The Appetite Episode #23: Was I Only Fast Because I Was Anorexic?

An Opal: Food+Body Wisdom Podcast

Does weight really matter when it comes to sport performance? Host Carter Umhau, LMHC, and Kara Bazzi, LMFT, CEDS explore culture around food and body within the sport world, and the idealization of the athlete. Kara–Clinical Director and former division I collegiate distance runner–shares from her own experience of an eating disorder, and we bring in dietitian Kelly Finan, RDN with the hard science to break some myths around the importance of low weight in sport performance.

Links and Resources:

 Lane 9: a resource for athletic women struggling with eating disorder or amenorrhea recovery

NEDA coaches and athletic trainers toolkit


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Episode Transcript:

Carter Umhau:                  Hello, and welcome to The Appetite, a podcast that’s all about food, body, sport, and mental health. The Appetite is brought to you by Opal Food and Body Wisdom, an eating disorder treatment program in Seattle. I’m your host, Carter Umhau, a therapist at Opal, an artist, and writer. Today, Opal co-founder, Kara Bazzi, joins me to reflect on the over emphasis of weight within sport performance. As a former collegiate athlete that struggled with an eating disorder, Kara has an insider view into how attitudes around weight sports can lead to a disordered, or even toxic, team culture. We’ll be debunking some myths around the importance of weight in sports, so stick around for when dietician, Kelly Finan, joins us to explain why weight loss really does not necessarily signify an increase in athletic performance.

Kara Bazzi:                           Kara Bazzi, I’m the clinical director at Opal. So this is a bittersweet time for me. I think on the sweet side, it’s fall; Fall represents fall sports to me, cross country season, I think of the many years I participated in that sport. My husband is a coach for cross country and he’s been doing that for the last 15 years, and then this year, it’s really exciting because my daughter has actually just started cross country and it’s been fun to watch her take up the sport and really enjoy it. But I also say it’s bittersweet because of the history I’ve had also with the sport that has been hard, and difficult, and brings up conversation about eating disorders, compulsive exercise, and my own history around that.

Carter Umhau:                  Considering how much you were struggling with food, I imagine that the team culture was maybe even supportive of that. Can you tell us a little about what the team culture looked like?

Kara Bazzi:                           Yeah, you know, it’s interesting because eating disorders are so complex, there’s so many factors. But yeah, for me, the team culture and the coaching were part of the start of my eating disorder. I certainly don’t believe in blaming particular parts, but it was part of the equation, right, and so I think in my team, there was a lot of things going amongst team mates that was seen as normative. And now looking back, it’s almost hard to imagine that we all believed that that was just normal behavior such as not eating enough food. I mean, I was aware of some team mates that were purging, and yet, in my mind, all of this was kind of in the name of athletics and doing what you needed to perform well. Here we were at the college scene which was so much more intense than in high school. And so it’s sad, but I really did it as normal and didn’t question until many years later.

Carter Umhau:                  I’m curious about kind of what the messages were for you around what would happen if you did gain weight back once you were recovering from your eating disorder?

Kara Bazzi:                           So, for me, when I got on the team, there was kind of an assumption that I would lose weight regardless just because of the extra training because I was, again, coming from a basketball background and I hadn’t… the mileage I was running was pretty low in high school. So there’s just kind of an assumption that with all the training I was going to have, I was going to lose weight which that’s an interesting assumption to make, too. But my extra training and I was highly restrictive, which again, I wouldn’t have classified it as that at the time. My weight dropped significantly and my performance did improve, but really what changed things for me was that eventually I couldn’t… I mean, I couldn’t keep that up and so I did start binging and going through more of a restricting and binging cycle, and my weight kind of fluctuated all over the board as a result of that. And again, there wasn’t an direct messages about my weight at the time and how that was going to be impacting performance, but I think it was kind of one of those unspoken… Watching other athletes and hearing kind of comments other people would make about that bias that a lot of the distance running community has that thinner is better, thinner is going to be faster, and me just trying to scramble because I just wanted to do my best and I felt like it was I couldn’t make myself stop binging and I thought it was a will problem, and that was really difficult for me given that I was such an achiever and I could usually accomplish anything I wanted. But that was back when I felt like I could’ve, kind of, play god, I guess, on my body, and control it, and manipulate it, and I just couldn’t do it. So I was very down on myself.

