I think our definition of success in sports is incomplete. We watch athletes reach top podium spots and break records, but we pay no attention to how long these winners stay in the sport. How many years do their bodies let them show up to start lines and reach finish lines? Longevity, right now, doesn’t count enough towards our measure of success.
In March 2020, I finally admitted to having an eating disorder. Many have spoken up before me. I've read stories from athletes who I thought had everything figured out. I've read about their struggles and have witnessed their subsequent progress. And I became more jealous of the guilt-free cookies they ate than I was of their achievements in sports. Reading about their challenges gave me the courage to confront mine. I hope this article might do the same for someone else caught inside this disease—one that takes up so much brain space and displaces so much joy.
It all started in the gym
Growing up as a gymnast, disordered eating has been a part of my life for as long as I can remember. It took on different forms as I was growing up. First, I was picking out carrots and corn out of vegetable medleys and refusing to eat carbs after 2 PM, despite training for over four hours in the afternoon. Then it manifested as refusing desserts—for 14 years of my life. Eventually I wasn't eating at all. Finally, it was purging at the end of the day, every day, for the past six or so years. Eating disorders took so much from me. I missed out on ice cream dates, dinners at friends' places, and exploring new food on my travels. When food was at the center of my attention, the joy of social interaction diminished. In the end, it was easier to just eat dinner at home or pack my suitcase with familiar foods when I traveled abroad. But there was one thing my eating disorders never took away from me: athletic performance.
An iron deficiency was making me exhausted
I had just started elite obstacle course racing (OCR) when I entered graduate school. Juggling classes, research, and training was a lot of work, and I remember feeling exhausted after most of my hour-long morning runs—so much that I could barely manage the 20-minute walk to work. InsideTracker partnered with Spartan that year, and as one of the pro team members, I had sponsored access to their tests. When my ferritin level was at 6 ng/mL, below the lowest mark on the visible chart on the platform, it was clear I needed to make changes. I added more red meat and leafy greens to my diet, bought supplements, and followed recommendations for better iron absorption. It took me two years to raise that value to an optimized range for an endurance athlete, and right now it sits at 59 ng/mL.
I wish I could end here—a success story of a once-tired athlete. I didn't manage to save my iron levels by eating more, and I found myself coming up with work-arounds using supplements to make my ferritin levels rise. But I wasn’t healthy. I just learned how to cheat.
My chronically-elevated cortisol was impossible to escape
You can supplement your way through vitamins and minerals, but there’s one biomarker you can’t cheat: cortisol. Cortisol is a catabolic steroid, meaning it breaks down muscles, utilizes the amino acids that they are made of, and converts them to glucose for energy. Performance-wise, elevated cortisol counteracts the muscle build we work so hard to achieve. Testosterone, on the other hand, is anabolic—it builds muscle. It's for this reason that the testosterone-cortisol ratio is a good indicator of whether you’re in the muscle-building or muscle-loss state. Since my first test in 2017, my cortisol level has been chronically elevated (in the danger zone) and my testosterone-cortisol ratio is low, meaning my cortisol is effectively dominating my testosterone.
Chronically elevated cortisol doesn't just negate training adaptations, though. It can also lead to anxiety, depression, decreased bone density, loss of muscle mass, a weakened immune system, diminished learning and cognitive performance, sleep problems, and even heart disease.[1] Cortisol concentrations rise as a result of any kind of stress—a hard training session, hard day at work, stress related to personal relationships, and even when your mind is stressing about food. Your mind can undo the hard work you put your body through, which is why mental health is just as important as physical health.
At first, I looked elsewhere for answers to my elevated cortisol. Maybe it was the stress of graduate school, maybe I didn’t sleep so well the night before, maybe the effects of that hard workout a few days ago still lingered. Test after test, it became clear that my eating disorder was likely at fault—it was causing major stress on my body. I was very vocal about the importance of healthy eating for athletic performance throughout those years, and if you followed me around during the day you would see my actions reflect those words—up until the end of the day, when I undid all that work squatting over the toilet. I thought that, if I talked loud enough about being a healthy athlete, my brain would hear it too. But my cortisol wouldn't listen, and it was impossible to outrun.
I was winning races. But wins don't equate to good health.
But for the past few years, my performance disguised these internal issues. In 2017 and 2018, I finished on the podium for the Spartan US National Series. I also won the World’s Toughest Mudder, a 24-hour running race with obstacles, both years. In 2018 and 2019, I won every other endurance OCR race I entered. And in 2019, I won the Spartan Ultra World Championship and finished second with my team at the Eco-challenge, a 700km+ adventure race in Fiji. My athletic performance, it seemed, wasn’t affected by my eating disorder.
