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.
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.
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 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.
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.
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 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.