Friday, July 22, 2016

Training on Empty: Chapter 7 (Possible TW)

Possible trigger warning with mention of numbers and behaviors.

Chapter 7 -Running on Empty

“Tough times don’t last but tough people do.”  – A.C. Green

I struggled with anorexia for over 20 years. Throughout this long battle I had periods of relative health and periods of severe illness, but what is most surprising is that for approximately eight of those years, I was one of the top runners in the nation, setting records and winning races around the country. Though I survived, my story isn’t pretty, and I suffered long-term consequences from starving myself while training intensely.

Training without proper nutrition can lead to many complications, yet it’s common for athletes to restrict their nutritional intake in order to achieve a lighter weight. According to world-renowned running coach Bobby McGee: “From a plain exercise physiological point of view, the lighter the runner, the higher their VO2 Max. This is their ability (measured in milliliters) to utilize oxygen per kilogram of body weight. This is a key performance factor in endurance events. The lighter the athlete, therefore, the better they perform – hence the warped ‘reward’ that these athletes receive for losing so much weight. Of course this period of heightened performance is finite as the effects of the illness start to shut down the system with its all too often inevitable outcome – terrible, terrible illness, anguish and even death.”

In addition, he states, “Athletes I have worked with over the last 25 years have displayed a myriad of conditions: ketosis, where the athlete begins to metabolize their own tissue (protein) for energy; dysmenorrheal, where the regular menstrual cycle becomes erratic, possibly due to too little body fat (I see the cut off at around 13%); amenorrhea, where bleeding ceases all together, which leads to losses in bone density, stress fractures, and eventual osteoporosis. There is obviously a great deal of mental and emotional stress in both the short term and the long term. The possible replacement of the eating disorder with an exercise addiction can also alter the nature of the situation psychologically.”

Bobby is clear that the long-term effects can be persistent and extremely detrimental. He further states, “The ability that the athlete displayed as a result of an increased VO2 Max due to weight loss in the early stages is rarely regained fully. The focus becomes the disease and the running a fantasy that harks back to a time when the condition was insufficiently advanced to warn those able to help.” According to Bobby, it is also evident that women can suffer erratic menstrual cycles and ill health long after normal eating habits have been restored. The “female triad,” the condition to which Bobby alludes, is a term coined by The American College of Sports Medicine that comprises three conditions: disordered eating, amenorrhea, and the loss of bone density, or osteoporosis, with the first two derangements leading to the third. The body is resilient, but not immune to self-abuse, especially the longer the abuse continues. If an athlete continually trains or overtrains on too little nutrition, it’s possible she may never return to normal health.

At the time I was running well, I felt indestructible. The thought of a compromised body or ill heath later in life never crossed my mind. As with any addict, even if I had some concept of what life might be like, I was too caught up in my compulsive behavior to truly grasp the possible outcome. Like a rebel teen who knows that smoking can cause lung cancer but does it anyway, I was too dedicated to my addiction to change my path. There were people who tried to warn me that I was heading down a dangerous road, but I refused to listen. The addiction was feeding something lacking in me. My running success gave me the attention I didn’t get growing up, and the compulsions distracted me from my past. Though I did suffer several minor injuries early in my career, such as a pulled Achilles tendon and several sprained ankles, I didn’t consider the long-term consequences of what starvation can do to the body. My sole purpose in life was to run and feed my addiction of eating a certain way while exercising intensely. Despite knowing some basic physiology of the human body, it seemed impossible that I could actually die from not eating enough. In the end, I came close to dying, but I was fortunate enough to survive. Whether it was my will to live that eventually made an appearance or something out of my hands that caused me to last, I consider myself lucky in terms of remaining on the planet.

In March 2006, Alex DeVinny, the 2003 Wisconsin state champion in the 3200-meter run, died from cardiac arrest related to anorexia. She was 5 feet 8 inches tall and weighed around 70 pounds at the time of her death. In a September 14, 2004 New York Times article, "When Being Varsity-Fit Masks an Eating Disorder," author Paul Scott addresses the tough position a coach can be put in when it comes to girls and running. He states, “Looking back, her coach, Dan Jarrett, questions himself. ‘I did not understand how someone with anorexia would be capable of making decisions that weren’t in their best interest,’ he said. ‘I totally failed to grasp what it meant.’ He is so troubled by her death that he has since quit coaching girls.”

Former Fairview High School cross country and track coach Joanne Ernst knows first-hand how difficult recognizing and treating eating disorders in runners can be. In an interview, she expressed her concerns as a coach. “It’s difficult to know how to intervene,” Joanne admits. “There is new science today that helps confront the issue, but the information is still changing.” Often, eating disorders such as bulimia can go undetected by a coach. In Joanne’s case, she was lucky to have relatively few runners who suffered from an eating disorder in her years of coaching at the high-school level. When Joanne did encounter one athlete who was visibly too thin, she had a talk with the girl’s mother and suggested that the girl not join the team until she was at a more reasonable weight.

In general, to help runners avoid injuries and other running-related issues, Joanne had a just a few simple rules that she had learned from her own experience as a professional athlete. Number one: Comments about weight were to be avoided. Good nutrition was emphasized, but there was no exact diet given or ideal weight mentioned. And number two: The running program was not based on high mileage. Instead, it was more about quality training, covering the basics of good training and nothing more. With the help of several assistant coaches, Joanne ran a very successful running program for eight years.

The job of a coach is not an easy one. A good coach relies on open, honest communication with his athletes. If the information given is skewed, coaches are not able to make sound decisions regarding the appropriate kind of training for their athletes. For an athlete with an eating disorder, it’s common to bend the truth. Lies about how much training is taking place are the most common breach of trust in the coach-athlete relationship. Food intake and actual weight can be an issue as well. Scott also addresses this issue in his article: “Even the best-trained psychologist can have a difficult time filtering through the deceptive acts and statements that can accompany an eating disorder.

And yet coaches have long been encouraged to identify a syndrome of under-eating, known as the female athlete triad, to help athletes avoid osteoporosis, stress fractures and – in rare cases like Ms. DeVinny’s – even death.” Unfortunately, most coaches are neither equipped to deal with identifying the specific symptoms that lead to the female triad, nor trained to detect the deceitful acts in which anorexics engage. By the time I entered high school, I had already been anorexic for over a year, so I was very good at deception. Most people had no idea what kind of struggles with food I had. They assumed I was thin because I ran, not because I was afraid to eat. Running was something I did so that I didn't feel so guilty about eating. In the end, I allowed myself the reward of eating because I ran; even though I understood intellectually that the body needs caloric intake even at rest, I couldn't embrace it on an emotional level.

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