September 25, 2008

An Athlete's Nightmare: Falling Victim to the Triad

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I dug my teeth into my lower lip to keep from smiling. Tsunamis of joy, originating deep in the pit of my grumbling belly, rolled upward and lifted my spirits. I stood on a scale with a stomach full of water and a hospital gown draped over my shivering frame.
The sliding weights on the scale rested three pounds to the left of where they’d been two weeks before. My mother’s frown sank to the floor and her brow buried itself in furrows of worry.
I glanced at the doctor’s notepad as he scribbled out his diagnosis in an ominous scrawl: anorexia.
I rolled my eyes at that word on a fall day nearly four years ago. I felt like a champion on that scale, clutching my bony arms and relishing in my hard-earned 83 pounds. Over the course of four years, those rolling eyes have turned into teary ones as my goals and my body have shattered, reformed and shattered again.
It all started during the summer before my 16th birthday, when I developed this alarming notion that I was fat. I panicked and spent the better part of the vacation eliminating my adipose tissue (fat, that is). It was only a coincidence that in my sport, running, losing weight is one dramatic way to get faster. I realized that faster times meant more winning, more pictures in the paper and more calls from college coaches.
Most dedicated athletes rank body weight and composition as important factors affecting performance. Sure, it is always important to be fit, for everyone. But as soon as you associate weight loss with enhanced performance, the black clouds come rolling in. Athletes are competitors by definition, so it is especially dangerous when the opponent becomes your own body.
And for all the nice things the body does for us, trying to force it into something it’s not is far from the thank you it deserves.
What eventually happened to me is referred to as the “female athlete triad.” As the name suggests, this condition has three components. The first, and the root of all the evil, is disordered eating. Anything along the spectrum of simply avoiding chocolate to jamming your finger down your throat falls under the category. For example, my lunch had to be five baby carrots and half a peanut butter sandwich on whole wheat bread that I baked myself. Breakfast, if any, had to be a measured one-half cup of dry oats.
My food rules baffled even myself, but I was miserable if they got messed up. Actually, I was just plain miserable all the time. Exercise can be disordered too. I stopped thinking of practice as an opportunity to work on speed or endurance or lactate threshold. The only motivation to run was to burn calories.
One thing that happens to a woman’s body struggling to meet exercise demands with too little fuel is that it shuts down one of the most energetically expensive processes. For women, this happens to be the menstrual process. A female athlete not eating enough or exercising too much will become amenorrheic, or without a period. Though it may sound appealing, all of those critical monthly hormone spikes and dips get dulled. Low estrogen levels from amenorrhea combined with poor calcium intake from disordered eating lead to the sneaky third component of the triad: osteoporosis.
Osteoporosis tiptoed in my shadow like a little monster kid, waiting for attention before playing his trick. I listened with plugged ears as doctors warned of stress fractures and infertility. They were things that wouldn’t happen to me. I’d already been running for six years without a single injury, so I shook my head and gave a big skinny no to gaining weight or swallowing any drugs.
Then I arrived at Cornell and discovered that my thin and speedy teammates ate like regular people. Well, why did I have to starve and they didn’t? I pulled the ultimate freshman move and gained ten pounds during the fall semester. Some of it was muscle from new training, some of it was fat. It didn’t matter much to my osteoporotic bones. Brittle after two years of abuse, they collapsed under the strain of the new weight.
First, the ball of my hip fractured, and I could not run a step for 115 days. I counted, because it was an eternity for me. I ran one mile on day 116 and was so happy that I cried. Two months later, my fibula fractured: another three months out of running shoes, and this time the tears were of heartache and regret.
My bones ate away at my precious college running time like my stubborn, stupid, ignorance had eaten away at them.
Three years later, I have finally escaped every component of the wretched triad. I feel like I wasted two long years at Cornell, often too frustrated to study and too restless to sleep. I missed so much in that time, but I did learn more from my mistakes than any class could teach about osteoporosis, amenorrhea, disordered eating, patience, frustration, hope and hard work.
Although members of certain athletic teams are more vulnerable to the triad than others, I’d argue that every single woman is at risk. I certainly didn’t want to hear it from anyone that tried to stop me from ruining myself, so I could never blame anyone for biting back a smile on the scale. All I can say is to appreciate the wonder that is your body. It is always and only trying to help you be the best that you can be.