tennessee and their “Team Enhance” approach. Team Enhance, which consists of a social worker, a nutritionist, an injury support group and a clinical psychiatrist, works together to cover all of the issues pertaining to the mental health of its athletes, including eating disorders. This team also works hand-in-hand with the university’s sports physicians. As Kristin Martin of UT states,
“There are few programs that address it like we do. We look at an athlete as a whole person, not just a talent.”
Jenny Moshak, the university’s assistant athletic director for sports medicine, explains, “Our opinion is that we should provide help and support for eating disorders, depression, etc. It is even a performance issue in addition to being a health issue, a happier athlete is going to perform better.”
While the University of Tennessee’s Team Enhance takes bold steps in nurturing the physical health of its athletes, the NCAA as a whole, even though it makes suggestions to its members, lags behind when it comes to preventing and controlling incidences of sports anorexia. The University of Tennessee takes preventative measures in fighting sports anorexia by banning coaches from subjecting their athletes to body composition tests (the ban includes taking weight, body fat and/or BMI measurements). Instead, the school places an emphasis on performance, conditioning and nutrition. Kristin Martin elaborates:
“We feel the risks far outweigh the benefits of having those numbers. On other teams, coaches have been known to use those numbers to motivate out of fear … say[ing] ‘you just have to lose weight’ … and when athletes are told to lose weight, they most likely won’t do it in a healthy [manner].”
In its defense, the NCAA adopts a similar attitude toward weighing and measuring athletes. Dr. Ron Thompson, of the Bloomington Center for Counseling and Human Development, does consulting work for the NCAA and co-authored “Helping Athletes with Eating Disorders”. Dr. Thompson agrees that weighing is unnecessary; he asks, “Now you have a weight, so what, what does that tell you?”
Although the NCAA publishes educational materials on the issues of weight and sports anorexia, “Reporting to the NCAA about cases of anorexia is not required,” says NCAA Public Relations Representative Jennifer Kearns. But, she adds, “Coaches are encouraged to be aware of the signs of an eating disorder.”
Nevertheless, the win at any cost attitude so pervasive in Division I programs has had a strong influence on the physical status of its athletes. In many cases the risks involved in cutting unhealthy amounts of weight are viewed as necessary sacrifices towards being number one. The responsibility of the coaches comes into play when the health of their athletes gets compromised because of this competitive edge. It is safe to say that no coach in the NCAA willingly risks the health of an athlete for victory, but most coaches are not aware of the gravity of eating issues.
Kimiko Soldati, a former collegiate and Olympic diver, has been incredibly open about her personal experiences with bulimia in her sport. “It was an educational process for everyone around me, I had to educate my coach, I had to educate my team…” says Kimiko. Her experience underscores the fact that just putting information out there on eating disorders is not enough; coaches, teams and athletes must be forced to understand how weight and eating disorders can negatively affect them and severely impact their performance.
UT’s Team Enhance sends this message to its coaches and athletes; it uses a holistic approach for preventing and treating eating disorders by educating athletes about proper nutrition in order to avoid serious health problems. However, if an athlete begins to exhibit signs of an eating disorder, Team Enhance tries to immediately address the situation and assist the athlete before the problem becomes debilitating. This can be a difficult task because an athlete’s physique, especially in sports where lower weights are desired, often masks an eating disorder until it becomes quite critical. UT’s Moshak explains,
“When it’s an environment of support, it can be far more successful. If they are in steadfast denial, they know at least we are keeping an eye on them and we continue the approach of ‘we care’.”
Even if their approach is not foolproof, it is clear that the University of Tennessee is on the right track. , They have laudably decided to step in where the NCAA has fallen short, but the majority of schools have not followed suit. Programs concerning eating disorders like Team Enhance are school sponsored and not mandated by the NCAA. While the NCAA has taken steps towards educating coaches about the mental, emotional, and physical hazards of eating disorders, their efforts have been suggestive at best. In an organization that strictly regulates substance abuse, recruiting and fund raising, it seems absurd that it makes no requirements for a dissemination of knowledge about eating disorders. What the NCAA has done is release educational information such as a Sports Medicine Handbook, which provides information to coaches about eating disorders in “lean sports” like swimming and running. Actions like these may be improvements, but they still dance around finding a true solution. As of now, the burden is on the coaches, but no one, especially the NCAA, holds them accountable.
