Disorderly Conduct

“You can’t outwork a bad diet.”

So reads the whiteboard in the weight room of the Palmer Dixon Strength and Conditioning Center, where men and women from across Harvard’s 42 varsity sports come to lift, train, and prepare for the grind of their seasons.

But perhaps these athletes don’t need the added reminder that this sign provides.

For athletes, eating habits don’t just regulate their choices in the dining halls. They also affect their lives on the river and on the field, in classrooms and in dorm rooms. Whether it is bulking up for training camp or slimming down for a weigh-in, for many Harvard athletes, diet remains a constant in the forefront of their minds, impacting their academic, social, and athletic experiences at Harvard.

Much has been made in the media about abnormal eating habits and disorders in young adults. But what happens when those exceptions become the norm? When the proscribed behavior on a team urges athletes to focus more on immediate results—a rower’s eligibility to race on Saturday—than possible long-term health ramifications?

Work done by sports scientist Marriane Martinsen and sports medicine professor Jorunn Sundgot-Borgen indicates that, for some athletes, the answer to that question is simple: to achieve peak performance level, they must subscribe to the demands—and diet—of their sport. In their 2013 study, the researchers found that young elite athletes (50.7 percent) were twice as likely than non-athletes of the same age (25 percent) to be considered “at risk” for an eating disorder.

This emphasis on the “correct” body type for an athlete has created a culture in which athletic feats and disordered eating go hand in hand, experts and Harvard athletes say—a phenomenon only intensified at schools like Harvard by the pressure to adhere to team expectations.

“WHAT DOES ‘FIT’ MEAN?”

If the white noise of the media wasn’t enough to portray the need to have a certain body to college athletes, the motivation to perform at a high level only fuels the flame.

Kate, who was granted anonymity by The Crimson due to the sensitivity of the topic, was a walk-on to the Harvard women’s track and field team; she eventually walked off, but not before witnessing widespread patterns of “disordered eating.”

“[Runners] have the media, whoever, saying be skinny,” Kate said. “And they know…mathematically speaking, if I’m skinnier I can go faster. But you also have to remember you need to consume those calories to be able to make your body go faster. It’s such a very, very delicate balance between eating enough so you have enough energy, and then being skinny enough for society.”

For Emily Kroshus, a doctoral candidate in the Department of Social and Behavioral Science at the Harvard School of Public Health and a former All-American distance runner at Princeton, these pressures create a standard that athletes feel compelled to meet.

“I think ‘looking fit’ is a term that is used by coaches quite a bit, usually with reference to someone looking thin,” Kroshus said. “But are you looking fit? No, you’re looking thin…. I think in many cases, team members want to please [their coaches], want to do well, want to move up in the roster spots, and I think often times they are looking for cues from their coach for what’s good.”

This influence of team dietary practices—established by coaches or upperclassmen—is one factor that can lead athletes to fixate on their weights. According to a 2002 study by University of Utah clinical professor Katherine Beals, 55 percent of female student-athletes reported “experiencing pressure to achieve or maintain a certain weight” from both internal (the self) and external (teammates and coaches) sources.

This pressure, said Kroshus, can often lead to serious consequences. The National Eating Disorder Association characterizes an eating disorder as a mental illness, one that “include[s] extreme emotions, attitudes, and behaviors surrounding weight and food issues.” While the common perception may be that those with eating disorders necessarily also have anxiety over their body images, the two are not mutually inclusive, experts say. As The American Psychiatric Association has stated, individuals can meet the criteria for an eating disorder if they exhibit “persistent behavior that interferes with weight gain,” whether or not this is directly related to self-image.

Those suffering from eating disorders are likely to have impaired physical, emotive, and cognitive functions. In fact, work done by University of North Carolina professor Patrick Sullivan indicates that eating disorders have the highest mortality rate of any mental illness.

