The scale reads 158.2. Up a pound from yesterday. And after a run, no less. Son of a bitch. I step into the shower and scrub the dirt off my calves and ankles, the sweat from my face, from behind my ears. I know it's irrational, but a germ of a thought percolates in my brain: Maybe, just maybe, collectively erasing these micrograms from my skin will bring me into 157-pound territory. I towel off and step back on the scale. I'm running my first marathon next month, and at five-foot-eight, I want to toe the line at 155 pounds, preferably 153. I'm hellbent on breaking four hours. I look down. Dammit. Same unfeeling numbers. Okay, scratch tomorrow's rest day. Later, as I pack my lunch–debating between one or two mini wheat bagels to go with a wedge of light cream cheese and an apple–I pray it's nobody's birthday at the office today. Cake is the devil.
Little did I know that nutritionists had a name for this swirl of thinking: disordered eating. At the time, I'd never heard the term. Eating disorders I knew about, but I was hardly a skeletal anorexic, nor did I purge my meals. I was simply a dedicated runner with what I considered serious willpower. Besides, didn't a marathon demand Spartan discipline?
When I'd mailed in my registration, I was 39 years old with a daddy belly and a double chin. I'd been running for six years, mostly five-mile stretches. I hovered just below 175 pounds, was prone to shinsplints and knee pain, and ran on dirt wherever I could find it. Obviously, 26.2 miles of asphalt could be a problem. The thought of being branded a DNF was my ultimate nightmare. But somewhere along the way, I'd heard that I'd run about two seconds faster per mile for every pound I lost. This bit of information–accurate or not–radically changed my diet.
For the first time in my life, I scrutinized nutrition labels. I parted company with meat and learned to love tofu and soy milk. For breakfast, it was fruits and fat-free yogurt. I'd begin my small dinners with an appetizer of boiled broccoli. No desserts. As my weekly miles piled up, my waistline started shrinking. I announced each lost pound to my wife like a sniper taking out another enemy soldier. The flattened landscape of my belly made me swoon. Food became one of my mind's favorite topics. I got off on the sensation of my stomach grumbling and learned to fall asleep hungry. But god forbid the scale go up. If it did, I seethed.
"The more competitive people are, even if they're just competitive with themselves, the more likely they are to have the kind of extremist thinking that can lead to disordered eating patterns," says Patricia Kaminski, associate professor of psychology at the University of North Texas, who's helped many people with eating disorders. "'If running five miles is going to help me train well, then running 10 is better. If a 1,200-calorie diet is good to help me lose weight, then a 500-calorie diet must be great.'"
Disordered eating differs from an eating disorder in that food intake isn't manipulated to deal with underlying issues of depression, anxiety, self-esteem, and control. The most common forms of eating disorders–anorexia (self-starvation) and bulimia (binging and purging)–are serious psychiatric illnesses, with significant physical consequences, and can be fatal. Disordered eating, on the other hand, refers to less-severe abnormal behaviors: eliminating food groups from your diet; regularly replacing meals with energy bars or coffee drinks; excessive weighing and calorie-counting; and tacking on extra miles as punishment for, say a cheeseburger the night before. Often, the regimen includes compulsive exercising like hitting the bike after an 18-miler.
The condition is far more common among female runners, mirroring the trend seen in the general public. It's estimated that three out of four American women between ages 25 and 45 practice disordered eating, according to a University of North Carolina at Chapel Hill study. A 2009 report in the Journal of American College Health showed more than a quarter of female college athletes exhibit disordered eating patterns. And in surveys of collegiate athletes, some 55 percent of women tell researchers they experience pressure (both external and self-imposed) to achieve a certain weight, and 43 percent say they're "terrified" of becoming too heavy. Between two and three percent of female college athletes have a diagnosed eating disorder, which is about the same for the general population. Men who compete in sports where body shape and size are important also are at higher risk for disordered eating.
The costs can be profound: Prolonged disordered eating can lead to anemia; loss of muscle strength, endurance, and coordination; more frequent injuries, including stress fractures; longer recovery time after intense workouts and races; anxiety; and fertility issues in women. The most worrisome consequence, however, is the onset of a full-blown eating disorder.
Leslie Bonci, R.D., director of sports nutrition at Pittsburgh's UPMC Center for Sports Medicine, says the most common sign of disordered eating is when food choices become about what not to eat.
"A lot of people have their good-food list and their bad-food list," Bonci says. "Nothing high in fat, nothing fried. They'll eat only organic, only local, won't touch anything processed. They might start to avoid social situations because they don't know what the food will be."
Obviously, runners, and especially marathoners, demand greater nutrition than sofa spuds. An endurance athlete's ideal fuel is glycogen, carbohydrates stored in the muscles and liver. A low-carb lifestyle is clearly counterproductive. When glycogen stores are low, protein, which is essential for muscle growth and repair, may be robbed for energy. Zinc and vitamins A, B6, and E are important for the immune system and bone health, but are found in red meat, nuts, and dairy–often seen as kryptonite by fat-phobes.
"When you look at a lot of media, the message is everybody's on a diet, everybody needs to lose weight or restrict," says Colorado-based psychotherapist and former U.S. marathon champion Jane Welzel. "Instead of how do you support your lifestyle through nutrition, the message is reduce carbs and fats, or this has a high glycemic index, or don't eat too many bananas. It's the sound bites, the headlines, that grab attention. Then people add it to their list of rules. It's totally out of context for what they need to do to support their level of training."
While not all disordered eating leads to an eating disorder, almost all eating disorders start as disordered eating, so it can be scary territory for a runner, particularly an emotionally vulnerable one or for someone dealing with significant stress. Manipulating one's food and body offers a sense of control and perfection, a substitute for happiness that may be absent when they're not laced in running shoes.
"People lose weight and run faster," says Bonci. "But for some it becomes like this addictive drug. It's a really a fine line between healthy and unhealthy weight loss, and there are a lot of people who straddle that line day in and day out."