What the NCAA does have is an opportunity to meet this growing issue head on by taking a solid stance towards unhealthy weight loss. Programs like Team Enhance are prime examples and models of the types of steps that can be taken towards promoting healthy athletic body images and endeavors. More importantly, Team Enhance is an example of a hands-on approach to the issue of sports anorexia and eating disorders in the NCAA. Instead of passively distributing educational materials, Team Enhance actively addresses eating issues by educating its coaches and athletes, providing support and facilitating preventative and corrective measures. It’s no coincidence that Kristen Martin, Jenny Moshak, Kimiko Soldati and Dr. Ron Thompson all agree that more needs to be done by the NCAA about this growing problem despite the apparent difficulty of enforcing it.
The NCAA needs to take the same action toward eating disorders that it takes with its recruiting guidelines and academic standards, where teams are sanctioned when players are not properly educated. Team Enhance can serve as a model for the NCAA to help begin similar programs of prevention and enforce the fight against eating disorders throughout the athletic community. Constant and rigorous affirmation by the NCAA combined with education and support can only lead to healthier and more productive and competitive athletes.
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Please note: As a result of the sensitive materials included in this article, the names of the NCAA athletes who were interviewed and the name of one of the article’s co-authors are being kept confidential. If you have any questions please send an email to Adam Jacobs, TheFinalSprint.com’s Editor-in-Chief and Co-Owner of The Final Sprint, LLC at: adam@thefinalsprint.com
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To learn more about Team ENHANCE, please click here and/or visit:
http://utladyvols.cstv.com/facilities/training-room/04index-te.html
Further research sources and for further reading: [USA Today], [Physsportsmed.com], [AEDweb.org], [MentalHealth.about.com]
Citations:
(1) See p. 270 of Nancy Clark, Sports Nutrition Guidebook: Eating to Fuel Your Active Lifestyle. 2nd Ed. Human Kinetics: Brookline, 1997.
(2) “Diagnosis and Treatment of Anorexia in Elite Sport,” 1995, cited by britishorienteering.org.
(3) See USA Today link above
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Matthew Halmy, Jodi Jacobs, Nicole Miller, and Bridget Sullivan also made significant contributions to this article.
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This article was also syndicated and re-printed with permission by: [Reuters] and [Runner’s World]
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Tags: anorexia, anorexia athletica, anorexia nervosa, anorexic, bulemic, bulimia, college sports, confidential interview, division 1, Dr. Ron A. Thompson, eating disorders, eating issues, exercise bulimia, female athletes, healthy eating, Jenny Moshak, Katherine Beals, Kimiko Soldati, male athletes, national collegiate athletics association, ncaa, nutrition, sports medicine, team enhance, university of tennessee, young athletes
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The Final Sprint
Thank you for posting this, Adam. Eating disorders are an extremely important issue that affect way too many talented athletes.
May 14th, 2007 at 5:19 pmWonderful article. I think that it is so important that your site chose to discuss this issue rather than cover it up! Great work.
May 14th, 2007 at 6:08 pmGreat article. Thanks for addressing this
May 14th, 2007 at 11:34 pmimportant issue and let’s all applaud the University of Tennessee for their healthy and rational approach to women’s sports.
This is a great article. NCAA division I coaches need to actually be held accountable for their actions. As a former Division I athlete, I was also subjected to weight and body composition assessments. I have seen so much athletic talent ruined in this manner. I have been beaten by runners of all shapes and sizes. Coaches need to realize that there is no ideal physique for success. An unhealthy athlete will not be a reliable performer.
May 15th, 2007 at 12:34 amIt’s a sad reality that athletes are sacrificing their health for the sake of their sports career. Those athletes need to realize that sports isn’t their life. After reaching 40, their sports life will surely be over.
May 15th, 2007 at 5:00 amWhile it is great any attention eating disorders can get because there is such a lack of understanding and education I was dissapointed in the article. It focused on the disorders being about weight and size. When you get to the bottom of any eating disorder or disordered eating it is not about the weight or the food or the size, it is deeper than that. This article is misleading to those who know nothing about the subject or have any knowledge about ED.
May 15th, 2007 at 2:33 pmDear Runner,
I am sorry you feel that way, but I appreciate and respect your input. It is also unclear to me how the article is misleading. The mental aspect of ED’s is discussed in this entry, but I would like to discuss your concerns with you and see if there is a way for us to clarify and/or improve our content.
Feel free to email me at the address in my signature at your convenience.
Thanks again and I look forward to hearing from you.
Take care,
Adam
–
May 15th, 2007 at 3:03 pmAdam Jacobs
Editor-in-Chief
TheFinalSprint.com
adam@thefinalsprint.com
I think they are too serious about sports. I agree with Yolanda that sports life is not yet their life. I think it’s only a taste of reality wherein athletes will later on realize their true purpose.