I was even able to interpret most of my bloodwork in the same way. Many of my biomarkers remained in the optimized zone. Because I’m on birth control, I never lost my period, and DHEAS, the non-cyclical precursor for sex hormones that drops as a result of under-fueling, remained optimized. Creatine kinase (muscle health), vitamin D (bone health and energy), calcium (bone health), folate (cell production and repair), sodium (fluid balance), and potassium (blood pressure regulator), all stayed within a normal range.
When I look back, however, I know I wasn’t healthy. In the years leading up to 2020, I mostly trained through pain. Whether it was my foot, ankle, or something else that was aching, running stopped being enjoyable and became work. I was still winning, but I became slower, so I gravitated towards longer events. When you race for 24 hours or for several days, the race is just as much of a mental challenge as physical, and I became really good at blocking out pain. But I could no longer push my body into the red zone. I lost speed, partly because I could no longer train at those intensities due to lingering injuries and partly because of my perpetual under-fueled state.
Finally, the turning point came. And it got worse before it got better.
When I got the call that the first race of the 2020 season was cancelled and realized there wouldn't be another race for a long time, a switch flipped in my brain. I decided, in that moment, to just stop. To stop purging. To stop restricting desserts. To stop skipping meals. To stop taking ibuprofen just to make it through an 8 mile run. I decided to finally let my body and mind heal.I knew that, once I stopped purging, I would gain weight. I accepted that I would slow down before I got faster. For over half a year, there were many days when I questioned whether I would ever be able to compete as a professional athlete again. I felt slow, heavy, and I chaffed in places that my skin never rubbed before. Training became really hard and I didn’t like how I looked or felt for a very long time. Objectively, I was still in great shape, looked lean, and ran fast, but I was heavier and slower than I was before, and some days that’s all my brain could focus on.
I told my boyfriend about everything, and on those hardest days, he held me accountable and kept me on track. I shifted more of my training to the bike, which was less punishing on my joints and where I had fewer benchmarks of my own past performance. And I reminded myself that this stage was going to pass.
I now know that cookies and ice cream make me faster
I did a ski mountaineering race last month. I started the day with overnight oats for breakfast two hours before the race. I raced hard, mostly in the threshold intensity range, feeling strong, fast, and light on the climbs. I was grinning of happiness on the descents and fueling with energy gels when I got to the bottom. I finished second. I had a bagel for lunch and cookie for dessert, which gave me the energy to do some fun downhill ski laps in the afternoon before a meal of pizza and an ice cream shake. Two days later, I did a recovery run completely ache- and pain-free. Foods that I believed for so long would make me slow and unhealthy actually made me fast, strong, and healthy.It took my body a year to relearn how to metabolize food. During that time, I avoided mirrors and photos and was grateful for the lack of races (and the opportunity to measure my performance against my old benchmarks or my competitors). I didn’t do any blood testing for over a year; I didn’t want to know. I worked with nutritionists, spoke out about my disordered eating, and forced myself to eat lunch and cookies and ice cream for dessert. Eventually, cookies and ice cream became less scary and eating lunch is something I now look forward to. When you add in another meal, the variety of foods you get to eat in a day expands, and so too do your energy reserves for afternoon activities. I can do evening races I used to be too tired and hungry for. I can now enjoy ice cream and cookies and be an athlete.
It shouldn't require a pandemic for athletes to stop and heal
COVID wrecked the world and caused so much hurt. People lost so much, from deaths of loved ones, to jobs, to social interactions some relied on for mental health. But the period of recovery that the COVID pandemic afforded me was my salvation. If it weren't for the year-long off season, I never would have had the courage to confront bulimia. I would have kept going until my body couldn't. I know this break also gave other athletes time to heal, and I imagine it saved more than just one athletic dream.It shouldn’t be like this. We should be celebrating longevity just like we celebrate podium finishes. We should put as much emphasis on mental health as we do physical. We should celebrate strength, power, and endurance instead of body types and six pack abs. We need to keep repeating that any food is good food, that cookies and ice cream are fuel, until all athletes hear us. We need to keep saying that, while under-fueling might get you to the top of the mountain now, it will take many more future summits away from you.
We shouldn’t need the world to get sick in order for athletes to get healthy.