Carter Umhau:                  And I bet for a lot of people hearing that you can’t play god on your body is actually not obvious. There are so many messages that really we should be able to control our weight, and we should be able to control what we eat. So I think I want to just point that out as especially as you talk about restricting for so long and then binging. Of course you were. If you weren’t eating properly, your body was desperate for food. And so, yeah. Just to put that out there that some of that really can’t be controlled at some point.

Kara Bazzi:                           Right, and at that point, I had no compassion for just biology. I thought it was more of a will, like my own control, like I wasn’t controlled enough, which is really ridiculous at this point looking back.

Carter Umhau:                  So when you did start running again, how did it go?

Kara Bazzi:                           So when I graduated, I actually ended my senior season with a stress factor which was devastating. But there was something in me, as an athlete, that just wasn’t satisfied with kind of ending, I guess, with that now that I call it like that bias around weight and performance, and I was determined… There was something in me that was determined to prove otherwise the fighter in me that says, “Is this really true? Was I only fast because I was anorexic?”. And I was doing enough work around myself at that point to be able to really engage that question and I knew at that point I could tolerate if the answer was, “Yes, so you were only fast because you’re anorexic”, and I knew that could be a possibility, but I wanted to see. I really wanted to have data points. And so at this point, I was fully nourished, I had restored weight, and I had just gathered data points. I remember at one point, my husband was coaching me. I also ran for club North West for a stint and I remember training for the half-marathon and it was sort of going to be my quote unquote… one of my quote unquote, “tests”, that I was doing because I had run a half in college. And I actually trained well for it, and that was race, I was 15 pounds heavier, and I was actually slightly faster than that half-marathon that I did in college, and there was something really meaningful about having that kind of information to break, to poke at this belief system around weight and performance, and to see, yeah, that is possible. I think that opened up this curiosity that I had that I was hungry to know more, what are other athletes where that this is their story, too? And like the… not only what are athletes that have this story, but if that’s the case, how sad that so many athletes are just in misery trying to get that peak performance and doing things to manipulate their weight and preoccupied with food and destroying themselves to get there when what if they don’t have to do that? It sounds almost too good to be true, but I would say now, with my relationship with running how it is, I certainly believe that’s a possibility. The scary part is it’s not guaranteed, but that is an even possibility. So through this last gosh, I’ve been in the field since 2002, and the health field and worked with lots of athletes and I could easily tell you a handful of athletes that I’ve worked that are distance runners, at least in my sport, who have proved that wrong, who’ve had had this belief that they had this race weight or this small little range of race weight, and they were willing to experiment and to eat adequately and nourish themselves, and their weight changed to some degree and they were able to perform just as well if not better. So I just think I want that message out there because… I mean, we need to question that, at least question it, at least poke at it because as far as I understand, there isn’t science that’s pointing to that there is a race particular weight that someone needs to be for peak performance. In distance running, in all of these more aesthetic demands or weight demands sports that there isn’t a particular way we need to be.

Carter Umhau:                  So I’d love to actually get some of the science around this. So we have Kelly here.

Kelly Finan:                         Hi, I’m Kelly Finan. I’m the sports dietician with Opal and I completed my undergraduate education and graduate education at University of Washington and got a lot of my experience in sports nutrition working there, and have since joined Opal team.

Carter Umhau:                  So, Kelly, as a dietician, what would you say about like why Kara would maybe be able to actually perform better at a higher weight?

