Nutrition and Eating Disorders

By Terri Milner Tarquini

An epidemic is defined as something that affects a disproportionately large number of individuals within a population.

A 2014 study in the Psychology of Sport and Excellence found that 13% of elite female figure skaters had an eating disorder. That is double the national average in the U.S., where up to three percent of the population struggle with anorexia in their lifetime and up to four percent battle bulimia.

Statistics are not available for male figure skaters, but of the 30 million people that struggle with an eating disorder in the U.S. at some point in their lives, one-third of them are men; however, it is likely that the percentage is higher for males who figure skate for all the same reasons that it’s more common in females who figure skate.

Eating disorders in figure skating are nothing new, but they also don’t seem to be getting any better, with several more-recent skater’s stories being highlighted this past Olympic cycle.

• U.S. national champion and Olympian Gracie Gold withdrew from the 2018 U.S. Figure Skating Championships due to depression, anxiety and an eating disorder. “Definitely athletes in the spotlight – figure skaters, especially – are under pressure to fit a certain mold and fit a certain body type,” Gold told “Today” in November 2017.

• Japanese national champion and two-time Olympian Akiko Suzuki, at the suggestion of her coach to lose weight to improve her jumps, lost nearly a third of her body weight, plummeting from 106 to 70 pounds on her 5’3” frame. Weakened to the point of not being able to skate, and her career – and life – at risk, she was diagnosed with anorexia nervosa. “There were all these younger skaters coming along with good proportions and I started wishing for longer legs. I got a real complex. But since there was no way I could grow, the only thing I could do something about was my weight,” Suzuki told Japan’s NTV network this past January.

• 2012 Russian Olympic team gold medalist Yulia Lipnitskaya quit skating entirely after getting treatment for anorexia. “Anorexia is a disease of the 21st century. It is quite common. Unfortunately, not everyone is able to cope with it. My only regret is that I didn’t do this before,” Lipnitskaya posted on the Russian Skating Federation website.

• In 2016, U.S. national champion and Olympian Adam Rippon was surviving on three slices of whole grain bread a day and cups of coffee sweetened with Splenda. In an interview earlier this year with the New York Times, Rippon said, “It makes me dizzy now to think about it. I looked around and saw my competitors and they’re all doing these quads and, at the same time, they’re a head shorter than me, they’re 10 years younger than me and they’re the size of one of my legs.”

What’s going on here: Figure skating is a sport ripe to attract perfectionists and rife with putting high emphasis on aesthetics.

“Sports that require a high level of precision attract perfectionists and over-achievers,” said Susan Walker, clinical director of the Walker Wellness Clinic in Texas. “Eating disorder sufferers as a whole also have the traits of perfectionism and over-achieving.”

And that’s the recipe for a perfect storm that can result in an epidemic.

In 2010, Jenny Kirk went public with her battle with anorexia that had a hand in ending her amateur career – but continued into her years as an ice show skater – estimating that, in her opinion, 85 percent of figure skaters struggle with eating disorders.

“I couldn’t believe, looking back on it, how prevalent eating disorders are in figure skating,” said Kirk in an interview during the Winter Olympics in February. “(Figure skaters) are supposed to listen, follow directions. Nobody wants to be labeled as needy or problematic, especially while climbing up the ranks.”

That’s another trait that goes hand-in-hand with those who are vulnerable to food issues.

“Generally, sufferers of an eating disorder are well-behaved, they have no conduct-disorder problems, they don’t break rules. In fact, they often avoid conflict,” said Walker, who has been in the mental health field for over 30 years, with a clinical expertise in eating disorders. “They also often have a higher I.Q. than the general population. They are very bright, but their self-esteem is very closely correlated to body image.”

Skaters now have the ability to pass tests more quickly than during the years of competitive school figures, which has had a hand in the median age of figure skaters trending younger. As such, skaters are learning jumps before they hit puberty. As their bodies begin to mature and jumps can falter – and younger skaters are coming up the ranks – the drive to stay small can take over.