While eating disorders are certainly present throughout the athletics, “disordered eating” is both more common on individual teams and more pervasive across teams. According to clinical psychologist Carrie Gottlieb, the difference between an eating disorder and disordered eating is a matter of gradation. An athlete suffering from the latter is “engaged in some of the same behavior as those with eating disorders, but at a lesser frequency or lower level of severity.” Due to the similarity between the conditions, those with disordered eating may “be at risk for developing” the more acute eating disorder.

Since witnessing such disordered eating firsthand at Princeton, Kroshus has investigated the impact of teams in promoting healthy behaviors.

In a qualitative study of two analogous cross country programs, Kroshus found that runners were significantly more likely to respond to and report a team member’s potentially problematic eating habits when nutrition had been an open topic of discussion amongst the group throughout the season, rather than when dietary habits were largely kept to one’s self. Kroshus attributes much of this effect to the former situation’s positive eating culture created through emphases on constant communication from both coaches and captains.

“People may be internalizing [supposed team norms], or there may be explicit pressure from teammates,” said Bryn Austin, the director of Harvard’s Strategic Training Initiative for the Prevention of Eating Disorders. “[Coaches] need to take a lot more responsibility for these types of things, [as] their expectations, whether they’re implied or explicit, can lead players to take desperate measures to try to control their weight.”

“IT’S A SHARED BURDEN”

For sports such as lightweight crew in which weight dictates whether or not one can compete in a given race, this pressure to control one’s eating habits becomes an obligation.

Consequently, for the men and women lightweight rowers, Friday afternoons mean one thing: weigh-in.

At 3 p.m., the women lightweight rowers take their turns climbing onto the scale at the boathouse, flitting their eyes across the screen to make sure their weight is less than 130 pounds. Just hours later, their male counterparts go through the same motions, hoping to make the 160-pound cut-off.

According to members of both teams, many rowers’ natural body weights are higher than the team-specific maxima, creating a situation in which the athletes must be continually aware of their caloric intake from the first day of the season—a cognizance that is amplified in the week before a race.

“I think a successful weigh-in is when you don’t need to starve yourself the day of,” said junior lightweight rower Tiffany M. Fonseca.

For senior lightweight rower Cameron J. Heron, “regimentation” would be the word to describe the seven days leading up to a weigh-in. Heron explained that on the Monday before a race, desserts, juices, and unnecessary calories will be eliminated from his diet, his focus on consuming proteins and vegetables. By Thursday, he restricts his diet to light foods, and on Friday, he says that rowers tend to “just eat what sustains [them] throughout the day,” as “whatever weight you put into your body [at that point] is going to be with you on weigh-ins.”

By the time of the Friday weigh-in, Heron said that he will have generally cut six to seven pounds off of his early-week weight.

The immediate necessity to weigh in at the right number largely results from the sense obligation rowers feel to their teammates.

“[There’s] a desire not to let your team down,” Fonseca said. “[Preparing for weigh-ins] is something you have to do because obviously you don’t want to be the only person to not make weigh-in, and then you let your whole boat down…. Sometimes it’s stressful if you have a lot of weight to lose, but I don’t think it’s something we’re afraid [to do].”

For men’s lightweight crew, the need to ‘average’—each boat must average 155 pounds a man—only places more emphasis on the unity of each eight-man boat, transforming weigh-ins into a collective effort.

Heron said that each boat member weighs himself daily, deciding upon a goal weight that he feels capable of hitting. This process enables some rowers to exceed the 155 mark, while letting others who are naturally smaller remain below.

“It’s a give and take just depending on how everyone is doing every week,” Heron said. “You end up being very conscious of where your body is. So in the process of losing weight it’s not like a couple big guys have to lose a ton and the small guys don’t need to do anything, we all help each other out.”

“It ends up that everyone’s losing about the same proportional amount of weight, so it’s a shared burden,” he added.

Neither of the lightweight coaches could be reached for comment.

While it might take place on the mats instead of on the river, wrestling, too, requires its participants to have a weigh-in prior to competition.