Kelly Finan:                         Yeah, I think in many sports especially those are focused on weight as something that can br manipulated to enhance performance that there may be an initial temporary increase in performance following restriction or just engaging in really controlling behaviors with diet and exercise. The explanation for that comes from kind of an initial, well, related to relative energy deficiency in sport just the initial temporary increase in performance is kind of associated with almost a euphoric state and then the body actually becoming more efficient in taking up oxygen and that leading to some performance improvements. So those are short lived though, I think is the key point with that. A lot of athletes do see an initial improvement, but then that’s quickly followed by risk for injury and leading to injury stress fractures, illness, things like that.

Carter Umhau:                  So there would definitely be sort of that positive reinforcement of like, “Oh, some weight has been lost, I’m doing so well, this is going great”, and then things come crashing down.

Kelly Finan:                         That’s where it’s really temporary and just seeing the impacts of the body not having enough energy to support continued movement engagement in sport. That’s where, yeah, the risk for injury is high, and illness, and just the stress of being in that state of low energy availability.

Carter Umhau:                  Okay, so when you talk about there being an only short lived amount of kind of peak performance, or at least improved performance, why do you mean by short? What would that look like?

Kelly Finan:                         So that can vary so much, I think, athlete to athlete, but I would say in terms of long term energy availability, there are often impacts on internal body systems that you may not be realizing that could happen before the performance impacts. So changes in hormones, the changes in immune functioning, and things like that, that could be happening earlier on, but there’s no set timeline and I think once athletes start to see those performance decreases, or impacts, of low energy availability on performance, that’s when they often recognize like, “Okay, what’s going on? What’s happening?”.

Kara Bazzi:                           So, Kelly, in my situation though, when I gained the weight, how can you explain how I was able to perform slightly better than my lowest weight when I did have that initial performance improvement?

Kelly Finan:                         So that’s where I think the focus on weight for performance can be harmful for athletes because it doesn’t address the importance of fueling on performance. So focus on weight is something that’s hard because weight is not something you can control or manipulate directly. Focus on fueling though to optimize performance, that can lead to a lot of benefit for, not only performance, but health and just longevity in sports. So I think with adequate energy intake and just really fueling for your sports, that’s where you see benefits for recovery, and muscle building, and body composition, and really just supports performance long term.

Carter Umhau:                  Is there anything you would say about maybe the emphasis on highly structured diet for body composition changes that would be relevant to this as well? Can you imagine that kind of being a slippery slope too?

Kelly Finan:                         Yeah, I think with individual clients or athletes, there’s always kind of what thinking about what’s going to be best for them and what is really going to support health, and sometimes the recovery process, and also performance in sport as it’s relevant. So I think looking at the evidence based guidelines that exist at the time and really turning to the research and seeing, “Okay, what’s best for performance, but what’s also best for health.”. So focusing on fueling and some specific strategies nutrition wise that could be helpful, things like training low or what nutrients to emphasize when in the diet could be helpful for performance instead of focusing on things that are restrictive. So I think specific strategies to really optimize one’s nutrition status are really effective and helpful, but that doesn’t mean that it’s restrictive or dieting.

Kelly Finan:                         So I think thinking about the difference between fueling nutrition strategies versus a focus on weight, there’s such a difference there.

Carter Umhau:                  Amen to that.

Kelly Finan:                         I think just thinking about all of the factors that impact performance beyond nutrition and beyond body composition, so things like sleep, stress levels, thinking about the bigger picture, and controlling the factors with performance, or the factors that impact performance that you can, because weight is not something that you can control really. You can focus on optimizing body composition through nutrition, but you can’t control what you’re weight is.

Carter Umhau:                  What do you tell people that say, “Yes, you can control what your weight is”?

Kelly Finan:                         I would say you have to think about how much of your weight, or set point, is from your genes, or encoded into your DNA, so the saying, “You can’t fool mother nature.”, is so relevant and important to recognize, yeah.

Carter Umhau:                  That maybe you could lose some weight temporarily or something like that, but at the end of the day, your body and your particular DNA is going to require, or wind up looking a certain way.

