coaching the eating disordered

A few times week I am asked about coaching athletes with eating disorders, mostly from other triathlon coaches, sometimes gymnastic coaches, a lot of people. I do a lot of speaking around here about it, parents often use me to help when intervening with their kids, that kind of thing. I was even once asked me not to write about it.

I think it's far too important to not write about it. It's the big elephant in the middle of the room.

Let's face it, triathlon and eating disorders go hand in hand. Almost as bad as dancers and eating disorders. Because I have been in recovery from an eating disorder and I coach triathletes..... there are times when people who are still active in their "EDO"'s....... come to me. Sometimes coaches come to me and ask for advice.

Don't get me wrong..... I understand EDO's. I even have a career in the medical profession which qualifies me a little bit to work with this disorder. The mistake happens when people come to me thinking I can cure them, or I will help them perpetuate their illness.

I am notoriously tough on EDO's. I don't tolerate them well. If you are a coach, you shouldn't either.

Because a long time ago...... someone did that for me. And a long time ago, one almost took my life.

I once coached a girl who, in our initial meeting rattled a list of stress fractures so long I stopped her and asked her how long she'd had an EDO. She seemed surprised, and maybe she even felt relieved. Misery loves company..... or so she thought.

Her goals were lofty and she had the ability. Trouble began when I'd plan a week for her, she'd hit everything. But then there would be a whole lot of "added time". Not 20 minute dog walks..... four hour ones. Injuries upon injuries would begin to surface...... I did the best I could, tried as hard as I could but eventually we had to part ways. I couldn't be a part of the illness.

That was very hard for me to accept. Just because I have been recovering from an eating disorder does not mean I can cure someone and doesn't make me an expert. I can want to save someone, I really wanted to help her. It hurt me very deeply because I found a path for myself but she couldn't even see the light at the end of the day much less the tunnel. It hurt me because I cared so much. I didn't want her to live in that hell anymore.

To this day the girl won't even speak to me. And I see her twice a week.

She hates me, and I mean hates me. What I have to realize however..... is that she does not really hate me. She hates what her illness has done and she hates her illness and she hates what it has done to her whole life. When it comes down to it, her anger and hatred have nothing to do with me.

I use this as an example to make the following point:

So you coach this girl. And she digs herself into a hole of injuries and over training (even though it's not what you plan for her). Because you care you try to help her. You set calorie gaols for her..... now are you a Registered Dietitian? Remember that for later on........ you set binge / purge goals for her....... (WHAT?) ...... there are a hundred tricks I have heard coaches use. And I don't mean just triathlon. I know some gymnastics coaches who have told their athletes "If you have only one episode per week for four weeks..... then you can ______".

Are you a therapist?

After months of coaching this athlete she doesn't get better. You find it eating away at you because you want her to get better. You really do. You may be like me and you have been through an EDO so you know that there's recovery..... which makes it so much harder than not having the experience of an EDO. If you've been there are you are recovering..... you know there is hope. If you have never been there..... then you just don't get it..... believe me that's the safer place to be.

You might refer her to a Registered Dietitian. You might refer her to a psychologist (good move). You might do what I do and refuse to coach her until she beings you a note from her medical doctor who is aware of her condition and gives her permission to train XX hours per week.

And then you call that doctor to verify.

Oh yes, that's exactly what I do. Remember that someone did this for me.

Because let's say this girl is me, and has a heart attack. Is in a hospital bed and in a coma. Her parents / family blame the triathlon coach because for the past 8 months all this athlete has talked about is her coach who does the Ironman and who trains XX hours a week too.

They might try to sue you. It won't be a very strong case but what if it is?

So you sit on the stand (and trust me this is such a weak case to begin with it would likely never get there). Every training log has been opened, reviewed by lawyers, everyone.

Imagine the cross examination., of you, the coach.

What is your degree in?

I have a degree in Economics.

And you coach triathletes?

I am a level II USAT Coach.

And you thought it proper to prescribe XX hours a week of training for this athlete who suffers from anorexia, has had 8 stress fractures, who occasionally binges?????

Yes sir.

Because you are a level II coach.

Right.

Do you have training in nutrition?

No.

Training in eating disorders?

No. But I had one.

Therapist?

No.

Medical degree specializing in eating disorders?

No.

So when you have this girl the goal of XXXX calories per day....... were you really qualified to make that assessment?

No.

Did you refer her to anyone for help?

No.

Not even to her doctor?

No.

See where this is going???????

Again it would be a giant long shot to even get to court but the whole point of this..... is that you have to know where to draw the line.

The hard part is that we care about the athletes we coach. We care a lot. But caring doesn't mean curing. You have to know where your limits are. Your limits are a lot closer than you think.

While I do a lot of speaking about my story, and I am in the medical profession and I am working towards my Masters with a focus in EDO's....... I am not qualified to be dealing with athletes who have EDO's. I can listen. I can relate.

I have an athlete who currently is in treatment for an EDO. She's okay with me writing about it.

I asked her to show proof that she was under the care of a medical doctor, a therapist and a nutritionist. I am delighted to be on her recovery team, I feel very honored she chose me to help with this process. I work within parameters set by her doctor, she records her nutrition in Training Peaks and her doctor, therapist and nutritionist all have access to and look at her nutrition and her training. We all require her to record her daily parameters of sleep, heart rate, blood pressure, weight..... all of those.

She's doing very very very well. Her entire life she has been haunted by this disease and when she came to me she had already begun the process of recovering. She's flourishing.

The key to her flourishing.... is that she wants to get better. Notice my first example.... she didn't want to get better. My current athlete wants to. She wants to have children in a few years. She has a lot of talent. She sees the writing on the wall.

We have to have the motivation to get better.

Be careful with athletes who do suffer from EDO's, realize what you realistically can and can not do for them. Don't hide behind the "I don't' understand EDO's" because they are not for you to understand..... they are for you to help get help for.

Understanding an EDO is not going to mean you can cure one. You also have to understand that you can't force someone to get help. There are circumstances where you have to walk away. That sucks. REALLY SUCKS. I have done it.

As a coach your responsibility is to get them plugged into places where they can get real help, and they have to want to. As much as I love Training Peaks and as much as I demand honesty from my athletes those two things have never been proven to cure an EDO.

It is your responsibility to not buy into the EDO. There is no goal binge or purge. Just like for an alcoholic there is no minimal drink they can have.

The hardest part is this: it is your responsibility to let them go if they can't get help and show you they are. EDO athletes are a tricky bunch. I was one of them. We will create a story about why and about how and we will not always be truthful about it. We've learned to hide the disease and just because I might be paying you does not mean I will not do what I have always done in covering up my disorder.

If I haven't been honest with myself, with my family..... what makes you think I will be honest with you? Because you are a level II USAT coach who won your age group in Hawaii?

Good try, but I don't think so. If anything that places more pressure to hide the truth.

Your responsibility as a coach and as a friend is to try to plug the athlete into places where they can get help. You can listen. You might want to advise. Under certain circumstances it might be appropriate to advise.

You can't cure an eating disorder by coaching someone to an Ironman. We all have limits to what we can do, and as a coach..... you must know yours.