As Kirk pointed out, it is much more common for skaters to go to the extremes to try and control and shrink their bodies, rather than adjusting their technique and talents to fit their more adult frames.

A staggering 90 percent of eating disorder sufferers are between the ages of 12 and 25 and the 2015 Journal of Clinical Sport Psychology found that female figure skaters experienced pressure to be thin as young as seven years old, a discovery the study linked to body image concerns and unbalanced methods of managing weight.

“As a society, it is time to redefine what we perceive as a healthy person,” Walker said. “I know that Tonya Harding did not have the body type typically associated with skating, but she did maneuvers that others weren’t doing.”

The first woman to land the triple axel was Midori Ito in 1988, followed by Harding, who was the first American woman to land a triple axel at the U.S. Figure Skating Championships in 1991 and then again at the World Figure Skating Championships that same year. Thirty years after Ito – with her strong, muscular thighs – made history, still only eight female skaters have landed the jump in international competition.

“Just because a certain body type doesn’t fit in the mold, doesn’t mean they can’t pursue that sport,” Walker said. “In fact, they could end up being stand-outs in the sport if it can be figured out how to capitalize on their natural strengths rather than being so caught up in everyone looking one particular way. It is up to the officials and coaches to start seeing things differently.”

Of course there’s logistics to consider: There is a tremendous amount of pressure on joints and the rest of the body when landing jumps. Studies conducted on the impact forces on the bodies of figure skaters show that what a skater feels when coming down from a jump can be as much as eight times their body weight.

“But maybe lean is not necessarily the most conducive for the sport, maybe that’s just how everyone’s been programmed so long that it’s the automatic path,” Walker said. “Lean can often come with many downsides. If an athlete loses muscle, they are more prone to injury. So, sure, they might have less weight to get up in the air, but they won’t have the muscles to be able to land the jump anyway. When their immune system becomes suppressed, they are much more likely to get sick, which of course takes them away from practice. There will also be a loss of stamina and endurance and they will not be able to focus and concentrate. From there, the potential risks only get worse. None of that is good for the athlete or the sport. Lean isn’t as important as strong.”

In 2017, shortly before the U.S. Championships, Rippon broke his foot while doing off-ice hops to warm up his legs – an injury that he came to realize, during his month in recovery, had to do with his unhealthy eating habits.

“I think I had a stress fracture before I broke my foot,” Rippon has said, “and I think that was absolutely not getting enough nutrients.”

As he began working with a sports dietician from the United States Olympic Committee, Rippon said a “fog of fatigue over him lifted.” Part of the process was a body composition analysis, an indicator of how genetics can best be used for an athlete’s gain.

At the Winter Olympics, Rippon was 10 pounds heavier than he had been in 2016 during his punishing diet. His physique of strong thighs and gluteal muscles was praised – as was his skating.

In the truest sense of the phrase then, it might not actually be one size fits all. A message that coaches need to be particularly cognizant of.

“Athletes have to fuel their bodies in order to perform and that message has to be hammered home,” Walker said. “Coaches cannot be critical or condescending. ‘You’re fat. You’ve gained weight.’ Absolutely not. Words cut deep and feelings get hurt. You cannot be vicious with your comments; coaching doesn’t give you that license.”

Studies show that sometimes it takes only one comment to send a person over the edge into an eating disorder abyss.

“Athletes want to please others and they are highly, highly disciplined – again, making them ripe for issues with food because it is something they can control and, oftentimes, get praised for,” Walker said. “Telling an athlete they need to lose weight or that they’ve gotten heavy is an antiquated approach. The emphasis with them needs to be on performing and exceling – and being healthy enough to do that.”

Especially in figure skating, where opinion and subjectivity often rule, athletes find themselves able to control their food intake, which makes them feel like they are in control of something.

And, in a sport where pushing your body beyond normal limits is praised, it’s a short distance to food becoming one of those limits to be pushed past as well.