May 15th, 2007 at 8:35 pmThis was a great article to post. But I was a little disappointed that the emphasis was on Division I athletes, I run for a really competetive Dvision II team and the issues are still the same all across the board not just DI. When it comes down to it, if you are competing on a serious team you are ultimately running into the same issues as any other program whether it be D1, D2 or even D3. Now a days it is almost a guarantee that a female runner at least once during her career will battle an eating disorder and that’s sad. Pretty much all coaches say in one form or another that the “lighter” you are the faster you run, which is wrong to say.
May 15th, 2007 at 11:22 pmThis is a great article and one that I hope will fuel positive changes in the way the NCAA and individual sports programs throughtout the country handle eating disorders. Our focus needs to be realigned towards winning with dignity and integrity and away from winning at all costs. Congratualtions.
May 16th, 2007 at 9:28 amThis is an outstanding article on a very sensitive and important topic.
I am copying an article from the Washington Post from December 25, 1993 that gives a perspective that many coaches often miss.
SATURDAY, DECEMBER 25, 1993
THE WASHINGTON POST
by
JOHN FEINSTEIN
A Daughter’s Deadly Struggle With Anorexia Is Coach’s Most Painful Loss
The loss was one of those that keeps a coach up at night, looking through the game tape again and again, knowing what he will find, yet unable to stop himself from watching because he simply cannot believe what he is seeing.
May 16th, 2007 at 10:20 am“One of those games you lose by three and think you should have won by 10,” Tom Asbury said.
There is a flatness in Asbury’s voice when he talks about his Pepperdine team’s defeat two weeks ago to Weber State. The emotion isn’t there. “I wondered how I would react to the first loss,” he said. “I almost wanted to be upset about it, angry, frustrated. But it just wasn’t there. My guess is it will be a while before it is.”
The Weber State loss came three months – minus one day – after Asbury’s 22-year-old daughter, Stacey, woke up in the middle of the night and started to walk downstairs. “She was probably going to get something to eat,” Asbury said. “That’s what anorexics do. They put off eating dinner for as long as they can. We all put off what’s hardest to do. For an anorexic, that’s eating.”
Stacey Asbury never reached the kitchen. As she made her way down the steps, she apparently felt weak enough that she sat down on the bottom step. Carlie Asbury found her daughter there early the next morning. The paramedics arrived in minutes but it was too late. Stacey Asbury’s heart had simply given out. Once a 5-foot-8, 130-pound teenager, she weighed 65 pounds on the morning of Sept. 12.
“She was never in denial,” her father said, sipping coffee on the afternoon of his team’s road game last Saturday against George Washington. “Stacey knew what her problem was and she tried to deal with it. But she couldn’t do it. She knew she had to eat to live and she still couldn’t make herself do it.”
Throughout most of the time that she was sick, Stacey Asbury could not work or go to college. She was in and out of hospitals, spending close to a year in all in hospitals. The Asbury’s $15,000 health insurance policy was used up during her first two weeks at the UCLA Medical Center.
Knowing how much her illness had drained her parents finances, Stacey Asbury applied for disability insurance. Her claim was rejected. The letter from the insurance company read, in part, “We have determined that your condition is not severe enough to be considered disabling.”
The rejection letter arrived at the Asbury’s house on Nov. 1 – seven weeks after Stacey had died.
It is that letter and the memories of what his daughter went through that stir Tom Asbury’s emotions now. “People simply can’t understand what this disease does to young women,” he said. “Friends come up to me all the time and say, ‘I can’t understand how you get to a point where you don’t eat.’,Well, I can’t understand it either and, at this point, my wife and I probably know as much about the disease as any lay-people alive.
“That’s why you feel so helpless. You see someone you love doing this and you can’t stop them. I used to say to Stacey all the time: ‘Honey, I love you and I want you to live. You have to eat or you’re going to die.’ She understood, but it wasn’t enough.”
It is the lack of understanding about the disease that terrifies and angers Asbury. Stacey’s problems began innocently enough when she began dieting as a junior in high school. “She thought she was getting a little bit chunky,” Asbury said. ‘1nitially, we didn’t see any problem with that.”
It was after Carlie had returned from a week-long trip to the Midwest during the winter of 1988 that the Asbury’s first noticed a problem. “Carlie looked at Stacey after being away for that week and it really hit her how thin she had become,” Asbury said. “We took her to see a psychiatrist and, after he had talked to all four of us [Stacey’s sister, Megan, is a 19-year-old Pepperdine freshman] he said he was convinced she had an eating disorder.”
At times, Stacey seemed to have the problem licked. After a long hospital stay in 1989, she got her weight back to almost 120 pounds. But as soon as she was out of the hospital, she fell back into her old habits, not eating and exercising obsessively.