Kelly Finan:                         Yeah, that your body wants to be at a certain place with weight to support health and performance, and if you’re forcing yourself, or trying to get to a weight that is not in that set point range, that’s where you’re going to see those performance impacts or the performance consequences in health consequences, yeah. Your body is going to fight you, yeah. Every step of the way.

Kara Bazzi:                           So you’re saying that if I wouldn’t have been restrictive and manipulated for that period of time, then I could’ve succeeded even more?

Kelly Finan:                         I would like to think that, yeah, that you know it. You know it’s hard to say, hard to say, but there’s so much benefit to focusing on fueling strategies and nutrition for long term period performance in health, not just the short term. So I think in terms of recovery, building muscle, preventing illness or injury, there would be definite benefit to more consistent adequate food intake to support performance.

Kelly Finan:                         Love it.

Carter Umhau:                  Thank you so much, Kelly.

Kelly Finan:                         So, Kara, what would it mean if actually weight wasn’t the main factor in improving performance?

Kara Bazzi:                           What I often see and I felt as an athlete and what I see with my clients with their sport experience is if we emphasize weight, then it’s kind of… I can’t help but think about placebo effect, right. So if somebody is saying like this is exactly what I need to… These are these specific conditions that I need to do well, and sadly, if we can’t control our weight very easily, that can be a very difficult place to be in that could actually negatively impact our performance. But what if it’s because that’s what we believe? Placebo effect is real, and so if we actually turn towards other performance factors that we have more… that are more in our control like, I mean, nutrition could be one of those. How are we feeding ourselves? How are we managing our relationships? How are we making decisions about sleep? How are we being free though? I think a lot of… where’s the joy in the play in our life because for those athletes that are especially on the over-controlled side, I think, a lot of times, they’re just, I think, they’re focusing on too much on the little things. I focus too much on the little things then I wasn’t having any fun. And that actually, I think, impeded my performance.

Carter Umhau:                  One of the things that I think is probably most attractive about watching sports is the magic of it. And so when we think about the athlete, we think about someone who has this power in their body and that then performs this magical feat. What seems to be happening most often in the sport world is that seems to be kind over-controlled then, this idea of the athlete being a powerhouse. How can we make the athlete even more powerful? How can we make sure that this person’s performance is at peak based off of this weight, based off of this intake, based off yada yada yada. And so what I hear in all of this, too, is just like, what does it mean if the athlete’s not a machine, and what would it mean if we were able to psychologically investigate a little bit more of the magic that could happen, too.

Kara Bazzi:                           Exactly, I think you’re hitting on something really important of just the robot versus the art.

Carter Umhau:                  I’m curious about if there are other athletes that you can think of that sort of serve as examples of maybe where this assumption around weight isn’t true.

Kara Bazzi:                           Well the first person that I think of that’s been pretty outspoken in the running community is Allie Kieffer. So she was the gal who ran in the New York City marathon and was second American to cross the finish line and she’s been very outspoken about trying to conform to kind of the runner ideal weight and feeling that pressure, and then in doing so, she was restricting and her performance suffered as a result of that, so she let go and nourished herself better and she had a 26 minute PR. So we need more stories out there like that. I think that especially for athletes who… You know, there is something to be said about the athletes that garner respect of people that are doing it in the high levels and to give that role model to model that for us, athletes that are free in the relationship with food, free in the relationship with their body, and they’re performing really well. So she’s definitely somebody whose outspoken, I think, Lauren Fleshman is another one in the distance running community that’s been spoken openly about it. But sadly, there’s a lot of people that taken down by it. Then they end up often times just leaving the sport because they’re trying so hard to do this and their life becomes miserable.

Carter Umhau:                  Because they’ve turned themselves into a machine, or someone else has?

Kara Bazzi:                           And then who wants to do something that’s that miserable for years and years. Joy, people. There’s some joy to be had, and I can’t help thinking about kids. I really can’t help thinking about kids, I think the competitive environment right now in sports is notable and it’s getting younger and younger, and I certainly hope that we’re cultivating joy with our youth athletes and not emphasizing kind of this machine mentality.