“When I was hungry, it made me feel strong,” Olympic gold medalist, two-time world champion and four-time national champion Brian Boitano told the New York Times. “It’s the same now as it was in my day, and I think it’s all figure skaters. We all live during our Olympic careers and, after our competitive careers, with an interesting relationship with food.”

It’s a possible shift in mentality that is being toyed with even by someone of Boitano’s legendary caliber.

“Could I have had superconsistent quads, could I have been stronger, if I had eaten the way I do now?” he asked. “It’s something that I wonder about.”

When a person is struggling with an eating disorder, weight is their sole focus in life. Every minute of every day revolves around weight and calories. It is a carousel ride that allows the sufferer to numb feelings and emotions.

As such, it cannot be overstated enough that eating disorders are not about food; food is the manifestation of the underlying problem.

Walker advises that a good approach is for the coach to talk to the athlete first.

“The trust developed between a coach and athlete is special and important,” Walker said. “The coach can say, ‘I am coming to you first, but I am concerned about your health. I will be talking to your parents and I would like you to be there. I want you to be healthy and I want you to excel so we need to help you.’”

Following talking to the athlete, the next step is following up with referrals to the athlete and the athlete’s parents of local doctors or dieticians, who are in a better position to recommend testing and therapy.

For a coach’s part, what is said and how it is said is extremely important when addressing these issues – and even things that are seen in society as being good, can actually be quite damaging.

“Praising someone for being skinny is seen as a compliment, but it’s every bit as bad as telling someone they’ve gotten fat,” Walker said. “For an athlete that gets that sort of praise from their coach, they want to maintain that and anxiety sets in as they try to figure out how to stay there. They have guilt and shame when they have a bite of a cupcake. It all boils down to one thing: self-esteem.”

The look of an athlete’s body or the number on the scale is the very, very last thing that should be emphasized.

“The focus has to be on having the proper fuel for the body in order for it to perform,” Walker said. “When a coach puts the focus on the performance and excelling at the sport, it helps the athlete admit they have a problem. It should never be about looks or weight. They are already obsessed with calories and the scale. It should only be about mental toughness, the ability to focus, physical strength and performance. These are things an athlete can understand and will speak to them.”

It’s important to know that, oftentimes, a sufferer doesn’t “look anorexic,” as understood by today’s society. Anorexics can be anywhere from five to 15 pounds underweight. By the time a sufferer looks emaciated, they are in a very dangerous place mentally and physically. A skater’s health can be in danger even if they are not overtly thin and it’s important for a coach, who is spending a lot of one-on-one time with the athlete, to act.

“I hear all of the time, ‘I didn’t know if I should do something, I didn’t know if it was the right thing to do,’” Walker said. “Never be afraid to address the problem. It’s always better to do something than do nothing. You could be saving a life.”

Here are the shocking facts: Every 62 minutes someone dies as a direct result from an eating disorder. That means eating disorders have the highest mortality rate of any mental illness.

Physical symptoms of the body not getting proper nourishment can include a slow heart rate, heart fluttering, heart failure, low blood pressure, feeling cold all of the time, frequent illness due to an impaired immune system, brittle nails or hair loss, stress fractures, fatigue, and overall weakness. The equally damaging psychological ramifications are a negative body image, depression and anxiety, a total obsession with food and weight and a severely decreased ability to focus and concentrate.

“Eating disorders are not a joke, they cannot be overlooked and they will not just get better on their own,” Walker said. “Acting with compassion from the beginning, can go a long way. Coaches need to be aware of what they say and how they say it. One comment can sometimes crush an athlete that is a perfectionist and is invested in their coach’s approval. Talk to your athlete about getting the proper fuel for their body so they can mentally and physically excel in their sport and they can reach the heights they are meant to reach.”

For those with questions or who are interested in learning more about eating disorders, please contact Susan Walker at swalker@walkerwellness.com or 469- 951-4490. Her book “Body Esteem: Piece of Cake and Peace of Mind” is currently on sale.