Within a campus culture that emphasizes physical fitness and activity, one subset of the campus population faces added pressures to maintain a physical form at a higher level: student-athletes.

With demands to perform for the most successful athletic program in the country, some Stanford student-athletes find themselves struggling with body image issues. And some of these student-athletes raise concerns about the culture of eating disorders and the resources and support provided by the University and athletic department to deal with them.

According to data collected by the National Eating Disorder Association, 25.5 percent of varsity collegiate athletes exhibited symptoms of eating disorders. Further, a study conducted by the National Association of Anorexia Nervosa and Associated Disorders (ANAD) found that elite female athletes were more than twice as likely to have an eating disorder compared to their non-athlete counterparts.

Part of the problem lies in the lack of discussion about the culture of eating excessively to gain weight or limiting food to lose weight.

“Unfortunately that culture is condoned by my sport … When you get to the point where you’re so starved, as soon as you can eat again you can’t stop – you turn into the cookie monster, and it’s this really scary moment where [you] can’t stop,” said Athlete A, a former female varsity athlete that dealt with an eating disorder.

Like many The Daily spoke with for this article, Athlete A was granted anonymity due to the sensitive subject matter.

 

Performance eating vs. disordered eating

For student-athletes, the eating habits necessary to make them successful in their sport can become unhealthy. While many athletes are able to separate their physical needs from their emotional needs, that line can become blurred when sports demand a certain body type.

Football player Denzel Franklin ’18 said that many football players have to change their eating habits in order to gain or lose weight. According to Franklin, the football team is able to develop these habits in healthy ways, curbing the possibility of unhealthy mindsets emerging.

Franklin said the healthy approach to eating and nutrition on the football team is largely driven by programs and education put in place by the coaching and training staff, such as a detailed checklist given to players to help track their nutritional intake for the day.

“[The football program] does a great job of encouraging healthy living habits,” Franklin said. “There’s nothing in our whole system where it’s like, ‘You’re too fat’ or ‘You’re too skinny’. It’s, ‘You need to do this to your body so you will perform better.'”

Certain sports put more pressure on weight and appearance than others. Sports such as women’s lightweight rowing and men’s wrestling have specific weight cutoffs.

In diving and gymnastics, an athlete’s scores may be affected by the judge’s impression of their appearance.

Sloane Brazina ’15, a member of the varsity diving team, said that divers must be aware of their body composition because it can affect their scores in competition.

“You’re being judged on your poise, and how your body looks in the air and your entry looks going in the water,” Brazina said. “There is always a pressure to be lean, and definitely keep up with appearances.”

The ANAD study found that female athletes in judged sports (e.g. gymnastics, ballet, figure skating, etc) were at the highest risk of developing an eating disorder.

While some athletes, such as Brazina, successfully balance the physical demands of their sport with a positive and healthy mindset, the high stress environment of athletics can cause other athletes to internalize their eating habits until they become dangerous.

Athlete A had to focus on her eating habits after gaining weight during her freshman year.

“Every time I slipped (in my diet) I felt so ashamed of myself. I felt like such a sorry excuse for an athlete,” she said. “I think that shame I felt towards my coach turned into shame I felt about my body, and that’s when it became more of a personal than a sports related issue.”

After gaining weight her freshman year, Athlete A worked with a private trainer over the summer who helped her develop a strict diet and track factors in her athletic performance such as body fat percentage.

While working with the trainer did help her stay at the weight and level of fitness she needed to be for her sport, she said that writing down everything she ate and having her body fat measured felt invasive and ultimately harmed her mental approach to food.

 

Control over injuries

For injured athletes, their relationship with food often becomes a wrestle for control, spurred on by attempts to defy the unwanted physical effects of “time off.”

Molly McNamara ’15, a varsity cross country and track and field athlete and Head of Athletic Mental Health for the ASSU Executive Cabinet, experienced this struggle with disordered eating while injured her freshman year. Her relationship with food began as one that initially had her feeling in control but that gradually spun out of control as illness, injury and depression struck her, seemingly all at once.

“When I came in as a freshman I was very strict about everything I ate. I wasn’t anorexic but I had an A-plus diet,” McNamara said. “Then, I got mono right before nationals in cross country.”

After taking a month off from running in order to recover from mononucleosis, McNamara was eager to rejoin her teammates at practice but misfortune struck again, this time taking the form of an ominous, dark line shown in an MRI of her sacrum.

“When I was coming back after that month off, I got a sacral stress fracture and I was off again for four months of no running,” McNamara said

Those four months would prove to be challenging times for McNamara, as the stress from issues on the Farm and back home began to weigh on her and to affect her relationship with food.

“In all this time, I was dealing with a family situation at home where my mom had been diagnosed with breast cancer. Just with the stress of that and not being able to run and trying to adjust to a new school, I started struggling with depression a bit,” McNamara said, “I would just be like, ‘I can’t run anyway, so why would it matter?’ and I would start stress eating.”

Thoughts about food and how she ate began to consume her.

