As she chases the soccer ball down the field, the world around her begins to blur. With each step, her head spins; stars fill her vision and her body weakens. The ball in front of her disappears, and in the blink of an eye seventh grader Kaitlyn Gonzalez-Arceo goes from sprinting on the field to passing out on the bathroom floor at halftime.
Gonzalez-Arceo recalls now, as a senior at Paly, that it was at that moment where she realized there was something seriously wrong:
Her long time eating disorder was finally catching up to her.
Unfortunately, Gonzalez-Arceo isn’t alone. High school athletes frequently push their bodies to the limit working towards perfection. But behind the scores and trophies, many young athletes face a silent opponent that few are willing to talk about. 42% of highschool athletes have some form of an eating disorder, which increases the risk of injury by eight-fold. In sports like running, swimming and wrestling, where being thin is considered an advantage, athletes are at the highest risk of eating disorders. Athletes in training have high caloric needs due to the amount of energy they exert, making the effects of disordered eating all the more severe. When strength, speed and endurance are everything, chasing after a certain body or appearance can come at a devastating cost.
Like any mental illness, eating disorders are not a choice. They are a struggle that can be felt by any athlete, across all sports and all genders. There are many forms of disordered eating that athletes struggle with. The most common disorders found in athletes are anorexia, bulimia and
binge-eating disorders, which can cause RED-S (Relative Energy Deficiency in Sport). An athlete with anorexia might limit their food intake in an attempt to lower their body weight. If someone is bulimic, they likely binge eat and then self induce vomit or exercise excessively to work it off. Additionally, if an athlete has a binge eating disorder, they may engage in abnormal eating habits such as restricting foods for long periods, and then overindulging in an unhealthy manner, utlimately experiencing guilt for doing so. Lastly, RED-S happens to an athlete when they aren’t energizing their body through food enough to keep up with the level of exercise they may be engaging in. This affects their metabolism, menstrual function, bone health and overall performance.
According to Jennifer Carlson, a Clinical Professor of Pediatrics at Stanford, these disorders stem from numerous different causes, including genetic, social and psychological factors.
“There is no one single reason that eating disorders (ED) start, we tend to think of it as a ‘perfect storm’ of factors that leads to an ED,” Carlson said.
Genetics and brain chemistry are usually the root cause of most eating disorders; those with a family history of eating disorders or imbalances in serotonin and dopamine may be more susceptible. Psychological factors such as perfectionism, anxiety or a low self-esteem also invite disordered eating as a coping mechanism. Additionally, environmental factors like poor family relations and traumatic events can also spark disorderly eating.
Cultural and social effects, such as unrealistic beauty standards and peer pressure further reinforce unhealthy eating habits. Today, especially for adolescents, a primary cause of eating disorders comes from societal pressures emphasized by social media. Social media can perpetuate unrealistic standards of what a “healthy body” should look like. Constant exposure to edited images or videos displaying thinness, curviness or muscularity as the ideal body type can lead to unhealthy comparisons. Oftentimes in the media eating disorders are glorified which is a major issue that perpetuates harmful online perceptions of eating disorders. Paly students agreed and shared their thoughts in an anonymous poll.
“Stop romanticizing eating disorders,” *Sally, an anonymous poll response, said. “Stop romanticizing fainting. I always see girls online romanticizing eating disorders, specifically anorexia, and it’s so damaging to viewers.”
Many people online present eating disorders as the best, easiest way to look “better”. Social media influencers or fitness models are constantly sharing new diets, workouts and products, encouraging disordered eating habits that teens latch on to. However, many of these influencers’ recommended websites and resources are not reliable or healthy.
These diets and online resources may be acceptable for certain people, including some adults, but growing teens, especially athletes, need much more nutrition than these sites recommend to function their bodies properly and healthily.
“I do not recommend using online calorie calculators as they tend to be aimed at adults and do not include the extra calories needed for teen’s growth,” Carlson said. “Athletes, due to their increased levels of exercise, will need even higher levels of calories than the average teenager.”
Online calorie calculators are just one example of encouragement for disordered eating in teenage athletes. But the effects of eating disorders are not just physical, and for Gonzalez-Arceo, her experience with Bulimia brought mental challenges as well. She experienced changes in mood, sociability and even was impacted by depression and anxiety.
“My mental health was at its worst,” Gonzalez-Arceo said. “It’s hard when there’s all this talk about body image from a young age.”
The pressure to meet and maintain these unrealistic standards contributes to the development of an eating disorder, especially if the user is younger and more susceptible to bullying or peer pressure.
This can often be one of the hardest challenges to becoming fully recovered, because an individual’s body image is one they have to get used to for their entire life. Often people with eating disorders have a distorted view of themselves, which can make recovery even more difficult.
For Gonzalez-Arceo, comments from her peers heightened her insecurities and initiated her struggles with disordered eating.
“[My teammates} would say things like ‘maybe if you lost a little weight, you’d run better, maybe if you got on a diet, the uniform would fit you better,’” Gonzalez Arceo said. “Eventually I did lose weight, but then the nice comments and validation I got from it just kind of influenced me to continue going down a bad path.”
Oftentimes, the mental aspect of these disorders are overlooked. A study published in BMJ Open Sport & Exercise Medicine found that athletes with eating disorders are over 34% more likely to experience depression.
