The Weighing Game: Disordered eating among high school athletes often goes unaddressed, with many students lacking proper nutrition education

*Names changed to protect identity 

Trigger warning: mentions of disordered eating 

No water. 

No food. 

Junior Tom Smith*, a varsity wrestler, had his routine down. 

Two days before weigh-ins, Smith pushed through the hunger and thirst. All to “make weight” before a match.

And if he didn’t, Smith would put on a sweatshirt, sweatpants and socks and begin running — sweating out the “water weight.” He once lost almost eight pounds in an hour.   

But Smith says it's not just him. 

Cutting calories, frequent weigh-ins, little water and the “binge” — overeating — after a meet or tournament has become an unspoken “expectation” for the wrestling team, according to Smith.

Besides the team bringing in a nutritionist once, Smith says most of his teammates haven't learned to properly diet, even with frequent cardio and strength-training workouts. After the season is over, the team receives no information on how to return to healthy eating habits. 

For athletes in high school, disordered eating and eating disorders are much more frequent than sources report, according to Dr. Lisa Vopat, a primary care sports medicine physician at The University of Kansas Health System. Most young athletes are uninformed about proper nutrition, and inadequate diets, which Vopat says, can lead to health issues beyond sports performance.

“I think this has to do with people [not having] a good definition of what health is,” Vopat said. “I often hear every time I get a dietary recall from a parent or an athlete, they want to convince me, ‘I eat good, I eat healthy.’ Your definition of healthy and my definition of healthy are often not the same thing. For example, healthy to me is an adolescent athlete [who] feels hungry and wants to go get ice cream with their friends and needs a huge ice cream sundae.” 

Disordered eating can refer to unhealthy eating patterns and problematic attitudes toward shape, weight, food and appearance, according to the National Eating Disorder Association. Disordered eating does not meet the same criteria as eating disorders, which are complex, persistent mental illnesses with frequent disturbances in eating behaviors and changes in psychological functioning. 

Both are prevalent among athletes, according to the National Association of Anorexia Nervosa and Associated Disorders. 

Whether it's the belief that a certain appearance can enhance performance, constant self-comparison to teammates, social media or nutrient misinformation, Vopat says high school can create “a perfect storm to underfeed your body.” 

Beth Marsden, assistant varsity cheer coach and SM East mom, says comparison, especially within the team and on social media, has worsened how some of the cheerleaders view their bodies. With few resources to educate the team on nutrients, many girls turn to social media or fellow teammates for information.  

However, this upcoming summer, Marsden says both the SM East dance and cheer teams will work to bring in a counselor and a dietitian to teach athletes how to make educated food choices and develop body awareness — healthy and conscious connections to the body. 

For sophomore Leah Norris, a dancer at the Limelight Academy of Performing Arts, the “90-pound and 5-feet-6-inches-tall” stereotype for ballerinas became a fixation starting in middle school. 

“When I would get fitted for costumes, I would suck in so my costume would be a size smaller, and so whenever I tried on the costume, it was obviously too small,” Norris said. “I would only eat saltine crackers before a performance [and] I would drink a ton of water the day before, then I would drink maybe a Hydro Flask worth of water the day of.”  

Now, looking back, Norris says she looked like a “zombie,” with hardly enough energy to get through a competition. And Norris isn’t the only one suffering from stunted energy after under-eating, according to Vopat. 

When athletes don’t eat enough, malnutrition can occur, leading to Relative Energy Deficiency in Sports (RED-S), according to Vopat. When the body doesn't get the proper amount of calories and appropriate macronutrient levels for the amount of energy exerted from exercise, RED-S develops. 

Vopat compares RED-S to a cell phone battery. 

“If you’re to fully utilize your cell phone, you’re going to be consistent with charging it up to 100% battery life every night,” Vopat said. “If you’re not consistent about that and you only charge it up to 50% every day, you’re probably going to have your phone go into low power mode every day. Some of the apps don’t work, some things crash, your phone goes slow, you can’t use it. So the body works in the same way.” 

Although RED-S isn’t a permanent condition, Vopat says possible weakening bone health effects can be irreversible. 

If athletes, especially those in high school, aren't receiving enough energy from food, Vopat says other physiologic processes throughout the entire body will slow. 

Vopat says this can result in skipped or absent menstrual cycles in females, slowed heart rate, fatigue, dizziness and several other health effects — all from malnutrition.  

For senior Eli Schaber, this became his reality. 

Schaber joined the Navy Junior Reserve Officers' Training Corps at SM North last year and the program's Athletic Team, aiming to become competitive. 

Practicing two to three times a week, the program focuses mainly on calisthenics — sit-ups, push-ups and other strenuous exercises — according to Schaber. 

When he first joined the team for the 6 a.m. hour-long practices, he had no idea the pressure he was putting on his body.