Carter Umhau:                  May be a strange a question, but why is everyone obsessed with sports? I don’t say that in a critical way. Not at all. I just sort of had a stepping back moment. Like why is there such a pressure for an elementary school kid to suddenly become obsessed with sports? I wonder what that is about.

Kara Bazzi:                           It’s a great question, Carter. I’m not entirely sure. I do know that there is just this… this could be extrapolated beyond sport, but sort of this, I’m, like, almost… If I don’t do this now, what’s going to be the negative consequence of, if I don’t get my kid into this sport, are they going to miss out because if the other kids started this young and they’ve done this training and this competitive stuff, they’re going to have an edge over my kid and they might not have as many options. I would say it’s coming from a restricted mentality of, we don’t have an abundance of options with elite sports and opportunities for college and professional athletics especially when it comes to training and development. And so if I don’t get my kid in it now, or yesterday, then they’re not going to have the opportunities. So I think it’s pretty opportunity driven especially from a parent’s perspective. We can get into the rising cost of education, scholarships, that could be a big motivation if people are afraid they’re not going to be able to afford their child’s education, and that’s, you know, but athletes get a lot of privilege when it comes to education, and scholarship, and money, and funding, and all those things, right.

Carter Umhau:                  It’s really striking to think about opportunity being such a big part of this. You know, I had spoken earlier about the idealization of the athlete and I’ve been thinking this time about kind of the Roman athlete in the coliseum and how many people would come to watch how these bodies were deified in a lot of ways. But to even think now about maybe kids from much lower socioeconomic status and their bodies are their ticket. I was reading about something in the French win for the world cup. I was watching Trevor Noah’s late night show talking about some congratulatory statement he’d made about, “Wow, you know, the entire French team is African, that’s amazing”. And the, I think it was the ambassador or the prime minister, I don’t know, the president of France maybe had responded and said, “No, they’re not African, they’re French”. And he was doing some incredible racial commentary on that statement, but the thing I really gleaned from it and feels relevant here is that the sport world brings people in in order to profit from them. So as we’re talking about a distance runner being able to find their peak performance at a particular weight of course there’s a kind of a larger umbrella system that’s asking this runner, this African soccer player to become a bit of a machine for their establishment.

Kara Bazzi:                           And that’s what, you know, high performance is a big deal and I can understand that on a lot of levels. I think the thing that I just want to keep challenging is, is it necessary to sacrifice these components of being a human in order to be a peak performer, and that’s the piece that I just think we do way too much of that. That I don’t think that’s necessary, but I think people believe it’s necessary and that’s why people do it or else why would you do that if you didn’t think it was necessary, right. We went to a conference last year and the victory conference which is an eating disorder and sport conference and one of the presenters worked for the international Olympic committee and she was the sports psychologist for the combative sports and it was fascinating to hear about their experience because these boxers were low SCS athletes who were doing incredibly dangerous practices to make weight and they had to be flown over into their international competition, and if they didn’t make weight, they couldn’t compete, and they didn’t have the money, the IOC wasn’t paying for their ticket back. So they didn’t have the money to fly home from being abroad, and so of course they’re going to, I mean…

Carter Umhau:                  They’re going to do anything to be able to stay.

Kara Bazzi:                           Yes. So I think there is a lot of that, and yet, I just can’t help but wonder if they described why weight class sports started to begin with and they talked about we’re just trying to have more fair matches, but then because of performance, people are trying to manipulate that to come out on top. So there’s just a lot to be motivated to come out on top. So it’s tricky. I mean I felt like I… that was a lot, I had a lot of pause hearing that story of just like that is a really hard place to be to help those athletes win. You know, them flying home is on the line. You know. Like they didn’t have the resources.

Carter Umhau:                  And the bodies are just being destroyed.

Kara Bazzi:                           Exactly.

Carter Umhau:                  I even feel weird just having said, “The bodies.”.

