Eating Disorders: public or silent enemy?

[sisinka]

Akiko Suzuki gave this short interview where she shares that during therapy she discovered it was the relationship with her mother that was at the root of her eating disorder. She was the only child and as such she was the only one to carry her parents' expectations and ambitions, and felt obligated to meet them. She felt her parents wanted her to excel in everything she did, to be perfect, so she felt burdened with these expectations and compelled to find everything easy and achievable. When she noticed girls around her started to lose their jumps, she panicked and went to extremes just not to lose her "perfect daughter" image.... It was reshaping their mother-daughter relationship that was crucial to her healing.
This is an interesting point of view as it points to the potential underlying causes for ED. I have a feeling it's been usually talked about as fuelled by skaters' athletic goals and ambitions, but she points to the secondary nature of these goals. Most of all, she wanted to satisfy her parents, and to this aim she used her achievements in skating, jumping was only means to winning, and winning was only means to meet her parents' expectations and prove she was a perfect daughter.
To me, it is a slightly different and precious perspective, and offering some deeper insight into the ED dynamics.
The article is in Japanese but you can easily translate it using your browser translation tool. It is a summary of a longer interview which is behind the paywall so cannot be linked.

Thank you for this story, it is more complex look on Eating Disorders issues.

I am glad you mentioned it. And once again thanks Akiko for sharing this.

Low self-esteem, self-criticism and perfectionism are connected with Eating Disorders, many science studies mention it, some skaters were talking about it as well.

Eating Disorders: public or silent enemy?

Excellent thread. I have nothing much to add except that on a general mental plain, there are many issues that face athletes. I live with an athlete so I know..... I think this article by Emmy Ma is very well done...

www.goldenskate.com

Eating Disorders is a form of self-harm. Person who doesn't like herself / himself (from various reasons) has tendency to self-harm.

Unfortunately there are more things which are complicating this situation.
For example figure skating itself with high level of negative criticism of not only performance BUT also look, body, behaviour, ...
Also majority of competitive skaters are in their teens, which itself is a period of time where young one is starting to look for own identity and is struggling with many inner conflicts and insecurities.

Lack of knowledge of people in figure skating world parents including is another issues which is not preventing skaters to treat themselves with respect and love (not matter how much they fall, how low their score is, how big their muscles are).

The Eating Disorders issue is indeed complex and it once again leads us to realise how much important healthy self-esteem and self-respect is.

 

[sisinka]

2024 is slowly coming to the end.

I wish to all skaters and people connected to this beautiful sport to keep:
- positive mind
- strong will
- big dreams
- never ending fighting spirit
- many and many beautiful moments.

I also wish to all of us to never lose the right direction.
To never stop growing both on and off the ice, both in personal and working life.
To never forget that there are people who love you and stay with you even in cloudy days.

Happy New Year to everybody!

 

[dorispulaski]

Any new info on this subject?

 

[Zora]

I recently read this interview with Medvedeva and found it really disturbing. I know everyone here is against a BMI rule, but maybe it would have protected her from some of this madness. Maybe they would have worked more on skating skills so she could still be "light" on the ice instead of just starving to stay light. Maybe the age rule will help with this issue and let strength and skating skills win over staying as light as possible. Last worlds I think showed, that women's figure skating is heading into a good direction.

 

[Jeanie19]

I recently read this interview with Medvedeva and found it really disturbing. I know everyone here is against a BMI rule, but maybe it would have protected her from some of this madness. Maybe they would have worked more on skating skills so she could still be "light" on the ice instead of just starving to stay light. Maybe the age rule will help with this issue and let strength and skating skills win over staying as light as possible. Last worlds I think showed, that women's figure skating is heading into a good direction.

As a fan of hers, it is sad. But she was talking about the importance to understand nutrition. When she went to Canada and went to a nutritionist, she was shocked that is was okay to eat blueberries. And Evgenia was naturally small for her age until she hit puberty at 16. I think Nutrition should be mandatory in all schools Freshman year. It would have helped me.

 

[Mathman]

I. for one, found this interview with Medvedeva -- my favorite skater from that era -- to be unbearably depressing. I am glad that she is feeling better about herself, that she has shiny growing hair, glowing skin and healthy nails. Still...