Sophomore Nick J. Stager, who wrestled in the 149-pound weight class this past season, spent last summer bulking up through both weightlifting and eating, trying to get as big as possible. The end result was that he approached the 170-pound mark in August, with the expectation that in September he would shed the added-weight and make the 149-pound weight class.

“My idea was to get as big as possible first, because it’s really hard to put on muscle when you’re starving yourself or when you’re close to starving yourself,” Stager said. “You have to expand before you can contract.”

In the week prior to a weigh-in, Stager would walk around anywhere from 155 to 159 pounds, needing to lose up to ten pounds in the days preceding the competition. For the final 24 hours before a meet, Stager would limit both his liquid and nutrient intake, eating only a sandwich for lunch that day if he considered his weight “good.” His dinner that night would be contingent on how he performed at practice in the afternoon.

On the morning of the competition, he would have just two pounds left to lose. After wearing added sweatpants and sweatshirts to induced increased perspiration during a morning-of practice, Stager would typically weigh in at 148.8, about 10 pounds less than his Monday mark.

“You never want to make the battle about making weight, because you want the battle to be the competition,” Stager said. “The competition isn’t making weight, but that’s a prerequisite.”

While cutting weight on a weekly basis might be the norm for his sport, Stager sees a wrestler’s choice of weight class as a potentially problematic situation—one in which too large of a weight drop could have related health complications.

“There are some people that may try to reach weight classes that aren’t optimal, that are unhealthy for them to wrestle at,” Stager said. “I have seen people, especially in high school, but even here, get injured…. When your body is depleted, when it doesn’t have the nutrition that it needs, injuries are more likely.”

“IT COULD BOTHER YOU THAT YOU HAVE TO BE SO BIG”

Then there’s the other extreme: bulking up to fit your assigned role on a team in which strength determines potential.

That is the situation that many Harvard football players find themselves in when they first enter Palmer Dixon in August of their freshmen year. In those early weeks, Director of Strength and Conditioning James Frazier assesses the incoming players, telling the athletes whether they need to size up or slim down in order to fill their role on the squad.

While it may seem counterintuitive, junior tight end Tyler D. Hamblin describes the diet required for bulking up as more regimented than that followed when trying to lose weight.

“You’ve got to be detail-oriented, you’ve got to be disciplined,” said Hamblin, who had to gain a significant amount of weight in order to change his body type from that of a quarterback to that of a tight end after his freshman season. “It’s a lot easier I would say to lose weight than it is to gain weight.”

While size may be key to the sport, it can also play a less welcome role off the gridiron.

“Self-esteem and body image are things that people [in general at] our age grapple with all the time,” Hamblin said. “[When people] see football players, they stick out like a sore thumb. When we’re not wearing our red jackets, you just know us by our stature.”

“And we’re at Harvard—smart people tend to be slimmer, fitter,” he added. “Being an athlete, especially a football player, it could bother you that you have to be big—you’re bigger than everyone else…. So I could definitely see how that would weigh on a student athlete in any sport.”

For these players, though, “getting big” always comes back to sizing up in the right way. According to Hamblin, transitioning from high school to collegiate play forces athletes to be increasingly “conscious” of their bodies, placing an additional “stressor” on the players.

No longer can the athletes solely rely on their instincts or athletic ability as they did in high school, but now they have to be wary of the foods they consume as well.

“An athlete’s diet is transparent by the way they play on the field or court,” Hamblin said. “You can always tell which one of the players is eating well compared to which one of the players went out at 11:30 at night to the Hong Kong…[and I think this need to be ‘conscious’] bothers a lot of guys when they’re starting off.”

“I WAS NOT GOING TO STOP AT MUCH TO GET OUT THERE”

Former lightweight rower Erin F. Flynn ’13 knew that there was an issue. In the days leading up to a weigh-in, she was performing poorly on the river and in the classroom, feeling both a mental and physical strain. After walking on to the team her freshman year, she decided to walk off after her sophomore season.