Despite the extensive negative effects of eating disorders, many suffer in silence. Eating disorders are frequently undetected, leading to dangerous outcomes for the health of young athletes. Wendy Sterling, a registered dietitian and certified eating disorder specialist who co-authored the book: How to Nourish Your Child Through an Eating Disorder and co-developed the Plate-by-Plate Approach specializes in sports nutrition and eating disorder recovery. She works with adolescents and athletes to promote a balanced, non-diet approach to health.
Sterling states that high performance athletes are often surrounded with an overemphasis on weight, which is not necessarily a helpful measurement of one’s health as a whole. There are many factors that determine athletic wellness.
“Performance is influenced by far more than just weight, there are at least 40 factors according to Dr. Ron Thompson who studied this, including skill development, endurance, flexibility, meal timing, adherence to recovery protocols and hydration, among others,” Sterling said.
In the case of many athletes, the effects of eating disorders can upend their athletic career and change their lives permanently. One anonymous Paly multi-sport athlete, referred to in this story as Jane, discusses how she found joy playing sports in her adolescent years. However, as she got older, Jane gradually became aware of her development of disordered eating.
“For me, an eating disorder was not something that just came on, it started and I didn’t know how to stop it,” Jane said.
Eventually, a doctor officially diagnosed Jane with anorexia; little did she know, the disease would soon overtake her life. At first, she was only restricted from participating in P.E, but as time went on, the physical effects began to take a major toll on her body and her performance,
“My activity was so limited that I was even worried for myself when I was walking,” Jane said. “I started to feel dizzy and my heart was pounding whenever I played. I was letting myself and my entire team down due to this disorder.”
Those restrictions quickly grew, and soon she was unable to participate in any physical pastimes at all.
The harmful impacts of eating disorders, like those experienced by Jane, extend beyond physical appearance, and can have devastating consequences on both the mind and the body. When malnourished, the athlete noticed her bones growing weaker with less muscle to support them, consequently breaking more easily. According to Jennifer Carlson, malnutrition can make individuals more likely to have muscular and bone injuries that can increase the chances of stress fractures and osteoporosis in the future.
“In one game, I broke my nose, a few games later when I was finally able to come back, I broke my shoulder,” Jane said.
Many athletes first develop an eating disorder in an attempt to be healthy or fit, yet they don’t realize both the short and long term repercussions eating disorders have on the body.
“The resulting energy deficiency negatively impacts every system in the body — including the heart, gastrointestinal system, bones and hormones,” Sterling said. “While also impairing sports performance by reducing recovery, endurance, muscle development and coordination.”
For women, REDS is especially detrimental because it can cause a loss of one’s menstrual cycle, which in turn negatively affects bone health, fertility and cardiovascular health.
Athletes frequently underestimate the permanence of these bodily changes and the seriousness of their disorder. When malnourished, it becomes increasingly difficult for an athlete to exert the necessary energy needed to improve their performance in their sport. This is a realization that Jane came to terms with during the turning point of her disorder. When she began high school at Paly, Jane tried field hockey for the first time, and fell in love with the sport. This love for field hockey inspired her to begin recovery.
“I realized if I want to be a high school athlete, I have to fuel my body,” Jane said. “You can’t have one without the other.”
Jane began a 100 day treatment program at The Healthy Teen Project, a recovery center in Los Altos. The Healthy Teen Project (HTP) is an eating disorder treatment center for youth. Based in Los Altos and San Francisco, this facility has both PHP (Partial-Hospitalization) and IOP (Intensive-Outpatient) programs. Both of these programs are quite time consuming for patients, often requiring teens to put their life on hold in order to complete these rigorous programs. Eating disorder treatment is a complicated journey and contains many different levels of care based on the patient’s needs. Most levels of care have medical teams consisting of a psychologist, therapist, dietitian, medical doctor and a family therapist, with the goal of fostering the most effective environment for the patient.
“I put my school, social life and sports all on pause and went to a treatment center,” Jane said.
She dedicated her summer to rebuilding her habits and strengthening her body. After 100 days of challenges and triumphs, Jane graduated from the program on the first day of her sophomore year, ready to restart her life and play the sport she loves.
“I knew I had to work harder to be able to play,” Jane said. “I came back to field hockey and it felt different; I knew I had to have a protein bar before practice, I knew I had to eat lunch if I wanted to practice, I knew my boundaries regarding how much I could do, and it felt so much better.”
According to Jane, her love for the sport kept her going. She didn’t want to go back to treatment, and her newfound awareness of her bodily needs has been necessary to produce success and happiness in her athletic, academic, and social life at Paly.
Jane’s recovery story is one of many, but it’s important to acknowledge that the road to recovery looks different for everyone.
Faina Birman, a nurse practitioner at HTP, has seen many different paths that patients undergo during recovery.
“Recovery is exceptionally individual, gradual, and almost never linear,” Birman said. “We don’t see the same path for everyone.”
It’s imperative to acknowledge and support anyone who may be struggling.
“Let them feel comfortable around you, that’s what they need,” Sally said. “Just be their friend. Raising awareness and encouraging recovery is hard, but I think that teens need to know that they will be supported, that they won’t be yelled at, cursed at, they just need an environment where they will be loved, whether that’s friends or family, and if they don’t get that, that’s why they reach out to their ED.”
As a society, it is crucial to reshape the overall narrative around eating disorders in order to provide genuine support rather than encouraging harmful behaviors.
By challenging stereotypes, being empathetic, and prioritizing education, we can create an environment where those struggling with an eating disorder can seek help without judgement.
You never know who may be struggling with an eating disorder. Our words and actions matter, and by committing to creating a supportive culture, whether that is online, on sports teams, or at 