“I would be like, ‘What does it matter?’ or ‘I didn’t eat well earlier so I already messed up the day at this point’ and would just binge,” she said.

“It went from the first part of my freshman year where I felt like if I veered off that perfect diet I was going to lose control to all the time I had no control ever,” McNamara said, “I just felt stressed all the time.”

McNamara conducted a study as part of the Stanford Sports Medicine Physical Therapy Clinic that looked at athletes’ responses to injuries. Of the 70 varsity athletes surveyed, 49 percent of female student-athletes reported that their eating habits had changed since becoming injured. 54 percent worried about their weight while injured or coming back from an injury.

 

Control over life

Athlete A’s experience exemplifies another common issue that athletes face that can lead to an eating disorder – using food to gain a feeling of control.

“[I thought], I can do this, because I have complete control over my life,” she said, speaking about the strict diet she followed after a freshman year defined by bingeing and purging cycles. “I was holding myself at this and felt so good about my level of control.”

Looking to eating habits for a sense of control is a common reaction to stress and to deal with anxiety, according to Carley Hauck. Hauck, who has a master’s degree in health psychology, teaches several classes at Stanford, including a course called Intuitive Eating that focuses on how mindfulness can encourage healthy eating habits.

“In the case of athletics, there’s anxiety [because] you’re being told, we need you to be a certain way to be able to perform well,” Hauck said. “So the reason that there’s this controlling aspect around food is to manage the anxiety … around what their coach is telling them or what performance they are hoping to achieve if they are at a certain weight.”

According to Hauck, the anxiety of college causes many students to develop unhealthy mindsets towards eating, whether or not they are athletes. Athletics place an additional source of pressure and anxiety on students already dealing with the stress of academics and social life.

For Athlete B, a female senior varsity athlete, this control can stem from a sense of pressure from various sources.

“When you see eating disorders in female athletes, often it’s not so much what their coach is doing but them just feeling pressure from a lot of different directions and not feeling like they have control over their bodies,” she said.

 

Athlete/female dichotomy

For some female athletes at Stanford, issues with having a “feminine” figure – one which might be curvy or look good in feminine clothing – while also maintaining an athletic physique that needs to be stronger and could seem bulky to some, can come into conflict.

According to varsity golfer Mariah Stackhouse ’16, athletes in certain sports, such as golf, feel the need to conform to an image of athleticism.

“I think a lot of people can be concerned about how they appear because they feel like they don’t look a certain way or how people perceive an athlete to be,” Stackhouse said. “How people stereotype athletes to look is not always realistic because there’s body makeup, there’s positions.”

For some female student-athletes, not looking athletic enough is not the concern – it’s not looking feminine enough.

“For female athletes, there’s body image issues,” said Amber Farrell ’15, a former hurdler on the varsity track and field team.

“[Body image issues] are exacerbated by the fact that you’re an athlete and you’re putting all of this stress on your body. You’re already pressured to look a certain way and you also have to perform a certain way,” Farrell continued. “And those things might not match up, the way you look and the way you’re supposed to look, the way you need to look for a certain event.”

Simone Manuel ’18, a member of the varsity swim team and an American record holder, is familiar with this frustration of her athletic body literally not fitting the ideal image of femininity.

“With swimmers, we have really wide shoulders. When I go dress shopping, I have a really hard time because I can’t fit into a certain type of clothing,” Manuel said. “It becomes frustrating because you look at other girls and they have a perfect body image, straight up and down, and we’re kind of like a triangle.”

A common challenge that female athletes face in their attempt to maintain a feminine body is becoming too “bulky” from weight training.

“When I came to Stanford I was very confident in that I always liked the way my body looked, and I like that I was athletic and slim,” Athlete A said. “But putting on all that muscle bulk – in some ways it feels very unfeminine, it’s very bulky.”

Farrell, too, has seen teammates “being in the weight room and not wanting to lift too much because [they] don’t want to look a certain way” and worries that the stress of conforming to feminine ideals is hindering their performance in their sport.

“But you need to do those things to perform well in a sport,” she says, “You’re not getting strong enough, not eating enough or lifting enough.”

“I think for female athletes in general, there’s so much pressure. Female athletes tend to feel like they earned their spot here, they can’t just be a good athlete, they also have to be a good student and really pretty and really nice,” she added.

 

The team dynamics of disorders

Sometimes these disorders can affect team dynamics as well. Resentment may arise when athletes are struggling with their self-image, and they see their teammates easily able to maintain a certain physique.

“It honestly became a bit of a divided thing, where it was like, the girls with the [ideal] body type and the girls without [it],” Athlete A said. “It’s not like they were making us feel bad or anything like that, but the girls without the [ideal] body type – the things we had to put ourselves through – they had no idea.

“I think that the culture at Stanford is to internalize your problems, and this is a general trend, so with my team, with other athletes I’ve talked to, you don’t really want to admit you’re struggling with something here,” she added.