“What happens with a lot of anorexics is that the people at gyms recognize the symptoms and they’ll tell them they can’t work out for more than one hour a day,” Asbury said. “What Stacey did, like a lot of anorexics do, is she joined five clubs so she could work out at all of them. It becomes an addiction.”
It is an addiction that almost exclusively afflicts young women, who are constantly reminded that this is a society in which thinness equals attractiveness. “The message is everywhere,” Asbury said. “Walk into any hotel gift shop and you see all the magazines with gorgeous women in bikinis or ads on how to diet so you can be thin and glamorous. Television is full of those ads. It makes you want to throw something at the screen.”
While Stacey’s health was going downhill, Asbury’s career was going in the opposite direction. When Jim Harrick moved from Pepperdine to UCLA in 1988, Asbury, his top assistant, replaced him. In five seasons, the Waves have reached postseason play four times and his record (including 6-2 this season) stands at 112-50. But there has been little joy in it for him. That is especially true now. “You try to go day-to-day and to bring the same enthusiasm to practice all the time,” he said. “But it’s not very easy. I know it’s been hard on the players. They really don’t know quite what to do. They’ve been great to Megan, like 12 big brothers, but they’re playing tight. I know they’re thinking that they have to be perfect because they don’t want to make things any harder for me. That’s not the best way to play though. In fact, it’s probably the worst. We’re all struggling with it right now.”
Today may be the toughest day of all. Christmas was Stacey’s favorite day of the year. “She was one of those kids who believed in everything that’s good about the holiday,” Asbury said very softly, wiping his eyes. ‘1 honestly believe she was 15 before it even occurred to her that there might not be a Santa Claus.”
Tom and Carlie and Megan will be in Florida today with Carlie’s parents. They will think about Stacey often and the memories no doubt will make them laugh and smile and also make them cry. It is those memories that drive Tom Asbury.
“We aren’t going to let this thing go,” he said. “I know there are other families going through what we’ve gone through and I want to help. I want people to understand what this disease does and what our society does to so many teenaged girls.
“They will find a way to control it someday, I know that. In the meantime, I would like to feel I can do something for other people who are going through this. I know the pain.”
He forced a smile. His words were choked now, but firm. “Someday, I’d like to know a little of the joy that will come with wiping this thing out. Maybe then, when we think of Stacey at Christmas, we can comfort ourselves knowing that we never gave up on her or on beating the disease. I think she would like that.”
She would not be alone.
I am too a x-country and track runner and I am also very skinny, and this info has good tips and stories. i don’t have a disease though, which is good because I am sure to eat a lot of meat and carbs. thank you.
May 21st, 2007 at 10:33 pm[…] HAL: The Final Sprint published an article about NCAA runners and eating disorders. How much of a problem do you think eating disorders and body image are in the NCAA, or in elite running in general? Where do you draw the line as an athlete between healthy and unhealthy? […]
June 5th, 2007 at 12:30 pmGreat information. Thanks
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June 30th, 2007 at 3:31 amEating disorders are much more common than many people, coaches, teammates, and parents realize, even in high school. My parents and I privately addressed my disordered eating, not involving friends or (high school)coaches.
Runners often put on muscle while losing fat. Initially, the difference isn’t noticable, especially to coaches who see the runner every day. Though the body mass index might not be alarming, the real trouble arises when the body fat percent drops too low. Not able to produce the proper levels of hormones leads to a heightened risk of bone density loss and stress fractures (just look at amber trotter, national champion who can no longer run…early 20s with the bones of a 70 year old)
What anorexic runners often don’t realize, is that the improvement they experience and attribute to weight loss is really from the dedication they now have that drives them to push themselves soso hard in workouts to get them to that next level. But they don’t attribute it to that. It’s the weight that they compulsively and obsessively check.
Thinking of being a BOLD runner, not a frail one, of being strong and powerful, and not allowing myself to run unless I properly fueled myself helped me to recover. I’m back up to a healthy body fat percent, running faster than I did a year ago at a much lower weight, and most importantly, happy and eating spontaneously.
Athletes, whether high school, D1, or professional, are first and foremost humans. Encouragement for healthy eating habits is way more important than to make a certain weight. Lives are truly ruined by this consuming mindset. On that note, I commend the program TN has initiated.
July 3rd, 2007 at 11:38 pm[…] Posted by admin as Uncategorized Studies show that disordered eating, including anorexia and bulimia, strikes at least one-third of all female collegiate athletes.(1) For years eating disorders have fueled the dark underbelly of our sport –most athletes and coaches … article continues at Adam Jacobs brought to you by diet.medtrials.info and conSALSITA […]
July 21st, 2007 at 10:25 am[…] The above paragraphs come from an article by Adam Jacobs of The Final Sprint. Here’s the full article. […]
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