After his first practice with the team, where he “had to run to the trash can,” vomiting, a few times and experiencing persistent body aches, his diet stayed the same, even with the increased exercise, constantly “pushing” himself. 

“I wasn’t given any advice when I first started,” Schaber said. “I just had to figure it out myself.” 

After only a couple of months, Schaber and his parents were concerned — he had lost a notable amount of weight. Schaber began sleeping through all three of his alarms in the morning, stopped eating before practice to avoid throwing up and fell asleep as soon as he got home, sometimes for hours. 

For almost four months, Schaber attended fewer practices as he slowly began to regain weight and strength.

“I slowed down [and] showed up less,” Schaber said. “I figured if I’m not working out as often, I’m not putting as much stress, and that gives me more time to figure out where there’s a deficit or something missing [that's] causing me to lose weight.” 

Like both Smith and Norris, Schaber had no proper information on how to fuel his body. 

Through balancing practices, school and extracurriculars, disordered eating can become a coping mechanism for the increased pressure of being a high school athlete, said Amy Sullivan, a registered dietitian and founder at Bellatore Eating Disorder Recovery. 

“Eating disorders thrive in isolation and secrecy, and oftentimes people just don’t know their good friend is struggling, or their child is struggling, or their sibling is struggling, because it’s really something that comes with a lot of shame and guilt,” Sullivan said. “It’s hard for an athlete that’s trained all their life in a sport to think about stepping back and taking time off.” 

Junior Mary Johnson*, a SM East cheerleader, said losing weight has been her goal since middle school. 

When she made varsity, Johnson, along with most of the team, practiced in tight biker shorts and sports bras.

“It was very hard not to compare myself to everyone,” Johnson said. “I was trying to get better at my sport and watching my body in a mirror, doing cheer, making sure I was learning all my counts and doing everything right. I think without realizing it, it was definitely getting to me.” 

Alongside Johnson's newly prescribed ADHD medicine, Adderall, which suppressed her appetite, she began eating less, sometimes not eating anything for days.

Her new prescription was helping her focus, but with less of an appetite, she was losing  weight. 

Johnson lost 60 pounds in four months. The uniforms she had sized before summer no longer fit. 

Losing four to eight pounds a month is recommended for safe weight loss, according to Cleveland Clinic Health Essentials. 

Johnson was losing around 15 pounds a month. 

When the cheer team started practicing again at the beginning of the school year, Johnson received comments on her weight loss from peers. 

“You look so good.”

“You look so much healthier.”

“You’re thinner than me.”

To Johnson, this was “praise.”

But being constantly fatigued and no longer fitting into clothing that had fit only months ago concerned both her therapist and her parents. Johnson had two options: get off Adderall to help regain her appetite, or seek professional help to prevent further weight loss. 

Not wanting to switch medications, Johnson began attending meetings at Bellatore, which provides outpatient programs for people struggling with eating disorders.  

“When you have an eating disorder, your brain is completely split into two, and there’s a rational side of thinking where I know this isn’t healthy, and I know I need to eat, and I know that you have to eat to survive,” Johnson said. “And the other side of me is like, this is what I’ve always wanted, I’m finally confident in how I look and just happy with how I look, and I don’t want to do anything to mess with that.”

Johnson now goes to Bellatore twice a week to meet with both a therapist and a nutritionist. 

“A big difference between last season and the beginning of this season to now is I am allowing myself to get help,” Johnson said. “Recovery isn’t a straight line, it’s not an easy fix, especially because it’s mental and physical and it’s all around you. The standard that people accept or think is pretty [is] really hard to escape from.”

Although she’s gaining medical and mental help, the lingering thought of uniform fittings is still “triggering” for Johnson.

“Recovery isn’t linear,” Sullivan said. “[There’s] a few steps forward, a bunch of steps back, and that’s just how it goes. I don’t know that it ever really gets easier. Some aspects do, but oftentimes, somebody will have to step back in [to Bellatore], and it doesn't mean that they failed. Life happens.” 

With the added pressures that nutrition has on high schoolers like Johnson, Sullivan says coaches, parents and even many doctors still lack the education around eating disorders and disordered eating awareness. 

Vopat says most coaches need to inform themselves, and parents should listen to medical professionals, especially if their child is struggling with malnutrition.  

Especially for younger student athletes, knowing how to properly fuel is crucial for performance and healthy eating habits, which, for most athletes, includes three meals a day and at least two snacks, according to Vopat. 

“If you can catch an eating disorder [in] adolescence, [there’s a] huge potential of turning that around, where that eating disorder may not affect the individual for life,” Vopat says. “If eating disorders are missed in adolescence and then you go on to college or you go on to early adulthood with an eating disorder, it's incredibly hard to change those behaviors and work on recovery.”