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Athletes and Anorexia Nervosa: An Elite Athlete's Story

Posted Dec 19 2009 12:00am

On the heels of my last post, which featured guest Blogger Patrick Bergstrom sharing about his experience as a male athlete with anorexia nervosa, we have another athlete's story for us today.

Lynn Bjorklund, an elite, record-setting distance runner who writes of her journey in my book, 100 Questions and Answers about Anorexia Nervosa, joined me on a radio broadcast a few weeks ago. The Dr. Casey Show on AM830 in Los Angeles is a sport psychology program and Dr. Casey dedicated the morning hour in November to the topic of eating disorders in athletes.

You can listen to the entire broadcast with Dr. Casey, Dr. Sari Shepphird and Lynn Bjorklund here... (just give the file a few moments to download...)

Dr Casey Show 11_15_2009_ AM830 KLAA

After the broadcast concluded, Lynn and I had a conversation about what she wished she would have shared had the nervousness of her first radio appearance not been a distraction to her. With gratitude to Lynn, she shares her "afterthoughts" with you here, and I am sure you will agree that they are an eloquent, powerful, and helpful account of her journey. 

It is getting towards Christmas and I always like to watch the presentation of the Christmas Carol by Charles Dickens.   I was intrigued at how the Ghost of Christmas Future helped to change the life of Scrooge in the present.   When I look back at my life and how an eating disorder so disrupted my dreams and plans, I wonder what would have made the most difference for me to prevent going down that path.  I think that if I could have seen the future consequences of my thoughts, choices, and actions, it could have gone a long way towards keeping me from falling deeper into the disorder.  I didn’t have that ghost of my future life to help me out, but perhaps I can be that for someone else.  That is why I decided to share my experience in the disease with others through writing and speaking. 

In my teenage years I never thought I was doing anything wrong or dangerous.  Quite the opposite.  I thought I was doing everything I needed to be doing at the time, just not well enough.  I was a young athlete who loved running and was trying to excel at my sport.  You are supposed to strive to be the best you can be; nothing wrong with that.   I learned that runners, especially distance runners, were supposed to be much leaner than the general population.  The overwhelming message that I got was the thinner the better.  Not only did extra fat and weight slow you done, it was downright evil.  Everyone seemed to be on a diet.  Back in the 1970s we were learning that the fat you ate caused clogged arteries, heart attacks, strokes, diabetes, and just no end of physiological horrors.  The fashion industry decreed that beautiful meant rail thin. If you wanted to be successful, loved, and healthy you had better be thin.  I believed there was no such thing as too thin.

I got started into anorexia in my teenage years when I was brutally bullied in Junior High School.  Kids that age can be horrifically vicious, and it is an age where you lack the perspective of anything but the now and your immediate environment.  Events can be enormously important and have tremendous impact and influence.  I lacked self confidence and self esteem.  I had a tendency for perfectionism and it felt that my world was out of control.   I felt lonely and isolated.  My escape was running in the mountains and I became a good athlete mostly by accident.  I won some races and set some records.  The excitement of racing and the camaraderie of being part of a team or just a participant in something exciting seemed to ease momentarily the feeling of self hate, loneliness and isolation that was my life at that time.  But it was never enough.  It can never be enough when you try to get your self esteem from external sources.

Where athletes get into trouble is when your sport defines who you are or gives you that sense of external and conditional self esteem.   I had tremendous drive and motivation to succeed and do well.  That drive and intensity are mostly admired in our society.  It gets athletes to the Olympics and winning gold medals.  It can also get you into eating disorders or trying performance enhancing drugs.  So how and where do you cross the line into a recipe for disaster rather than the formula for success?   I think it comes down to knowing the why of what you are trying to accomplish in your sport and what is really important in your life.  What are you running for or what are you running from?  I think to be a good and successful athlete you have to start with solid self worth apart from your sport.  You need to have a balance in your life such that you are much more than a good athlete; you also know that you can contribute to the world and others in many different ways.  You can be a good friend and valuable member of your community and know that people like you apart from how you happen to do in your sport.  Then you are truly free to be the very best that you can be.  The pressure is lifted and you can have a more long term attitude towards enjoying your sport for a lifetime.   You don’t have to deny that your body is tired and needs to rest.  You don’t need to hobble those 10 training miles with a stress fracture or tendinitis, or be back out there pushing your limits the day after a high fever.  You can eat when you are hungry even if you are injured or taking a day or two off. 

An elite athlete trains on the edge of disaster.  The body responds beautifully to the right schedule of training stresses.  However, too much stress and not enough nutrition and/or recovery pushes your body towards injury and illness.  Too little or too much stress makes a tissue weaker.  You need to stay in that zone of just enough, and that takes a very high tuned and honest appraisal of yourself.  It takes wisdom and patience to take a day off or an easy day because that is what your body needs, rather than what your mind thinks you should be doing.  The mechanism of denial can be so powerful, that many a young, motivated, athlete just doesn’t see the signs of overtraining until way too late.  A good coach is one who knows when to hold an athlete back a little. 