Kara Bazzi:                           Right.

Carter Umhau:                  At some point, been thinking about someone that’s having to drop weight that quickly and then left in whatever place they didn’t make weight, or the NFL players who are losing their brain function from repeated concussions. Like so many body- [crosstalk 00:26:27]

Kara Bazzi:                           It’s an ethical question, right. It is an ethical question, like, at what cost? At what cost, and does the athlete get to choose that. But I would also propose that how informed is the athlete. Again, are they really making an educated and informed decision of the at what cost question. Are they getting the actual appropriate information, too, like how many athletes are educated about reds, and adequate nourishment, and the effects of malnutrition, and long term psychological impact that could have on themselves. I doubt many athletes are getting that kind of education.

Carter Umhau:                  No, I don’t assume so.

Kara Bazzi:                           Yeah. It’s hard, I feel like that’s where I have so much energy around how can we get this message out there to more people and at least if something’s that you’re not sure if… if there’s something they’re not sure about, st least we’re asking the question, and wondering, and seeing if we can go about this differently. With the same goal of, I mean, performance doesn’t have to be just taken off the table. I think that the Me Too Movement has just impacted lots of different systems and certainly what happened with Larry Nassar has gotten a lot of press and I do think people are having to athletic departments and sport organizations are having to now actually pause and consider things in a different way than they ever have before. Things aren’t tolerated in that the way that they had and there’s still a lot of shifting and changing that needs to occur around how we are caring for our athletes. I think that mental health is an interesting one because in most athletic departments, the mental health services just pale, like the amount that is invested just pales in comparison to a lot of the things that have to do with the physical training, the equipment, the training room, the uniforms. You know, all of the money that is put into sports and just such a tiny little drop of fraction is put into mental health, and so I would love to see that just grow in mental health and psychology to be elevated as a more important factor because I certainly know, and we see this in the news, all these mental health things that come out with really incredible, famous athletes. And again, at what cost? It’s like after somebody has performed really well and then they go through drug rehab or the drug and alcohol piece of it is also a huge cost that can occur that isn’t getting attended to probably well enough.

Carter Umhau:                  So, yeah. Both the actual hell that someone can go through because they’re trying to tolerate how much the pressure is on them, maybe something they’re doing to themselves, but then of course also being in a system full of power and no emphasis on caring for the athlete as a whole person. It makes a lot of sense that there could be sexual, emotional, psychological abuse within any of those systems given how much power there is and how much pressure there is to perform. So given the fact that there is such a power dynamic and the sports world is just powerful in of itself. I’m curious what you think, Kara, about why, or how, the coach could change all of this?

Kara Bazzi:                           Yeah, well I certainly don’t think all of it is all on the coach, although, the coach has such power in a athlete’s life certainly more than treatment providers typically do. I just feel like that basic thing is for a coach to address this, like reflect on this, ask themselves what are their beliefs around weight and performance, what are their beliefs around nutrition and performance. Kind of have an assessment of where they’re at, and then also get resources and get the support and… I mean, there’s a humility involved in that and I think that can sometimes be hard given that a lot of coaches about having an authoritative presence, but it’s not like coaches have training around these topics, and they’re very complex. I would hope that there’s so many resources and we’ll make links on this episode of where coaches can get some more information and some specifics of sound, good information around nutrition and weight, and body image, and eating disorder issues, and I also think whatever system that this coach is a part of also has to be a part of the change agent to support coaches in getting educated, thinking about prevention in a larger context because certainly we want to… It would be a much better if we could address this in a prevention stand point before athletes are farther down the path and it’s really difficult to make changes. So I would want to see it, look at it more systemically. I think of some of the screenings and things that have become mandatory around concussions and I would love more things to be implemented that are mandatory when it comes to eating disorder education within the sports teams and systems, even all levels, university setting, professional athletics, education at high school athletes, youth athletes. Even a little bit of training would go a long way.

