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Title/Topic: Eating Disorders Running Rampant in Girls Cross Country
Posted On: 11/3/2007
Nov 3, 2007 (The Atlanta Journal Constitution) – Teenage girls who run high school cross country, some competing for fun, others for championships, are showing signs of eating disorders that could harm them for life.

Too many girls are too thin, coaches say. Some over-train, skip meals, suffer from anemia, pass out during races and develop the mindset that skinny means fast.

disorders that are more prevalent in sports in which appearance and weight are emphasized.

“It’s a sport that is predicated on being fast,” said Dr. Ken Mautner, an assistant professor of orthopedics at Emory University School of Medicine. “You look at the athletes. Most are very thin, long-legged. This is sort of seen as the norm.”

Fifteen of the 21 metro Atlanta high school coaches who responded to an AJC survey said eating disorders are common on girls teams or it’s a problem that needs to be monitored.

“Much like a car accident, even though it affects a very small percentage of participants, you can’t leave a [cross country] meet without noticing that some of the girls have a problem,” Woodward Academy coach Scott Freed said.

Jennifer Sewall, coach of Whitewater High in Fayette County, has recommended professional help to one runner who was over-training to lose weight.

Sewall said she recognized the problem because that’s what she did as a cross country runner in college 10 years ago – purging calories by running three times a day and exercising for five hours. Sewall, a triathlete, has required other runners to keep food logs to ensure that they are strong enough to handle running 30 to 50 miles a week.

“I have to work with my girls and parents to see that cross country is a sport and not a weight-loss program,” Sewall said.

Page Love, a nutrition therapist for the Atlanta Center for Eating Disorders, says she has been treating eight local high school runners this fall who have symptoms of anorexia or bulimia. Two passed out during races and needed medical attention, Love said.

A majority of coaches who responded to the survey said they would support a proposal by Love that runners with low body mass index be required by the Georgia High School Association to get clearance to compete from doctors who understand eating disorders.

“It appalls me how many girls have been cleared to run with these quick [school] physicals,” Love said. “They’re barely looking at their vitals, not looking for the risk for stress fractures or asking about menstrual history. These girls are being cleared when they are at-risk for serious medical problems.”

But GHSA executive director Ralph Swearngin said his organization never has considered weight management for cross country and he is wary of singling out runners because of weight or body fat.

Body mass index (BMI) is an estimate of body fat using height and weight. A BMI of 18.5 to 25 is considered normal. Less than 18.5 is considered underweight. The same measurement applies for girls and boys.

In 2006, fashion shows in Madrid and Milan banned models with BMIs less than 18.5. Ski jumpers with BMIs below 18.5 were banned from The winter Olympics in 2006 by the International Ski Federation.

Love says a high school runner with a BMI of 18 or below should be screened for what she called the female athlete triad disordered eating, osteoporosis (loss of bone mass) and amenorrhea (loss of menstruation).

The GHSA began a pilot weight management program with wrestlers in 2005, and its provisions will be enforced for the first time this winter. A male wrestler with a body fat of 7 percent must obtain a doctor’s clearance stating that he is in his natural condition. Wrestlers may not lose more that 1.5 percent of their weight per week.

The movement to regulate wrestling trickled down from the NCAA, which made changes when three college wrestlers died in 1997 after attempting rapid weight loss.

In girls cross country, news of disordered eating among elite young runners is common. In 2006, former Wisconsin high school champion Alex DeVinny died of complications of anorexia at age 20.

Kathy Kroeger, the 2006 Footlocker National high school champion from Tennessee, was told by her doctor to sit out track season last spring when her weight dropped to XX pounds*. She’s running again this fall, XX pounds* heavier.

North Gwinnett cross country coach Mark Karen would support using BMI to identify at-risk runners.

“I have absolutely no issue with this at all,” Karen said. “The student-athlete’s health is my number one concern. … You would be risking someone’s health for what? A better team? Not worth it.”

But other coaches said they would be uncomfortable putting girls on scales and emphasizing weight for any reason.

