National Eating Disorders Awareness Week: Signs + Symptoms

Previously: Introduction || Eating disorders defined + explained 

Similarly to yesterday’s post where I briefly described the different types of eating disorders, this post is going to list some of their warning signs and symptoms, as well as how your rowing is affected by them.

Due to the higher prevalence of and more readily available information for certain eating disorders than others, I’m only going to go over anorexia and bulimia. This is in no way meant to make light of the other disorders I discussed yesterday or take away from the seriousness of their complications though. These two disorders have much more severe physical consequences that directly effect rowers (and athletes in general) so that’s what I’m going to spend time going over.

Anorexia Nervosa

“A serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.”

Warning signs

Dramatic weight loss, refusal to eat certain foods or abstaining completely from an entire food group (no fats, no carbs, etc.), frequently suffering from or displaying signs of anxiety, engaging in negative self-talk (we all do this, but in this case it’s taken to the extreme), having carefully calculated food rituals (obsessively chewing, pushing food around the plate, etc.), maintaining rigid exercise regimes regardless of weather, injury, health status, etc. (part of the reason why this disorder can be easily hidden amongst rowers is because most of us already do this), making excuses to avoid eating, increasing your intake of caffeine (since caffeine makes you have to pee, which leads to water loss), etc.

Symptoms

The body eventually goes into starvation mode due to malnutrition, hair and nails become brittle (multiple your standard dry hair and split ends by tenfold), your skin dries out (sometimes you can actually see scaly patches), you frequently get chills (due to the body’s inability to regulate temperature and from the lack of fat mass), energy levels plummet, vital organs are damaged (the kidneys can’t handle all the proteins being broken down or the lack of water, heart rate slows, blood pressure falls, the brain begins wasting away, etc.), electrolyte imbalances are exaggerated, the lack of and/or loss of calcium leads to weakening of the skeleton, you’re in a perpetual state of confusion because your brain isn’t receiving enough energy to maintain function, muscles are broken down for energy when there is no fatty tissue left, etc.

How this effects rowing

Anorexia (and other EDs) affect your rowing in all the obvious ways. Carbohydrates and fats are the main fuels we use during practice and races. If our glycogen and fatty tissue stores are depleted, the next thing the body is going to go to for fuel is protein, which is what our muscles are comprised of. If your muscles are being broken down, your kidneys go into overdrive trying to filter the proteins from your system, which can eventually lead to kidney failure due to the stress put on them. Not having any muscle mass is a huge detriment to rowers because, obviously, that’s where we draw our power from.

As the muscles begin wasting away, so to does our ability to maintain the amount of power we can produce. As we try to continue maintaining a high power output, we have to exert more and more energy to do so, which is hard to do when our energy levels are at rock bottom levels due to the lack of nutrients from not eating. Low energy levels + high power output = fatiguing fast. If your body isn’t getting any nutrients, your brain isn’t either which can lead to increased incidences of you experiencing serious bouts of confusion, dizziness, and fainting. I’ve seen people pass out on the water in the middle of a row (including some in my own boat) and it’s terrifying.

Another consequence of reduced brain function and low fat mass is the body’s inability to regulate it’s own temperature. Temperature regulation is very important to rowers since it’s very easy for us to become overheated quickly. With disorders like anorexia, the inability to regulate and maintain temperature tends to cause those suffering from it to experience intense cold chills all the time, which sucks to begin with because who enjoys being cold all the time, but it’s also dangerous when you’re out rowing in the fall, late winter, or spring when the temperatures are low.

Bulimia Nervosa

“A serious, potentially life-threatening eating disorder characterized by a cycle of binging and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.”

Warning signs

Unexplained stomach pain(s), blood tests indicating electrolyte imbalances, withdrawing from friends, family, and activities (most often as a way to continue hiding their behavior), decay and discoloration of the teeth, swelling in the face (due to damaged glands in the cheeks), rigid exercise regime (similar to anorexia), evidence of purging (frequently leaving meals to go to the bathroom, signs and smells of vomit, finding laxatives and/or diuretics, or the less often discussed but still obvious sounds of purging – vomiting obviously, but the longer-than-necessary sounds of running water can also be an indication that something is going on), and evidence of binge eating (large quantities of food suddenly go missing in short periods of time, finding empty food wrappers hidden away), etc.

Symptoms

There are overlaps between anorexia and bulimia, but additional symptoms of bulimia include irregular heart rates, heart failure (leading to death due to dehydration and the lack of potassium and sodium), electrolyte imbalances, inflammation and/or rupture of the esophagus, development of gastric ulcers, tooth decay, acid reflux, etc.

How this effects rowing

The biggest detriments to rowing for someone suffering from bulimia come from the electrolyte imbalances and heart problems. Everything else is just an added layer of discomfort on top of what can already be an uncomfortable sport. Electrolytes “affect the amount of water in your body, the acidity of your blood (pH), your muscle function, and other important processes. You lose electrolytes when you sweat” and “must replace them by drinking fluids”. Electrolyte imbalances, as I talked about with anorexia, leads to heart and brain function problems. When we’re rowing at high pressure/rates our heart rates enter the red zone a lot. Having a condition where the heart rate is no longer regulated and you’re experiencing palpitations, arrhythmias, atrial fibrillation, etc. (which can and most likely will result from those imbalances) can lead to many things, including stroke and/or death.

Acid reflux, bowel irregularities, etc. are serious issues on their own but when you’re out on the water, they are a huge inconvenience and will make you miserable. How well do you row when you don’t feel well? Now think about being on the water, doing hard steady state, and suddenly having a stroke. Seriously. Imagine what that would be like for second.

A lot of the medical issues associated with bulimia are ones that are detected through medical tests (or a dental check up) but even though we routinely go through physicals, clearance procedures, etc. the root issue of the eating disorder itself can still go undetected unless you are specifically questioned on your eating habits.

If you go through your medical exams and it’s determined that you have or on your way towards developing one or more of these problems, hopefully that will serve as a wake up call that you need to make some changes but also that you should reach out to someone for help, particularly if you feel like you’re losing or have lost control over your habits.

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