Disordered Eating or Eating Disorder?

By: Claire Dorotik

Let’s face it, running is hard. We have all experienced a run that feels harder than normal, a tough trail, or the long run that seems to never end. And sometimes the only thing that seems to motivate you to keep going is carbo-loaded meal at the end of the run. Cheeseburger in paradise, right? Although it is normal to crave a favorite meal after a hard run, do you ever wonder if these cravings have become out of control?

To answer this question, think about these: Do you constantly calculate calories and numbers of fat grams? Do you weigh yourself often and feel obsessed with the number on the scale? Do you avoid eating meals or snacks when other people are around? Do you exercise because you feel like you have to, not because you want to? Has weight loss, dieting, and/or control of food become one of your main concerns? Do you ever feel like you are out of control when you are eating? Are you afraid of gaining weight?

According to a recent study done at Oxford Brookes University, if you answered “yes” to any of these questions, you could be dealing with disordered eating. According to the Eating Disorders Association, (EDA), for the more than 5 million people who suffer from disordered eating, it can feel like your cravings are controlling you. And for a runner, the risk of developing disordered eating, or an eating disorder, is much higher (15 to 62 percent). When asked about her daily training schedule and eating patterns, Olympian Deena Kastor, related that, “I dream about food”.

Competing on an elite level like Deena Kastor, or competing in a sport where being lighter is an advantage, can be a contributing factor to developing disordered eating. Some of the other causes include, past trauma, sexual abuse, significant loss, perfectionism, compulsiveness, low self esteem, high family expectations, or family dysfunction, and inability to cope with stress.

While running can be a wonderful outlet for stress, it can also be overused, as in the case of Anorexia Athletica. A condition defined by characteristics such as: weight loss of more than 5% of body weight, gastrointestinal complaints, absence of medical illness explaining the weight reduction, excessive fear of becoming obese, and caloric intake restriction. Those suffering from this condition can also exhibit menstrual dysfunction, delayed puberty, binge or compulsive eating, disturbance in body image, and use of purging methods, often running.

It is the use of running as a purging method that differentiates Anorexia Ahletica from the more common Anorexia Nervosa. Whereas those with Anorexia Athletica will run excessively to stay thin, those with Anorexia Nervosa will starve themselves to the point of not being able to run, or walk for that matter.

Starving oneself is a major sign that something is wrong, but not all disorders include this element. Binge Eating Disorder and Bulimia Nervosa both include binging, characterized by out of control eating, and eating to the point of discomfort. While Bulimia involves purging methods such as vomiting, use of laxatives, diet pills, and excessive exercise, it is different from Anorexia Athletica in that with Bulimia normal weight is maintained.

While these disorders can be easily differentiated, those with disordered eating, may exhibit a mixture of signs that do not fit into any specific disorder. Elite Trail Runner, and holder of many course records, Steve Warshawer, relates, “I’ve done the three day juice fast, or running 175 miles a week, and still wore racing flats on a 100 mile run, because I still thought I was too heavy.”

For Steve, what is clear about disordered eating is the distorted body image, but what not be so clear is the cycle of dieting, carbohydrate cravings, bingeing, weight gain, increased guilt and anxiety about fatness, purging or starving, guilt and self dislike, and increased resolve to diet.

We’ve all been through this: going out with friends, eating too much, feeling fat, deciding never to do it again, increasing our resolve to run further, train more, eat better, and setting ourselves up to feel deprived and do it all over again. However, for those with true Anorexia Athletica, the consequences can be much worse than a little guilt.

How do osteoporosis, iron deficiency, headaches electrolyte imbalances, depression, increased susceptibility to infection, increased risk of injury, gastrointestinal problems, and cardiovascular changes sound? These are just a few of the effects of disordered eating according to the Santa Clara University Wellness Center.

While a hard headed runner may try to run through these problems, what can’t be run denied is the decrease in strength and endurance. So if you are watching those times climb, it might be time to take action.

Sports Nutritionist, Nancy Clark, MS, RD, suggests starting with looking at the way you view food. “Food is fuel, and just as your body needs to sleep, urinate and breathe, it also needs to be fueled,” suggests Clark.

Everyone needs to eat, and according Clark, when food becomes viewed as fattening energy, you will struggle with every mouthful. And for those suffering from disordered eating, she suggests beginning by calculating your daily caloric needs.

To do this, take your weight in pounds and add a zero, this is your resting metabolic rate, (RMR). For example the average 120 pound woman needs 1200 calories just to lie in bed and breathe. Next estimate your daily activity level. If your activity level is sedentary, multiply your RMR by .2-.4, if it is moderate, multiply your RMR by .4-.6, and if you are highly active, multiply your RMR by .6-.8. Lastly, estimate your caloric expenditure in exercise, (for a runner, it is about 100 calories per mile for the average 150 pound runner).

Clark also suggests making exercise fun by varying your routine, aiming for enjoyment, not exhaustion, and talking to a professional.

A professional will help you develop a normal eating pattern, establish alternatives to binge eating, practice problem solving techniques, and develop a maintenance plan. According to the EDA this will include a relapse plan that includes listing things that may trigger the disordered eating pattern. Stress, dealing with underlying issues in therapy, becoming overwhelmed by emotions, death of a family member, marital and family problems, feelings of shame, loneliness, guilt and anger, can be just a few of these triggers.

The EDA also recommends making a list of situations that may cause a relapse, and healthy ways of coping with these situations. Additionally, listing negative self statements, challenging these statements, and replacing them with positive ones, can be very helpful as those with disordered eating tend to be very critical on themselves. Lastly, they suggest listing healthy coping mechanisms for crisis situations. This may include names and numbers of supportive family and friends.

Family and friends can remind us that life after all, is supposed to be fun, and so should be running. And knowing that caloric restriction decreases life expectancy should be enough to encourage any runner to return to healthy eating patterns.