“I just don’t know how high school girls would handle that,” Kennesaw Mountain coach David Ravenscraft said. “I’d never be for putting girls on a scale and checking body fat. Discussing weight with high school athletes is a no-no for our staff.”

Some coaches are concerned that their sport will be stereotyped or stigmatized if the GHSA were to implement weight management. Runners come in all heights, weights and sizes, they say. Some are lean, others chunky. Some have become champions by running 80 miles a week, others by running 30.

“Girls cross country teaches incredible lessons about self-reliance and confidence,” Woodward’s Freed said. “It gives young women a chance to accomplish things they never thought they could. It teaches them to be strong in a society that is filled with very weak role models for young women.”

But sometimes, runners fall into traps.

Tom Williams, who has coached Walton’s cross country teams for 19 seasons, says natural weight gain and physiological changes for girls in their high school years can slow them down when they’re training just as hard. That may tempt a girl to cut weight to regain speed, Williams said.

“It’s a curse; it really is,” Williams said. “I’ve had parents get mad at me because their daughter ran 20:30 as a freshman and now they’re running 20:45, and I’m thinking I’m doing a good job because she was XX pounds* and now she’s XXX*. … It’s just hard for girls, and society doesn’t cut them a break at any time.”

Of the 21 coaches responding to the AJC survey, 11 said they have had private talks with a runner or her parents because of concerns that the runner was underweight or unhealthy. Six have held out runners until they gained weight. Eric Daugherty of Union Grove said that he has intervened with runners and their families twice in his seven seasons.

“It probably should have happened a few more times when I first started coaching,” Daugherty said. “I will set up a food log with their parents that must be signed off by both. This, along with a lot of information about what they are doing to their bodies, has been enough to make them see the light.”

McEachern coach Travis Gower said he sees at least one or two runners at most meets who appear underweight.

“I do know of some top runners who worry me,” Gower said. “Some coaches and parents realize the issue and watch and take care of it. Some don’t. The coaches I am around most times look for it and monitor it, but at times, parents don’t see the same thing we do.”

Ellie Sharp, a junior at Lakeside High who finished fourth in the DeKalb County meet last month, said she sees about two to six runners at each meet that she thinks are underweight and lacking adequate muscle mass.

Sharp battled anorexia for two years before being cleared to run as a freshman.

“You can’t tell by looking, because there will be some who look normal but who are torn up inside and bulimic, and some who are naturally thin,” Sharp said. “But I do wish I could go around to people and say, ‘I really want to help you,’ just because I know how bad it is.”

Love and other eating disorder experts said that studies on the incidence of eating disorders in sports often are unreliable because athletes with the disease are notoriously dishonest about it.

An NCAA survey once found more incidents of eating disorders in women’s cross country than in any other collegiate sport, although the research is 16 years old.

Laura Belli, a psychotherapist in Woodstock who specializes in women’s issues, says she hid her bulimia as a college runner in Kentucky. She said most of her teammates had eating disorders.

“I had two [stress] fractures, and still no one knew it was from an eating disorder,” she said. “They all thought it was because if you’re training at this elite level, it’s from the miles you’re putting in. So if you’ve got athletes walking around not being honest with research, how do you know?”

Eight of 21 coaches surveyed told the AJC that at least one of their runners this season had suffered a stress fracture, which can be caused by overtraining, training errors or osteoporosis, a major health risk of anorexia or bulimia.

Other consequences of eating disorders include loss of regular periods, anemia, abnormally slow heart rate and heart, kidney and liver damage.

Dina Zeckhausen, the co-founder of the Eating Disorder Information network in Atlanta, said the characteristics that make someone an outstanding runner may also make them vulnerable to an eating disorder. They include personal drive, perfectionism and the sense of control and accomplishment that comes from focusing on numbers times and distances.

“The longer these problems go untreated, the harder they are to turn around and the more [they become] part of the person’s identity at a time when every girl is trying to discover her identity,” Zeckhausen said. “We want our daughters to feel special about who they are as people so they don’t die trying to feel special about being the fastest girl in Georgia.”

* Weights removed by Pale Reflections

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