So how can athletes feel secure? For some, their teammates were a source of support.

“There’s definitely been a really healthy attitude towards diet on the team. Nobody ever has anything to say about anyone else’s food choices or their physical appearance,” Stackhouse said.

The attitudes definitely differ between teams, and teams with a stronger sense of “groupthink” are more susceptible to disordered thinking, according to Hauck.

“It’s the reason eating disorders are so rampant in sororities. It’s a way of being a part of the group. ‘If this person’s doing it and this person’s doing it, maybe I need to be doing it too,’” Hauck said.

Coming to Stanford and the increased expectations that go along with being a student at Stanford can be adjustments that proves overwhelming for many.

Retired Olympic figure skater Rachael Flatt ’15 stressed the importance of finding a support system, even in a new environment.

“Knowing that other people are going through that with you, you think, ‘Oh, okay, I’m not the only one who’s going through this.’ I thought that was really what helped me a lot,” Flatt said.

While Flatt never dealt with an eating disorder, she did experience the pressures that come with competing in a sport with judges.

“People like me, and some of the other skaters, who aren’t fat by any means – we just have a more athletic build rather than a very thin, sinewy type – we got criticized for that constantly,” Flatt said. “It wasn’t just coming from officials in private, it was commentary on national television and people in the media.”

Some coaches do try to create a team environment which does not put unnecessary stress on the athletes.

One varsity coach talked about his efforts to create a team in which every member had an important role, rather than giving too much focus to a few students.

“I try to individualize my attention, from the all-Americans to the walk-ons, so it’s not a competition for our attention,” he said. “It’s basically just relationship building, with a simple level to begin with, which is just to talk to them about things more than just [the sport], like school, family, how things are going.”

 

Resources and their availability

The athletic department has an official procedure for dealing with eating disorders. It involves both the Athletic Department and Vaden Health Center working with the student to offer support, wrote Scott Anderson, director of Athletic Training, in an email to The Daily.

Some athletes, however, aren’t aware that these types of resources are available to support them if they need it.

“I didn’t seek out the help I should’ve gotten … at the same time, I wasn’t sure what my resources were,” Athlete A said.

According to Anderson, if the coaches and the Athletic Department are aware of the situation and it becomes severe enough, more drastic measures are taken.

“We often remove athletes with poor vitals from participation and have admitted many who are in danger of developing a life threatening condition,” Anderson wrote.

That measure, intended to protect students’ health and safety, can work as a detriment. Even if athletes do know where to go, the fear of being taken off the team or prevented from participating in their sport can discourage students from reporting an eating disorder that they or a teammate are hiding.

“The culture on the track team did not make us feel like we could go to the coach … because we felt like the girl might be punished,” Farrell said. “Especially for varsity scholarship athletes, we don’t want [the coaches] saying, ‘Okay, well, you’re off the team, or you’re not running in the next few meets.’ ”

Not all students have negative experiences with the University’s resources, and Stanford is making a concerted effort to improve the support system for athletes. This year, Stanford hired a sports psychologist and a nutritionist, intending to help students and coaches alike learn how to better address eating disorders.

“I think moving forward, there’s going to be a healthier coach culture emerging around this topic,” Brazina said. “I think there’s definitely a demand from student-athletes in past years about getting people like this [trained professionals] on our staff.”

Even if the Athletic Department provides more staff, students still have to feel comfortable approaching those professionals. Athlete A said she found some support from the resources of the sports fitness center, but it ultimately wasn’t enough.

“It was … a matter of going and speaking to them, but there was only so much they could do because at the end of the day it’s your body,” she said.

Farrell still feels like she wouldn’t know how to help a friend whose behavior concerned her.

“If a friend came to me or if I felt like a friend might have some kind of eating disorder or something, I still wouldn’t exactly know what to do,” Farrell said. “I think it’s a big enough problem that there should be a resource for that directly.”

Brazina has some ideas on how to make accessing those resources more comfortable and acceptable for athletes, like involving Cardinal Council.

“Student-athletes might feel more comfortable approaching a designated team member…to talk about issues surrounding weight and body image,” Brazina explained.

 

Student-athletes and Stanford

With a continued push for athletic excellence, Stanford might continue to see athletes with eating disorders.

“We’ve been in this situation [of dealing with eating disorders] quite a bit,” the varsity coach admitted.

The problem, the coach suggested, was the short term benefits of eating disorders. “In our sport, eating disorders temporarily work.”

The answer lies perhaps in not only making resources known but also in understanding that athletic performance is not the most important thing.

“[We] make sure the [student-athlete] knows you’re involved in whole process [and] not just punting them to someone else,” the coach said. “They need to know you care about them – if they think you only care about their performances, then that’s bad.”

 

Contact Katie Zingheim at zingheim ‘at’ stanford.edu, Chelsey Sveinsson at svein ‘at’ stanford.edu,  Sarah Wishingrad at swishing ‘at’ stanford.edu and Leela Srinivasan at leelas ‘at’ stanford.edu.