"If a coach who is genuinely invested in your results says..., ‘Your waistline is showing through your dress, which I believe is unacceptable in our sport,’ that’s constructive criticism."

"Right now, Eteri Georgievna Tutberidze’s tour is happening, and I’ve spoken with the girls —Sonya Akatieva, Adelia Petrosyan — who are still actively competing. When I look at them, it’s like looking at myself 7-8 years ago. All these heated discussions about weight, weigh-ins, food, dinners, and running around wrapped in plastic — everything."

What I hate about it is this. Children are not trained monkeys who have no other purpose in life than to provide adults with amusement and entertainment. Here is the saddest of all:

"I realize that my mindset is totally different [healthier] now. And it makes me wonder: if I had this current mindset back when I was competing, what kind of skater would I have become? Would I have achieved anything at all? But that’s something we’ll never know."

In other words, either you win an Olympic medal at any coat, or else you are nothing.

 

[Zora]

As a fan of hers, it is sad. But she was talking about the importance to understand nutrition. When she went to Canada and went to a nutritionist, she was shocked that is was okay to eat blueberries. And Evgenia was naturally small for her age until she hit puberty at 16. I think Nutrition should be mandatory in all schools Freshman year. It would have helped me.

But the thing is, according to the interview, she actually tried to work with a nutritionist and a dietitian in Russia and the former made her gain weight and the latter also told her she ate too little and that wasn't what Evgenia wanted to hear and therefore she left both of them. There was no one to intervene, not her mother, not her coaches. Maybe because they all had a conflict of interests. It turned out more or less good for Evgenia, she became a successful skater with some health issues, she probably doesn't have to worry about money. But what about all the skaters, that had to endure the same, but never became successful. To change this mindset in coaches, parents and skaters, it maybe needs some rule changes to prohibit these dangerous habits, like in ski jumping.

 

[sisinka]

Any new info on this subject?

https://www.mdpi.com/2072-6643/16/16/2686

- systematic review from August 2024
- 31 studies were evaluated
- association between athlete's body image and eating disorders was studied, as well as gender, age, race, kind of sport

RESULTS
Who is more prone to body dissatisfaction and eating behavior disorders:
- Gender: Females
- Age: Adolescent females
- Race: White females
- Sport: Sports emphasizing leanness.

- As to connection of athlete's body image and eating disorders. Some studies suppport that these two go hand in hand. But other studies point out other mechanisms potentially leading to eating disorders (not negative body image) - for example sport performance or appearance expectations, when an athlete believes that certain weight will improve the quality of performance. Obsession with healthy eating or / and exercise is another mechanism.

 

[Mathman]

Thanks for the article. The mani impression I got is that no one really knows how the two main factors -- body image and eating disorders in athletes -- are related.

The simplistic "I think I'm too fat so I'll starve myself" doesn't seem to explain anything.

 

[sisinka]

I recently read this interview with Medvedeva ....

Evgenia mentioned one disease...

OSTEOPOROSIS

- is metabolic bone disease which leads to lower bone density and lower bone mass

= bones are more fragile and more prone to fracture

- this disease is common in older adults population, BUT...

- malnutrition is risk factor for osteoporosis

- loss of period is another risk factor for osteoporosis

- low level of vitamin D is another risk factor for osteoporosis

Which means that skaters suffering from malnutrition are in risk of osteoporosis as well (despite their young age).

Few weeks back one general practitioner told me that people in Czech Republic have low level of vitamin D. She did the research with her patients and founded that all had low levels...even those who spent a lot of time outside on the sun during summer months. She recommended to take vitamin D and calcium supplements. (I do expect most of skaters have these supplements.)

How about OSTEOPOROSIS and prolonged healing of the fracture?

