Going off the Grid: When Injury and Stress Increases Eating Disorder Behaviors in Athletes
Rebecca McConville, MS, RD, LD, CSSD
To an athlete, an injury or illness, change in coach or retirement from sport may feel like a traumatic event. These are three factors in which the athlete has the potential to go off the grid from their usual support systems: teammates, coaches, athletic trainers or strength coaches.
As a result of this stressful time, the incidence of disordered eating or eating disorder behaviors has the potential to increase. These athletes share stories of how these impacted their eating disorder and provide insight how as professionals we may be able to bring about awareness and interventions.
"I was put in a cast to provide non-weight bearing relief for a persistent injury. It was meant to be a time of healing, but my eating disorder knew it could grab the entirety of my focus and rule my life. When you put everything you have into your sport/profession it becomes an identity. My only other identity outside of "ballerina" was "ED". When the immense focus, drive, and determination to perfecting your craft are taken away, it is so easy for ED to take control. I spiraled even deeper into the disorder and ultimately never found the healing I was searching for in that period of rest." - Molly
Athletes tend to panic at the fact that their activity level is diminished due to the injury and significantly reduce their usual intake leading to poor healing and increased disordered eating. They may also use their dedication to eating “healthy”, exercise beyond physical therapy or decrease their body weight as a way to prove their dedication to getting back or a way for them to feel in control. Pain also can impact the risk of disordered eating diminishing the athlete’s appetite making them more susceptible to energy imbalance.
Tips for coach, athletic trainer or parent:
Compare behaviors before the injury. If there have been changes don’t hesitate to ask why.
Encourage the athlete to participate as part of the team so they avoid isolation.
Echo the importance of nourishment & rest so they can fully heal to return to sport & team.
Change in Coaching
“I was recruited by a coach that I felt comfortable with and had already felt like I had a relationship with. When I got to college I found out she decided to stay home with her new baby. Part of the recruiting class decided to not commit after finding this out and the new coach showed favoritism to his recruits. I was so disappointed and frankly heart-broken.” - Broken basketball player
Coaches are such a profound part of an athlete’s life similar to a family member. The athlete may feel a sense of mourning if they were really close with the previous coach. If in a college setting, the athlete may feel isolated from athletes that the coach has recruited. This may also lead to an increased pressure to impress the coach at all costs.
Tips for coach, athletic trainer, and parents:
Make an effort to get to know your athletes and assure them they will be treated equally.
If previous staff is still present find the time to learn more about your new players and how to relate to them.
For parents, encourage your athlete to work on skills around change and that everyone on the team likely feels the same.
Transition out of sport
“Any life transitions challenge my disorder because uncertainty is scary! I quickly want to run to old habits as a means of control. However, when I retired from basketball, which I had played for 26 years, I faced the hardest transition of my life today. I walked through letting go of deep, embedded emotions that rocked my identity. Finding my new normal apart from sport has been the longest yet most rewarding process. My team of support who I have leaned on has carried me. The Lord, my husband and close friends have challenged me and not let me go back.” - Sidney Spencer (former Vol & retired WNBA)
For an athlete that has been in sports most of their life, this can be a frightening time and even feel like a loss. Many athletes have reported similar feelings of grief and turn to familiar comforts such as control of food or exercising to a point of exhaustion.
Tips for Coaches, athletic trainers, and parents:
Keep the discussion open through their whole career about what kind of person they are outside of sport.
What would they do if their days & weeks were not centered around sport?
Normalize for the athlete how tough this can be and that you will be there for them and help them find resources is needed.
From a recovered runner now running coach:
“Before injuries even occur, I believe it's important for coaches to show that they are open to listening when an athlete feels pain, and to distinguish injury pain from soreness pain (pain that is achey and dissipates vs pain that is sharp, persistent, and worsens). We are responsible for giving them the knowledge to avoid injury by training SMART (not overdoing mileage, workouts, taking easy runs easy, etc), and fueling and hydrating throughout the day. When an athlete is injured we might address these potential risk factors to see what we can improve on in the future, and then move forward with the proper treatment options. This, of course, is the way to handle the physical side of the injury, but mentally, we want our athletes to know that we care for them whether they are running or not, and that we will always support the decision in the best interest of their bodies and minds.” Rachael Steil (former collegiate runner and author of Running in Silence)
When the door is left open it leaves the opportunity for the athlete to feel in a safe place that they can ask for help and that you will be providing it for them.
Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.