Carter Umhau:                  Sarah Taylor, our production assistant, was also mentioning before that episode, too, just what a crazy thing that is now more emphasis on brain function and not on necessarily mental health as if they’re not somehow connected as well.

Kara Bazzi:                           Exactly.

Carter Umhau:                  So I just love that point because there is becoming more and screening for the concussion, but what about all the other things that would really impact someone’s brain function and also their life.

Kara Bazzi:                           Exactly. Like I think of, even with my kids, all the forms I have to do for each of their sports. Where’s the food and body stuff? There’s a lot of opportunity, I think, but it does take time and thought and I know a lot of these systems are under a lot of pressure and time constraint and that’s a barrier. I think we can… It certainly a lot of time and resources when someone develops an eating disorder, so we can save the energy on that end and put it into the prevention side.

Carter Umhau:                  Brilliant, right?

Kara Bazzi:                           Yes.

Carter Umhau:                  Before we end today, Kara is going to be sharing her letter to her coach. This is a piece that both highlights the athletes experience on a team, but also really is a bit of a call to all the coaches out there to really explore and think about issues of eating, and food, and weight within their team culture.

Kara Bazzi:                           Dear Coach, let’s get reacquainted. I know there’s been some tension in our relationship and I’m hoping we can clear the air by getting to understand each other better. This is what I assume about you: You’re doing your best, period. I also assume that some days you probably enjoy the influence with your athletes, and some days you wish you didn’t hold so much power, or maybe you don’t even know how much power you have. I also assume that you haven’t had much training with body image issues and disordered eating. I imagine it is tempting to not say anything on the subject for fear of saying something wrong. And if you do give nutrition advice or tell an athlete to change their weight, I assume you’re well meaning and believe this advice will help your athlete. I also assume you’ve had a lot of pressure about how your athletes perform. I can’t imagine how difficult it would be to hold that responsibility. I think that type of pressure would certainly impact your decision making and maybe lead you into murky waters as a coach. Lastly, I assume there’s so much I don’t know about your reality. As a fellow human, you have your own personal life that impacts you on a daily basis both for the positive and the difficult. I hold a lot of empathy for you. To be honest, this hasn’t always been the case. As an athlete, I adored you. In my recovery process from an eating disorder, I felt confusion, anger towards you, and didn’t make sense of our relationship and the power you held in my life. Now many years later as a mental health provider and eating disorder specialist, I can fully appreciate the complexity of the relationship between you and I. Let’s go back. When I was an athlete, I adored you. I would give anything to make you proud of me and would do anything you told me, or perceived you wanted from me. I wanted your attention and quickly perceived that being a top athlete would secure my relationship with you. So I tried hard, very hard, and I did everything in my power to be the fastest I could be. By following the practices of the faster, older team mates, I introduced food restriction into my life. It started slowly, but the ramp up was disturbingly quick. I ate less, less, less, and at the same time, my time’s dropped and dropped to the point where I was on a podium for a championship meet. Now let’s be clear; that year was a blast. I didn’t know I had a problem. In fact, I thought I was the subject of some sort of miracle god thing that took over my body and allowed me to race so quickly. But the subsequent years proved otherwise. During the next year season was my first nightly food binge, and then as fast as I had fallen into restriction patterns, I was now deep into a daily restriction-binge cycle that would last for the remaining years of my collegiate career. My scientific, logical, brain was convinced that I could will myself out of this pattern. I just needed to figure out how to stop binging and all would return to normal. So much denial. So much fight in me to keep running well. Pleasing you was the top priority. By my last year in school, I finally accepted that my time’s were never going to touch those from freshman year and I might enjoy the team and other ways to make an impact. Boy, that was a heartbreaking reality, but I finally let it sink in. That was almost two decades ago. Guess what, coach. The pain and suffering was not all in vain. After I graduated, I got help, and I used my athletic tenacity to dig deep, search for truth, and pursued an answer to the question: Was I only fast because I was anorexic? It took me a couple years to truly be brave enough to find out the answer to this question. I first needed to work on me and find out some of my inherent worth outside of performance in order to be open to test the question. And test it I did. I was racing again. This time, in a nourished body. This time with a more intact psychological health. And guess what, I could still be fast. Not only could I still fast in my bigger body, I felt so much more joy in my relationship with running. And therein lies my life’s work and passion; to help other athletes to discover that they don’t have to compromise their mental health and their bodies to perform. I have now worked with hundreds of athletes and hold hundreds of stories of athletes like me. Young women who have done their best to achieve in sport and find themselves broken and suffering from the complexity of disordered eating and body image concerns. These are smart women, intuitive women, sensitive women, bad ass women. It’s a gift and privilege to walk alongside them and offer alternative paths. You get to coach these gems. So now here comes the part where I think I can help you. I’ve learned so much from my journey, but so much more from all the young women I’ve had the pleasure of knowing. I feel inspired to use my position of power and my developed voice to pass on advice that you might consider. Get to know all your athletes as a whole person. Although many athletes exude confidence, this is a culture that breeds low self esteem and a underdeveloped sense of self, and athletes are not exempt. Your athletes need to know that you care about them beyond their performance. Ask them about their life outside sport, show interest, invest in them. You are like a pseudo-parent, they desire to feel your care as an embodied person. Reflect their goodness for being, not just doing. Do not stay silent on food and body image issues please. Your athletes who are at risk for disordered eating are sensitive. They will likely interpret your silence as, one, you not caring about the issue, two, you endorsing disordered practices in the name of performance success, or three, you being indifferent. These interpretations may not be accurate, but your athletes won’t know unless you tell them.