The effect of osteoporosis and its treatment on fracture healing a systematic review of animal and clinical studies - PMC

Osteoporosis is characterised by low bone mass and micro-architectural deterioration of bone structure. Its treatment is directed at the processes of bone formation or resorption, that are of utmost importance in fracture healing. We provide a ...

pmc.ncbi.nlm.nih.gov

- scientific review from 2021

- some studies support the idea that osteoporosis is risk factor for "non-union of the fracture", some studies does not support this
- one study found "a prolonged healing time in patients with osteoporosis"

Advancement in the Treatment of Osteoporosis and the Effects on Bone Healing - PMC

Osteoporosis (OP) is a major global health concern, with aging being one of the most important risk factors. Osteoarthritis (OA) is also an age-related disorder. Patients with OP and/or OA may be treated surgically for fractures or when their ...

pmc.ncbi.nlm.nih.gov

- science article from 2022

- "...The fracture healing of osteoporotic bone proceeds through the same phases as normal bone but the healing process may be prolonged and complicated by a reduction in the number of mesenchymal cells and angiogenesis..."

 

[Mathman]

That was very interesting about vitamin D. As far back as the 1920s this supplement was added to milk (mandatory in the U.S.) to prevent rickets in children.

 

[Tutto]

That was very interesting about vitamin D. As far back as the 1920s this supplement was added to milk (mandatory in the U.S.) to prevent rickets in children.

Then it might interest you that it is actually possible to die from vitamin D deficiency. I very nearly did 5 years ago!
As it happens I am allergic practically to every food containing vitamin D + my skin can not take sun anymore (hives).
So without me knowing the level of vitamin D in my body was dropping slowly but surely till at some point it came to 0 which resulted in a severe hypocalcaemia. On Christmas Day 2020 I had a seizure because the level of calcium in my blood dropped below the level the brain, heart, muscles etc can function.
My survival was described as a miracle (it was actually linked to FS but that is another story). The doctors told me that there were 3 possible scenarios such as heart failure, brain seizure or asphyxia (due to tetany).
Since then I got into habit of asking people I meet (to their astonishment) whether they take vitamin D supplement!
The truth is so many people have no idea that they might be deficient and it is not something that a routine blood test would show.

 

[dorispulaski]

The Problems of Vitamin D Insufficiency in Older People - PMC

This report reviews evidence on disorders related to inadequate vitamin D repletion in older people. Vitamin D is as essential for bone health in adults as in children, preventing osteomalacia and muscle weakness and protecting against falls and ...

pmc.ncbi.nlm.nih.gov

Old people also need to watch their vitamin D level.

Vitamin D

Learn how this supplement affects bone health and other health conditions. And know the possible side effects of taking too much.

www.mayoclinic.org

You should consult a doctor about this to get the best dose for yourself.

 

[Mathman]

To me, the whole vitamin D thing shows the challenges faced by sports authorities that keep tabs on "performance enhancing drugs" by athletes. If you take a vitamin D supplement to make your bones stronger and to heal from injury faster, is that really any different from the drug that Kamila Valieva was allegedly given for the same purpose?

 

[elbkup]

Then it might interest you that it is actually possible to die from vitamin D deficiency. I very nearly did 5 years ago!
As it happens I am allergic practically to every food containing vitamin D + my skin can not take sun anymore (hives).
So without me knowing the level of vitamin D in my body was dropping slowly but surely till at some point it came to 0 which resulted in a severe hypocalcaemia. On Christmas Day 2020 I had a seizure because the level of calcium in my blood dropped below the level the brain, heart, muscles etc can function.
My survival was described as a miracle (it was actually linked to FS but that is another story). The doctors told me that there were 3 possible scenarios such as heart failure, brain seizure or asphyxia (due to tetany).
Since then I got into habit of asking people I meet (to their astonishment) whether they take vitamin D supplement!
The truth is so many people have no idea that they might be deficient and it is not something that a routine blood test would show.

A frightening story.. thanks for sharing and so glad to know you managed it well..
in my 40’s (late ‘70’s now) my doctor was in shock at my low level of Vitamin D .. I had no clue! She immediately put me on a strict regimen (I too am allergic to sun and many foods rich in the vitamin).. I pulled out of it thanks to her. Hate to think what would have happened otherwise. Now at my advanced age she keeps a close watch and has advised me to cut back somewhat.

