When food is the foe: Disordered eating in athletes

Among athletes (and ordinary mortals, too), thinness is associated with success, beauty and acceptance. Be you a runner, cyclist, gymnast, skater or fitness exerciser, you likely believe "The thinner I am, the better I will perform."

Yes, being 10 to 20 pounds overfat can likely slow you down as an athlete. But being 10 to 20 pounds underweight can also take its toll -- both physically (stress fractures, reduced stamina, weaker muscles) as well as mentally (spending too much time thinking about what to eat and when to exercise).

It's hard to quantify the number of athletes who struggle with food issues. One survey of 425 female collegiate athletes from seven universities suggests about one-third flirt with disordered eating, if not a full-blown eating disorder (Beals, Int'l J Sports Nutr 12:281, 2002).

As a sports nutritionist, I counsel these athletes on a daily basis. You also may interact with them (they are your friends, teammates, training partners) and hear them complain: "I'm too fat," "If only I could lose these last few pounds." Your response "You are NOT fat." seems to fall on deaf ears.

You may feel frustrated, unable to help the dieter find peace with food and his or her body.

The purpose of this article is to shed light on eating disorders, as well as suggest ways you can help yourself (if you struggle with food, weight, compulsive exercise and even alcohol problems) or your friend, teammate or loved one who struggles with food.

Much of the information is adapted from The Anorexia Workbook: How to Accept Yourself, Heal Your Suffering, and Reclaim Your Life by Michelle Heffner and Georg Eifert (2004, New Harbinger Publications).

Eating: What it is, what it isn't

Eating is the means to an end. Food provides the fuel you need to achieve your goals in life. As an aspiring athlete, you need to fuel your body so you have energy to live each day to the fullest. But some athletes try to not eat; food is the enemy.

Why would an athlete want to not eat, you may wonder... Well, to an athlete with anorexia, not eating is a way to be more perfect, to feel unique and special. Not eating is a way to pursue perfection, the ideal, happiness.

We are brought up to believe that happiness is the norm, that bad feelings should not be present. The reality is, happiness is not the norm; most of us suffer from events dealt to us by life's deck of cards.

Society has taught us unhappy feelings and angry or sad thoughts are bad; they should be minimized. One way to minimize and avoid those bad feelings is to diet. Dieting offers a sense of empowerment, achievement, control. The less you eat, the more powerful you feel. And the less you eat, the more you think about food, not unhappy feelings.

Unfortunately, dieting offers no long-term solutions to your pain and suffering. Rather than trying to eliminate unwanted thoughts, try to observe your thoughts and feelings. Sit with them (or walk, ride or run with them); feel them come and go.

When you mindfully observe your emotions, you'll notice they ebb and flow. They are not permanent; they are not right nor wrong. Accept them.

Emotions are not facts. That is, you might fear eating birthday cake. Birthday cake is not going to hurt you. Birthday cake can simply fuel you for a stronger workout.

If you are afraid you'll eat the whole cake, eat mindfully, slowly. Enjoy each mouthful, one by one. Athletes who eat mindfully are able to notice their body's fullness signals. You won't overeat if you listen to your body.

Weight: What it is, what it isn't

"I have to lose 5 pounds," "I'm too fat," "I'll be happy once the scale reads 109 pounds." I hear these phrases time and again, as if thinness equates to happiness, and a number on the scale can improve one's life.

Weight is just a number, a word; nothing more, nothing less. Say that word over and over and over, and it becomes just a sound. Meaningless. Yes, the number is meaningless.

I invite you to focus on performance, not a number on the scale. Losing those 5 pounds might hurt your performance, and be counterproductive.

Living life, instead of avoiding life

People with eating disorders are strong; they have a zealous drive and commitment to be thin and to excel as an athlete. Yet, there's a very fine line between being a dedicated athlete and a compulsive exerciser.

If you fall into the compulsive exerciser category, think about the benefits of putting that commitment into being a better friend to yourself, if not your teammate.

If you are more committed to being thin than to being available as a friend, think again. Your relationships with people give true meaning to life.

You may have thought dieting is your ticket to being slim and feeling good about yourself. Not the case. Dieting interferes with your valued living.

I doubt anyone will talk about your weight or your looks at your funeral. Yet, they might say "I feel so sad Amy never lived her life to the fullest ..."

If you cannot accept your body, that's OK. You can still shift your focus away from what your body looks like and begin to appreciate how well your body performs. You can feel unattractive AND still live the way you want. In the end, it's not the beauty of a body that counts. It's the beauty of your life.

What to say, what not to say

If you have a friend with an eating disorder, you are likely frustrated that this person cannot "just eat" -- like everyone else does. That's because eating is complex and food is far more than just fuel.

When talking to your friend, remember that she or he uses the eating disorder as a means to survive. The eating disorder helps her cope with life.

Thinking about food and weight are nicer problems than the painful problems presented by life. (For example, an estimated 50% of people with eating disorders have experienced sexual abuse.)

When talking with your friend, try to not talk about food or weight but rather focus on the real issues. For example, if your friend talks about needing to lose 5 more pounds, transform that desire to lose weight into a statement: "You seem very concerned about the number on the scale ..."

Let her provide the insights into why weight is a big issue. (Perhaps she feels inadequate and imperfect compared to her teammates.)

If your friend refuses to eat any birthday cake, gently say, "I'd like to understand why you don't eat cake." You'll likely get more information than if you just insist she eat a piece. Remember: not eating is the symptom; it is not the problem.

Food for thought

The drive to be thin is like a hammer. An athlete can use that hammer to build or to destroy; to be healthy or unhealthy.

I'd like to think you value the goal of building a strong body. Stop saying "Yes, but ..." -- "Yes, I want to be a good athlete but I am too fat."

"Yes, but ..." keeps you stuck. How about "Yes, I want to be a good athlete AND I will fuel my body for top performance" ...? Now that's the way to win!

Sports nutritionist Nancy Clark, MS, RD counsels both casual exercisers and competitive athletes. Her private practice is at Healthworks, the premier fitness center in Chestnut Hill MA (617-383-6100). Her popular "Sports Nutrition Guidebook" ($23) and "Food Guide for Marathoners" ($20) offer valuable information on how to win with good nutrition. The books are available via www.nancyclarkrd.com or by sending a check to PO Box 650124, West Newton MA 02465.

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