We often talk about rugby injuries, but why don’t we address the threat of long distance running for girls at risk of disordered eating.

[IslaIska]

Particularly those starting young, who are pushed and may try to keep a childish shape. See it at a local public school, with long distance running at the prep. It is pushed and taken seriously. Some of the girls look frighteningly thin and seem very anxious.

It looks like a slippery slope and yet only seems to be discussed as a positive thing. Yet the ED risks are up there or beyond ballet for that age group. In the US it is discussed and starting to be acted on.

The statistics are appalling:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708838/

https://pubmed.ncbi.nlm.nih.gov/17490455/

https://globalsportmatters.com/health/2019/05/15/disordered-eating-plagues-female-distance-runners/

The testimony from the runners is shocking and sad:

https://www.runnersworld.com/uk/nutrition/a34963527/disordered-eating-runners/ 

https://www.theovalmagazine.com/post/three-women-one-issue

I'm in shock by that. I would see it being a consequence of an ED but not a cause. I feel a bit naive now. I'd have always thought you need so much energy to be able to run competitively so had no clue.

Well, the two are very different, aren't they?

All coaches should be aware of this and should be monitoring their female athletes' periods (not na weird way, just checking that they are regular).

Coaches should also know about optimum nutrition, and should be keeping an eye on their runners' weight to ensure they are healthy.

The best middle distance and lonng distance runners are naturally slim and have a similar build.

The 'local public school' you're talking about - how old are the kids there? What distance are they running? Shouldn't be far.

Female runners should know about RED-S too: see https://www.runnersworld.com/uk/health/a33589189/red-s-relative-energy-deficiency-running/

It is shocking @Lovingitallnow and just not talked about. In real life the answer to concerns raised is always that runners need to be strong, they must be getting lots of energy to run far, etc. Yet runners speak out on trying to keep a prepubescent body shape, the performance benefits of very low BMIs and coaches pushing this: https://athleticsweekly.com/performance/how-anorexia-nearly-claimed-the-life-of-talented-runner-rebecca-quinlan-1039961092/

If you're not aware of The Well HQ you should look them up. They're doing brilliant work in supporting sports coaches to approach training for women and girls differently, and not in the same way they coach boys and men

I don’t think there is an equivalent risk between the long term consequences of repeated head injuries and disordered eating.

sadly, ED is seen in lots of different sports, including athletics. However, I’ve never seen coaching that encourages anything other than good fuelling, particularly for endurance sports, and there are strict rules on distances for younger age groups. England athletics will not allow under 17s to participate in anything over 5k, for example.

Its an important to issue to raise but I don't think whataboutery is the way forward.

These are different issues.

Every coaching course I've ever been on and a lot of the material I've read has covered this. It is talked about.

There's a lot going on here. Endurance sport can surface EDs - this is pretty well known. Exercise addiction can also 'cure' EDs - the number of clearly exercise-addicted crossfitters who suffered EDs when younger is testament to this, personally I think it's healthier to have exercise addiction than an ED but disaster can strike after an injury.

Awareness of RED-S is a big thing in endurance sport coaching at the moment - I've attended training sessions on it put out by my governing body and know quite a few athletes who have suffered from it - in cycling it became much better known about during COVID when everyone was absolutely destroying themselves doing Zwift races every night.

What I'm struggling with is that there are endurance sport coaches in the UK who are still telling their athletes to lose weight. Again, in my sport (cycling) we are not permitted to have weight management as part of a coaching programme at all for youth and junior riders - we can't even mention it. I'm pretty sure that UKA have the same policy in place for their coaches.

I don’t think there is an equivalent risk between the long term consequences of repeated head injuries and disordered eating.

Osteoporosis, damaged organs including the heart, infertility, neurological disease, starving to death.

Exsctly this, it IS being talked about and any coach should be aware of both EDs and RED-S. I’ve no idea what goes on in private schools but at club level this is absolutely something that coaches watch out for and have lots of guidance on.

Many might not have EDs or be underweight but they are obsessed with exercise and not enough body fat can cause your periods to either stop, be irregular or never start in the first place. Ballerinas are encouraged to be as thin as possible.

