The competition in eating disorders: lifelong athletes’ search for fulfillment in identity

So many of us wrap our identity around the things we do, the accomplishments we achieve, and the trophies we receive — in terms of school graduation, career success, or athletic competition.  We, as animals, thrive on a healthy sense of competition, as it keeps us motivated and pushing forward towards our goals.  Athletes, in particular, know this sense of purpose very well.  The faster you run, the better place you will get.  The better you dive, the greater team you will join.  It can feel authentically validating to be acknowledged for your hard work and perseverance, and it can feel absolutely devastating to land in second place.  Your time and your place can solidify themes of who you are — your identity.  In addition, how you look physically (strong, solid, agile) can contribute in significant ways to your ability to achieve in ways that align with the identity you have created for yourself.

This obsession with perfection, size, and achievement can be an invitation to an eating disorder.

What happens when you retire from your sport(s)?  Or are injured and can’t compete anymore?  When your life is your sport, how do you cope?  There was an article in the Denver Post last week entitled “Body obsession fills void left by sports” which chronicled the lives of several retired athletes (and by “retired” I do not mean AARP eligible; I mean in their mid-20s).  One gymnast “who, since the age of 7 had devoted herself to gymnastics and without it felt a loss of identity”, developed bulimia as a means to have a new fixation: her body.  Sports such as gymnastics are very vigilant about body size, shape, and weight.  To succeed at the highest levels, you need to be thin and light.  For some of us for whom that does not come naturally, that might lead to restricting food or purging it in order to maintain or lose weight.

Not only do these athletes not have the expectation to look a certain way in order to support their identity, they shift their entire lives to find a new meaning for who they are….which may seem daunting and elusive.  Who am I if not a figure skater?  Whether the eating disorder was developed during the years of training and competition, or if it was adopted after retirement, these types of questions are the challenges that we must all face as we walk the path of recovery.  The eating disorder may try to mask or take away parts of who we are — and the beauty of recovery is rediscovering those parts of ourselves — but the initial confrontation of “what if there is nothing else to me?” is quite overwhelming.

The article states that “at least one-third of female college athletes has some type of eating disorder”.  Think about how big that number is!  What contributes to this?  For one thing, the competitive nature of women (and men) in sports can contribute to the feeling of needing to be “the best” — and this can also blend into social spheres.  The best athlete might also be the most popular girl on the squad, and we all know how important that might feel when making new friends in college.  You might get compliments from coaches, family members, or mentors who notice the “hard work” and support it.

It appears that life after sports can leave a void and can create a feeling of loss.  Loss of that team environment and cohesion that the athlete thrived in for so many years.   If a member gets an injury and cannot play the sport, “she may feel like an ‘outsider’ and unable to contribute to the team anymore.”  States Veronica Sykes, “I needed a new distraction, and I was able to fuel all of that angst into running — the same thing that made me good at my sport made me want to get really skinny.”  Another aspect of risk in life after being an athlete is the distance that may come between former athletes and their colleagues and coaches.  After retirement, people tend to split up and get out of touch.  This can be a dangerous time for eating disorder development, as women may be searching for their identity and feel a lack of support and community.

This is a population that needs intervention and attention, as the environment of competitive sports can lead to an expectation to be perfect in life outside of that arena.  It seems to me like a key point in self-care for retiring or active athletes is identity.  Who are you without your sport?  What parts of yourself can you nourish in a healthy way so that you don’t feel lost and separate?  How can you boost your self-esteem and self-concept in affirming and positive ways?  We all can ponder these questions and maintain awareness about the triggers of eating disorder and how to begin intervening.

“Why are you sad? – you have a healthy baby!” and other misconceptions of Post-partum depression

I attended a fascinating presentation earlier this week by established Denver therapist Dr. Jennifer Harned Adams about the “Psychological Aspects of Women’s Reproductive Health”.  Dr. Adams is a specialist in women’s issues relating to fertility, complicated pregnancy and childbirth, pregnancy and infant loss, and pregnancy and Post-partum Adjustment and she uses a Whole Woman Wellness Approach to consult, assess, and treat women (and their partners) who are going through these issues.

The entire presentation was full of great information and resources about pregnancy and related issues; I had no idea how complicated and complex these concerns can be and how many decisions need to be made that can affect emotional states and coping.  In the realm of fertility, there is so much to consider, whether you are fertile and want the child, or infertile and want to have children.  Dr. Adams referenced a recent New York Times article The Two-Minus-One Pregnancy, which focuses on the new trend of couples who have used in-vitro fertilization or another type of treatment to conceive, and find that they have multiple embryos growing when they had only planned for one — this may be due to financial or health reasons.  Some doctors are helping couples terminate unwanted embryos — can you imagine the debate and controversy that this invites?  I encourage you to read the article and the comments it produced.

Dr. Adams also touched on the sensitive and deep issue of pregnancy and infant loss stating that some women undergo smas facelift, after they have been through the post pregnancy depression .  She works with couples who have lost pregnancies and who are in mourning of this loss, and she described the common reactions that couples have to this trauma:  emotional numbing, fear, anger, having a sense of still being pregnant, guilt, and shame.  I was taken aback by the high statistics that she presented on this type of loss:  approximately 25% of all women will experience a pregnancy loss at some point in their lives.  “Many women,” Dr. Adams stated, “may not even know they were pregnant and lose the baby thinking they were having an abnormally heavy period.”  She also offered the statistic: “10-25% of all medically confirmed pregnancies will end in loss”.  That is shockingly high.  A point that stuck with me was how men are just as much victims of pregnancy losses as their partners are, and they are often overlooked or forgotten.  A loss such as this needs lots of attention and empathy for both partners, as each will cope in his or her own way.  Working with a professional such as Dr. Adams or another specialist can help couples define their feelings and come together in healing instead of shut each other off to their feelings.

The area where Dr. Adams focused and in which I was particularly interested was that of Post-partum Adjustment (which can include depression).  Post-partum depression is not talked about much in our society.  There is an expectation to be “happy and joyful” when you have a child (and of course, exhausted and adjusting).  What happens when a mother is depressed during or after her pregnancy?  She may be ostracized. She may hear quotes such as in the title: “why are you sad? you have a healthy baby!”.  This can be especially difficult for a depressed mother to hear if she has gone to extreme measures to conceive (such as in-vitro) and still feels down.  Many women may experience the birth of their child as traumatic in some way and the anxiety and stress from that event can carry forth into post-partum if not treated.

It is very common for new parents to experience the “baby blues” (up to 80% of new moms experience this).  What is the baby blues?  You may have trouble sleeping, eating too much or too little, feel tearful, overwhelmed, or have mood swings — typical new-parent adjustments.  Post-partum depression, however, is more severe and lasts longer.  Post-partum depression affects 1 in 8 new moms — the most common medical complication of childbirth!  It can be influenced by prior depression or a family history of depression, and usually peaks at 3-4 months post delivery.  It is a serious condition in that it can affect the new mom’s ability to bond with her child or provide it with the best care for its needs.  While we are often thinking of the baby and its health in the first few months of its life, we may forget to check up on how the new mom is doing.  Doctors should be giving mothers screenings at their six-week check-ups (which they may avoid if they are depressed) to see if the symptoms are present.  Most cases of Post-partum depression are not treated because they are not diagnosed or the mom (or dad, who can have PPD as well) do not disclose their feelings.

There is great need for intervention and treatment in the area of women’s reproductive health.  I am grateful that I met Dr. Adams and was given all of these wonderful resources so that I may use them to help my clients or give them appropriate referrals.  You can find out more about Dr. Adams at her website.

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