 

[Magill]

To me, the whole vitamin D thing shows the challenges faced by sports authorities that keep tabs on "performance enhancing drugs" by athletes. If you take a vitamin D supplement to make your bones stronger and to heal from injury faster, is that really any different from the drug that Kamila Valieva was allegedly given for the same purpose?

Yes, to me it is very different. The difference is that you supplement vitamin D to make up for a deficit which should not be there, not to increase it above its naturally-expected level. To me, the difference can be showcased by asthma medicine taken by athletes with asthma or without it. If you are healthy, asthma medication is a performance enhancing drug, and therefore banned as doping. But if you are actually diagnosed with asthma, medication is permitted because 1. you really need it for your health and to function properly 2. in terms of sport performance, it is only acting towards equaling your chances against a healthy athlete with "normal" breathing, which are never really equal anyway. That is, if you really have asthma, not just papers, of course.
With vitamin D, if you take more than you need, it becomes toxic. Hopefully, nobody intentionally overdoses it.

 

[Mathman]

I was once in a long term study (30 years) to see whether vitamin E and another supplement were an effective preventative for prostate cancer. After 15 years they came out with a big announcement. "The study is over. Throw away any supplies you have left. We gave the remaining million dollars of funding back to the government agency that sponsored the research. Thank you for your participation."

Later it was revealed that the experimental cohort was way. way above the placebo cohort in the category, "death from all causes."

 

[sisinka]

To @Tutto and @elbkup : Thank you both for sharing the story. I am glad that medicine is on such level that we are able to solve such things nowadays. And in case of @elbkup even make a prevention of big troubles.

Yes, to me it is very different. The difference is that you supplement vitamin D to make up for a deficit which should not be there, not to increase it above its naturally-expected level. To me, the difference can be showcased by asthma medicine taken by athletes with asthma or without it. If you are healthy, asthma medication is a performance enhancing drug, and therefore banned as doping. But if you are actually diagnosed with asthma, medication is permitted because 1. you really need it for your health and to function properly 2. in terms of sport performance, it is only acting towards equaling your chances against a healthy athlete with "normal" breathing, which are never really equal anyway. That is, if you really have asthma, not just papers, of course.
...

Agree. Nice example.

That was very interesting about vitamin D. As far back as the 1920s this supplement was added to milk (mandatory in the U.S.) to prevent rickets in children.

I was once in a long term study (30 years) to see whether vitamin E and another supplement were an effective preventative for prostate cancer. ...

You always come with some interesting information from past, I like it!

 

[sisinka]

The Problems of Vitamin D Insufficiency in Older People - PMC

This report reviews evidence on disorders related to inadequate vitamin D repletion in older people. Vitamin D is as essential for bone health in adults as in children, preventing osteomalacia and muscle weakness and protecting against falls and ...

pmc.ncbi.nlm.nih.gov

Old people also need to watch their vitamin D level.

Vitamin D

Learn how this supplement affects bone health and other health conditions. And know the possible side effects of taking too much.

www.mayoclinic.org

You should consult a doctor about this to get the best dose for yourself.

Thank you for articles @dorispulaski .
From the second one - Mayo clinic - I find especially interesting interactions and research. Prevention against sclerosis multiplex seems promising.

This is not for active skaters, but coming to interactions many people are taking Atorvastatin / Thiazide diuretics / Digoxin, whose are interacting with vitamin D supplements.

Also vitamin D is fat-soluble, so it is recommended to take it with food which contains fat.
(So yes, skaters really need to eat food with fat. It is for their health!)

 

[elbkup]

To @Tutto and @elbkup : Thank you both for sharing the story. I am glad that medicine is on such level that we are able to solve such things nowadays. And in case of @elbkup even make a prevention of big troubles.



Agree. Nice example.




You always come with some interesting information from past, I like it!

Slightly different topic regarding Vitamin E … an observation: (Again) years ago I was using a lip balm that contained Vitamin E; a friend and medical student at the time was interested saying Vitamin E was the only vitamin that could be absorbed through the skin. Since then I have used body lotions, hand creams etc that contain Vitamin E. However, now, they are more difficult to find. Most lip balms containing Vitamin E have disappeared from the market. Food for thought..