While athletes often recognize the link between poor nourishment and injury, few take the time to reassess and prioritize their health. But when Flynn did that following her second year on the team, she decided to walk off crew and walk straight onto ECHO, Harvard’s peer counseling group that specializes in body image and eating concerns.

“Seeing the practices and being part of the practices of really trying to maintain a low weight, and dealing with the stress of it both mentally and physically was tough,” Flynn said. “I found that when we were going to have weigh-ins, I didn’t really want to get out of bed, and was just waiting for that moment when I could eat a bagel.”

While there has since been a coaching change on the women’s lightweight crew team, Flynn stated that the culture on the team just three years ago was one in which it was “taboo” to discuss weight-related issues.

“I don’t really know whether it was an actual lack of awareness on the coach’s part that this was happening or if it was a tacit understanding that it wasn’t in the coach’s purview,” Flynn said. “I would never accuse any of the coaches of knowing and perpetuating this...but I think it was a tough topic to broach.”

While it may not have been in the team management’s purview, it is a recognized concern for the Crimson athletic department, said Harvard University Health Services Sports Dietitian Meg S. Schrier.

“Our first priority is always the health and wellbeing of every student,” wrote Schrier in an email to The Crimson. “We work directly and regularly with student athletes to ensure that they are receiving the nutrition education they need to stay healthy, in and out of their sport. As part of this work, we would immediately respond to the needs of any student athlete who demonstrates signs of nutritional deficiencies or disordered eating.”

However, in Flynn’s experience, taboos remained loud and clear within the team, largely silencing conversations on potentially harmful eating habits. What developed in its place was an undercurrent of unhealthy weight-cutting strategies, including completing additional workouts, skipping meals, and chewing gum to induce incremental weight loss prior to weigh-ins.

“There was this ‘healthy way to lose weight’ that everyone wanted to follow, and of course if you could do that, then you did it,” Flynn said. “Then there was the reality of the situation where if you still had a few pounds to lose before the weigh-in, you had to...skip a couple of meals.”

More than once, Flynn saw a situation go too far: what had begun as cutting weight for a sport, turned into a more prolonged, out-of-season eating disorder.

Similarly, in long-distance running, the perception that trimming one’s weight would trim one’s competition time has led some athletes to restrict their diets in ways insidious to both their health and their performances.

“For some people, there is an idea that being thinner is being faster,” said Daniella, a former long distance runner who was granted anonymity by The Crimson due to the sensitivity of the topic. “And to an extent, that’s true, but only for a limited amount of time, and only for some people. [A] lot of the people that do take the more dangerous path toward becoming thinner in order to go faster end up getting injured. It’s a pattern [and] it’s just not something sustainable.”

But while an athlete’s problematic eating habits may have become self-apparent, a lack—or fear—of communication between the athlete and coach led to the former racing, whether he or she was physically and psychologically ready or not.

“I wanted to compete, and I was really not going to stop at much to get out there because the reason I did crew was that I loved to race,” Flynn said. “From the athletes’ side, [the question becomes] how do you admit to [eating concerns] when you’re scared you might be pulled out of the boat because [the coaches] realize that you are nutrient deficient?”

According to Kate, this need to compete—and compete at the highest level—can drive runners to fixate on their nutritional choices as the one training area entirely under their control.

“You can control your muscle mass to some extent, you can control your training to some extent, but you can really control your eating,” Kate said. “If you want to eat less, and if you have the willpower, you just eat less.”

However, it’s not always easy to differentiate between what is needed to excel at a sport and what can be considered disordered eating. For some, the boundary between the two is blurred and always changing.

“For the distance girls, is this a disorder? Is this just what you need for athleticism? Are the two mutually exclusive?” Kate asked. “It’s hard to draw the line for any psychological disorder, but it’s especially hard with eating disorders with athletes, who are perfectionists, who are under a ton of pressure from the athletics and the academics—is that an excuse for not eating? Is that an excuse for being too skinny? I don’t know. I wish it were that simple.”