In the teenage years, the brain doesn’t have the full ability to really understand future consequences like you can in later years.  That State Meet is all important, and you rationalize that you can rest up and change your ways later.  A young woman can think, “I will worry about not having my period and eat more after this season is over.”  The way athletes fall into the disorder of anorexia is that it seems to work really well for them for awhile.  It did for me.  I was diligent about cutting down the calories and increasing my workout schedule.  The pounds fell away and it seemed to result in better racing.  Being successful at something is a powerful feeling of positive energy and control.  It is easy to think if a little is good, more should be even better.   With the resiliency and adaptability of youth, it may even be that way for awhile.  You can deny that you are starving and exhausted.  After a period of time, however, I would always crash and pull up injured, and be forced to cut back.  Then when my body was rested I might sneak in a race and do incredibly well.  How much better it would have been to just take some days off prior to getting injured.  Anorexia doesn’t let you do that.  The disorder pulls you away from health and vitality ever so slowly and subtlety.  When I was firmly in the grasp of anorexia I believed that if I didn’t run 10 miles or more that day I didn’t deserve to eat.  I wasn’t good enough to eat, and if I did, I needed to punish myself by not eating for a long time and exercising as intensely as I could.  If I did well in a race – even set a National record, it was never good enough.  It was a lucky accident if I won, and I needed to be thinner and faster next time.  There was no real joy or sense of accomplishment in anything I did.  The theme of my life was: it is never good enough.  After a very short period of success, I was increasingly caught up in anorexia, and thus began the steady decline of my ability to participate in my sport. 

There are varying degrees of eating disorders from life threatening to just an obsession that decreases your quality of life.  So what are the future consequences of falling into an eating disorder? 

1.    For women, the effect of not having your period can cause life long damage to your bones.  The most critical bone development that will see you through your lifetime occurs in your teens and early 20s.  If you are not having periods during this time it means your body isn’t producing estrogen that is so important for bone development in young women.  On top of that, you aren’t getting the adequate nutrition to enable strong bones. If you are severely underweight, you also aren’t putting the lines of stress on your bones that would encourage that growth and strength.  If you are in the disease long enough you will never have the bone strength and density you would have had in normal circumstances, especially in the spine.  Even after recovery, you likely never get this back. Such was the case for me.  This may not be a problem for many a decade, but can cause you great misery and expense in your older years.  Bone density drugs may help, but they have side effects, cost a lot of money, and the bone mass is never as strong as what you could have had naturally. 

2.   You put yourself at risk for frequent injury and long term injury.  When you are very underweight your body will use muscle tissue for energy.  Anything that is not directly being used for your activity gets used up.  You may think you don’t need any extra strength and muscle, and that it could even be a hindrance.  But strong bone and muscle is essential for long term health and success in your sport.  The diminished muscles that hold your joints stable may not be adequate to prevent injury and damage.  For example, with the knee not tracking properly due to weak hip and quadriceps, many runners experience knee pain, and the cartilage can wear out in non uniform patterns putting you at higher risk for an early arthritis.  Good muscle strength and balance are so important to help prevent various chronic joint and back problems.  You may get away with a lot in your youth, but then become more prevalent and limiting in your older years.

3.   When you are a fit athlete your heart rate is lower.  That is a good thing, right?  It usually is, meaning that your heart is stronger and more efficient.  In starvation, however, the body tries to adapt, and the resting heart rate may be even lower yet in an attempt to lower metabolism and save energy.  Couple that with starvation and electrolyte imbalance which is crucial for heart beat regulation, and you have a potentially deadly combination.  This is often the scenario that occurs when you hear reports of anorexic athletes who died in their sleep because the heart just stopped beating.  Sometimes the athlete isn’t even labeled with anorexia, just someone (men and women) who were at the peak of fitness and at a very low body weight.

4.   Once you get into an eating disorder you loose touch with the naturalness of eating and create a monster.  You replace easy, spontaneous, healthy eating habits and patterns with fear, obsessiveness and emotion based eating.  Even if you don’t get into life threatening extremes, this obsessive pattern greatly diminishes quality of life and can be very hard to overcome. 

5.   An eating disorder dominates your life and becomes very isolating.  I never realized just how much I lacked good communication and relationship skills until I was trying to support myself with a job that demanded these qualities.  I had to make up for a lot of lost time and learn the skills most people develop during their teenage years.

6.   You may loose the enjoyment of your sport and perhaps the ability to continue with it.  The goals of the disease and your sport get intertwined.  It may become a desperate way to try to survive in the world rather than true sport – the fun, relaxing, fulfilling part of your life that it was meant to be.

These can be some of the consequences of falling into an eating disorder.  It should provide motivation to avoid falling into one in the first place and seeking early help if you are already engaged in one.  To end on a positive note, here is a partial list of what you can get out of the recovery process.  It may be difficult and expensive, but will be one of the greatest investments with the greatest returns you will ever make.

You learn skills that will serve you for a lifetime.  You integrate body, mind and spirit to be more complete within yourself.  You develop an empathy and understanding for others in various addictions and life struggles that you may never have had otherwise.  You are in a unique position to help those engaged in these battles.  You learn a true sense of self worth and self confidence.  You find that you can channel that energy and determination that used to be associated with an eating disorder towards other goals such that you can make contributions to the world around you that you would have never guessed or imagined.  As an athlete you are finally free to enjoy your sport the way that it was meant to be.  You are able to listen to your body with honesty rather than denial, and take care of it such that you truly can be the very best that you can be for all the right reasons.

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