Sorry @Woodyandbuzz1 , I did not mean to downplay the seriousness of ED, but meant that the nature of the risk is completely different. Conversations around head injury risk and spotting ED in young athletes and encouraging healthy training not damaging over exercise alongside restricted nutrition are not the same conversations.

I agree that whataboutery is not helpful.

It’s also worth remembering that inactivity and lack of exercise is a far greater problem that over exercise for a vast number of children.

I agree it is being talked about at the older competitive level and at coaching courses.

There does not seem to be much awareness among parents of younger girls, who are a group who will be particularly at risk as their bodies change. Nothing from the coach at the public school, which I was surprised about. The perception seems to be how strong the girls must be, how much energy they have to run so far, etc. Completely ignoring the research on this, testimonies from older runners and the worrying appearance of some of the young girls.

https://www.runwashington.com/2018/11/06/running-on-empty/
https://lane9project.org/2020/01/07/the-epidemic-in-womens-distance-running-and-what-it-did-to-me/

@IslaIska, what are you hoping for by posting here? Looks like lots of MN members are aware of the risks!

You might be better contacting the school you mentioned, or talking directly to people you know who are the parents of girls who run?

Are you in the USA?

Ballerinas are encouraged to be as thin as possible.

I'm not an expert, but from what I've seen ballerinas actually don't starve themselves (those I know anyway) but figure skating (especially pairs and singles ladies) skating has an absolute epidemic of eating disorders. I think pairs girls are probably put under most pressure to stay tiny, but also single skaters because pre-puberty bodies can rotate much quicker and easier in the air.

Slightly off-topic, but I think this can affect anyone at any age. I have a middle aged male relative who’s a long distance runner and I’ve long suspected that he has an ED. He tracks his weight by the ounce. 🙁

I agree that the physical consequences can be shocking, he looks far older than he is due to lack of body fat. An obsession with weight and exercise can be dangerous for anyone .

@IslaIska is the coach at this school actually a coach or are they just a PE teacher? Are they accredited by UKA? Do they do continuing professional development? Do they attend regional coaching seminars and meet-ups to talk to other coaches about best practice? Do they get 360 feedback from other coaches observing their sessions? My guess would be no to all the above.

Go to a proper AC rather than a random school and you’ll see a very different picture.

Is it just running?

I presume they are not a specialist coach @coureur and hope the picture is very different elsewhere (purposefully not disclosing the school/county, as I do not want to inadvertently identify the girls).

I know a male ultra runner who runs to the point of harm @BruFord Scary stuff, including being taken to hospital with kidney problems. I know a few others who are serious about it, but don't have that skeletal look.

And I know half-a-dozen male ultra runners who don't.

What's your point. You know one fool ergo everyoone who does that activity is also a fool?

No. Sorry.

@IvorTheEngineDriver I think her point is that ED’s are sometimes hard to detect when they’re hidden by dedication to a sport.

Restricting food intake and over-exercising are symptoms of anorexia, but if someone’s a dedicated long-distance runner, it can be hard to recognize that their commitment might have turned into an ED.

Preps shouldn't be doing long distance running at all

For cross country, by year 6 the distance should not exceed 2,500m (lower limits for younger ages); if a prep that goes to year 8 then 3,500m and all u18s it's 10k.

Or were you thinking of different kinds of running? You have to be 17 to enter a half marathon (you can't insure younger runners) and for most marathons it's 18

So it sounds as if the prep and the public school you cite may be taking an idiosyncratic approach to distance running (and putting themselves in breach of central athletics policy). And that is of course wrong, just as it would be wrong to breach safety guidelines for any other sport.

How do you know how far the children at this school are running?

My DC are both at a prep and participate in cross-countries, but they’re only 2kms max.

My DD was doing XC at primary school and they were max 1500 to 2000m BUT training runs for the better runners could 5 to 8km and 1 h to 1.5hr long interval sessions.

tbh though, considering the mass dropout rates in female school sport (even if they ever do any) & our ever growing waistlines, EDs whilst relevant to the top runners are less of a problem in girls generally.