“GOODNESS, I NEED TO DO THAT AS WELL”

For many, this preoccupation with diet is perpetuated by two concerns: wanting to perform well for the team and wanting to be aligned with the team.

However, athletes are aware that their sports require a precise balance between dietary restriction and nutritional needs. Too much weight shed or too restrictive of a diet would produce the opposite effect of what was desired, debilitating their performances completely.

“[The coaches] don’t want any of their athletes to be starving themselves because then they won't be effective rowers,” Heron said. “We’re not going to win races with someone who doesn’t have the energy to even practice.”

For one individual, however, this effort to strike a supposed sweet spot only exacerbated the existing issues in her sport’s nutritional habits.

“I think it was always the generic, ‘eat healthy or else hard work goes to waste.’ Eat healthy or all these hundreds of hours will be for nothing—I guess you could call it a fear tactic,” Kate said.

Kate stated that this “or else” mentality convinced her to look to her older teammates for advice in how to avoid “wast[ing]” her training

“I think [seeing how the older girls acted] definitely made me think twice before I would open a bag of chips, as opposed to a banana or something,” Kate said. “You just look up to these girls. They’re phenomenal athletes...and if they’re eating an orange and going on to win the Ivy League Championships, goodness, I need to do that as well.”

However, perhaps due to the importance of endurance in long-distance running, eating concerns continue to affect a majority of cross country teams.

“I would say it’s very rare for a distance runner in college not [to be] somewhere on the spectrum of disordered eating,” Kroshus said.  “[On my team at Princeton, there was a] disordered preoccupation with food that I think we thought at the time was very normal, but looking back now was clearly problematic…. [I feel] that our eating behaviors were really tied into feeling like there was something wrong with us."

“I think we had a pretty normal culture for the sport—some shining stars, some people who had real issues, but most people somewhere in the middle trying to figure it out for themselves,” she added.

“MAK[ING] NUTRITION A NORMATIVE CONVERSATION”

While disordered eating affects athletes on a day-to-day level, so too does it have consequences for the months and years that follow.

The long term effects are myriad. Eating disorders and disordered eating can result in anomalous heart rate patterns, pregnancy complications, kidney failures, and earlier age of death. According to the National Association of Anorexia Nervosa and Associated Disorders, nearly half of those with eating disorders fit the clinical criteria for depression.

But on the track or on the river, often the only statistic in an athlete’s mind is that of a personal record or a team-best. This emphasis on the now rather than the later is what many believe perpetuates disordered eating.

If practices aren’t changed and this fixation on weight remains a part of athletes’ collegiate experiences, the research demonstrates that their nutritional restrictions and disordered eating will endure even after they cross the final finish lines.

“Those patterns are going to continue after college,” Austin said. “They’re not going to stop after track season is over or after they stop competing in whatever sport. Those patterns are set, for most people, until they get treatment.”

Kroshus’ work indicates that it is within the abilities of coaching staffs and team leaderships to change how athletes think about food.

“[Coaches need to] make nutrition a normative conversation,” Kroshus explained. “They shouldn’t dance around the issue of nutrition and let the team interpret it…. I think there isn’t enough conversation about how teams can play a really positive role—because they can.”

While the possibilities for improving team cultures are becoming apparent, the first step to alleviating some of this disorderly behavior is for athletes to recognize that the norms set forth by their sports are anything by normal.

“For me, I never questioned it or was surprised by it because I was living it,” Flynn said. “When you’re in it, it’s really hard to see anything else because you are living it yourself, you’re living it with the team, and you’re living it with the whole culture that you’re ingrained in. It can be really hard to break out of.”

—Staff writer Orlea L. Miller can be reached at omiller@college.harvard.edu.

—Staff writer Juliet Spies-Gans can be reached at juliet.spies-gans@thecrimson.com.