Kara Bazzi:                           Have a no tolerance policy on food and body talk. Create a culture on your team where athletes know they can’t disparaging comments about their bodies, other’s bodies, and food. No good food, bad food. Remove judgment. And if an athlete makes a disparaging comment about food or their body and you hear it, stop it right there. You’re providing powerful modeling by holding to the boundary to protect the athlete and the team culture. Don’t talk negative about food or your own body. What you say about your body and about food are just as important as what you’re saying to others. Your athletes are listening and trying to discern all the time about your belief systems, so be cautious. Encourage adequate eating. Support more permission with eating. Do not encourage your athletes to diet or restrict food intake. If you try to control your athletes eating habits, you’re setting them up to rebel and make those restricted foods more enticing. Instead, give them suggestions they can experiment with and learn about their own bodies when it’s done with fueling and performance. Help give your athletes a long term vision of their life. When athletes are in college, they’re in a life stage where they’re mostly connected to the short term. They feel invincible and are not motivated by how their actions, behaviors now, might impact their future. Gently remind them with your wisdom you’ve lived more years than them and have perspective about life that is rich and important to share. Get to know the resources in your community. Although you play a big role in your athlete’s lives, you’re not the person that will be offering professional treatment for disordered eating and body image issues. This should come as a relief. As such, take time to figure out who you can work well with. Start with a dietician, mental health therapist, and a doctor, then understand and have expertise with eating disorders. And if your community doesn’t have these resources, visit NEDA online to provide guidance. Coach, what a big role you play. Please get the support you need as this is a tough job. I want to support you and be a part of a movement to keep helping you and your coaching peers to be successful and healthy and full of hope. Yours sincerely, mental health therapist.

Carter Umhau:                  Thanks so much for joining us today. And thanks to Jack Straw Cultural Center for sound engineering, to Aaron Davidson for the appetites music, and to Sarah Taylor for production assistance and editing. Thanks also to Kelly Finan for joining us as a contributor today. If you haven’t already, please subscribe to The Appetite on your preferred podcast app so you can follow along as new content is released. If you or someone you know is struggling with an eating disorder and you’re hoping to learn more about potential resources for recovery, visit You can follow along with The Appetite and Opal on Opal’s FaceBook or Twitter. And if you ever have any questions or comments for us, please feel free to reach out to us at The Appetite at Thanks again, and talk to you soon.