Let’s Talk About Disordered Eating and Male Athletes

Published September 12, 2018 03:31PM

One thing that you learn when you are a coach (or a teacher, or a therapist, or just any open-minded empathetic person) is a simple truth of the human experience: the people you meet in life are going through a lot. Fifty thousand years ago, our species was a middling primate on the plains of Africa, and now we’ve put homo sapiens on the moon and on Twitter. There’s bound to be some collateral damage as our survival mechanisms get requisitioned for new tasks, whether that’s sending a tweet or running a really fast marathon.

What does that mean for our day-to-day lives? The old saying is “be kind, for everyone you meet is fighting a battle you know nothing about.” That statement is unequivocally true. Life (like pimpin’) ain’t easy. It’s not just being kind to others, though. It’s essential to be kind to yourself.

Other people might not know what you’re going through, which can make you feel alone in the struggle. But you’re not alone. Lots of people are right there alongside you, even if they don’t broadcast what they’re going through on their social feeds. People that see behind the curtain understand the murky truth of the human condition, and they usually come to a similar conclusion: You are enough, no matter what, unconditionally.

That rambling preamble is just meant to set the table for the main discussion: disordered eating in male athletes. It’s one of those topics that is rarely talked about, where some of our evolutionary survival mechanisms can turn themselves against our long-term health. But the problem is prevalent, even if it’s not talked about openly that often.

As a coach, I see it all the time behind the scenes, often framed as wanting to get an extra one or two percent out of performance through eating less (or even eating “cleaner”), but sabotaging performance in the process. Before I was a coach, I faced the problem myself, chasing marginal performance gains through a misconception about marginal body weight losses.

The exact definitions of disordered eating and eating disorders aren’t important for this article. For our purposes, just think of it as an unhealthy relationship with food and/or body image, with these things developing disproportionate importance in a person’s day-to-day life, falling on a spectrum from subclinical annoyance to major health crisis.

The article is confined to male athletes because disordered eating and eating disorders in female or transgender or other athletes is not my story to tell (my wife Megan and I wrote about body image here). But hopefully anyone dealing with issues can find something relatable in this article (even if it’s just the Big Daddy Kane “pimpin’” reference).

First . . . storytime! In college, I was a 200-pound football running back with a neck the diameter of the Lincoln Tunnel. After I quit, I did the logical thing and . . . developed big dreams in long-distance running. Don Quixote himself would have been impressed by the hubris. But I chased that windmill, slowly transforming from from a running back to a kicker body type.

That body-image incongruence came to a head in 2012, when I was interning at an environmental organization in Colorado. I was living off of a few dollars per week, running 100 miles per week, chasing some big running dreams. And my body withered away.

I didn’t realize it at the time, but I demonstrated some disordered eating behaviors. I thought it was good to wake up a bit hungry, a sign of fitness to lose a pound, a compliment when people said to eat a cheeseburger. I ate a lot—”more than almost anyone I know!,” I thought—but not enough for 100-mile weeks. And I had a great race result to end that summer, winning the USATF 10k Trail Championships. Woohoo! I thought my approach was validated. But next, as the story almost always ends, things came crashing down.

I spent a large part of the next year injured, learning that my thinking about bodyweight and performance was not only wrong, but dangerous. Mostly, it was persistent pains when running, quickly exceeding my deductible at the doctor’s office. Sometimes, it was reduced energy and bonking in longer events, including a DNF at mile 15 of the US Trail Marathon Championships. Now, I probably weigh 15 pounds more than I did back then, but I have no idea because I haven’t stepped on a scale in years.

Later on, when I started coaching, it was with a central premise on these issues: you have a perfect runner’s body no matter what, just like you are generally enough no matter what. Unconditional self-acceptance is what it’s all about. From there, sustainable running performance (and happiness) can follow.

“Burger Sunday” (or the vegetarian equivalent) became a weekly team holiday. Photos of personal pizzas that could fill a crop circle populated our Facebook page. Some of the team’s success in the years since can probably be explained by the phrase we (Megan Roche, my SWAP-coaching partner, and I) tell our athletes: “Eat enough, always. Eat too much, sometimes. Eat too little, never.” Countless studies show that avoiding chronic negative energy availability is a requirement for long-term training, adaptation and health.

But even now, I look in the mirror and I’m pretty sure I see something different than what other people see. I feel a bit guilty eating that extra slice even as I know it’s good for me as an athlete. The contagion rarely goes away completely after it’s planted.

My situation may have fallen through the cracks in a study on eating disorders, likely classified as “subclinical disordered eating,” and only then if I was totally honest with the researchers. It’s like that for a lot of male and female athletes. These issues are relatively common and don’t have to be something you hide from. The same personality traits that make you excel at anything in life can open you up to negative consequences.

Let’s throw down some numbers. A 2004 study in the Clinical Journal of Sports Medicine found that Norwegian male endurance runners had a higher prevalence of clinical or subclinical disordered eating than the general population. That study pinned the number at 10 percent. A 2006 review in the journal Sports Medicine summarized a few studies that wound up with similar numbers. In most of the studies, there is a disclaimer that the existing data is likely an underestimate of the overall prevalence due to the stigma associated with it.

It’s not just runners. Rowers and wrestlers and bodybuilders are also at higher risk, though just because you don’t do sports doesn’t mean you’re not susceptible. There is even an interrelated body-image disorder called “muscle dysmorphia” where there is a preoccupation with becoming more lean or muscular, as outlined in this peer-reviewed 2015 piece from Medicine Today. Whether the number is 10 percent or 20 percent or 40 percent, it adds up to thousands of male runners that deal with these issues.

Somewhere, there is a line between wanting to have the optimal nutrition for performance and unhealthy eating behaviors or body image issues. In retrospect, I think I tried to tight-rope that line and ended up falling off.

Here’s the most important thing to remember: many, many athletes (male and female alike) go through the same thing. Issues with disordered eating in male athletes are becoming more common to talk about, but as outlined in this 2016 meta-analysis from the Journal of Sports Sciences, the research area needs more development.

However, just because something is common doesn’t make it easy to live through. So what are other techniques that are important for athletes that may be dealing with this issue? The first step, as said in the Medicine Today article: “Dismantle any biased thoughts they themselves may have that eating disorders are a ‘female’ problem.”

Second, as discussed in the Sports Medicine article, is education. That can include everything from statistics to discussing the performance impacts associated with negative energy availability. As the article says, “Education may play a vital role in diminishing some of the secrecy surrounding these disorders in general, and specifically the conspiracy of silence so often seen among coaches and trainers.”

Seeing a professional is almost always recommended in the standard of care for eating disorders. That can be a psychologist, therapist, doctor, nutritionist or dietician. Short of that, talk to friends, family members, coaches or others. Men with clinical eating disorders may also have higher rates of depression as outlined in this 2000 article from the American Journal of Psychiatry, so broader treatment options may also be important.

One thing is for sure: this article won’t solve the problem. But being open about it can be a first step for some people. Disordered eating in male athletes is common, and it’s okay to be going through something. Being open doesn’t make you less masculine.

On top of that, it’s essential to disconnect the association between lighter and faster. Running is a power sport that requires the body to transmit and absorb massive forces over time. Strength is almost always speedier long-term, even if skinnier can seem faster in the short term.

Food is fuel. But it’s also family, friends and fun. And perhaps most importantly for runners that find themselves with these issues, it’s essential to remember one more thing: Food is fast.

—David Roche partners with runners of all abilities through his coaching service, Some Work, All Play. His book, Happy Runner, is co-written with his wife Megan and available for pre-order now at Amazon.