Mar 31, 2017Fearing Food
Molly is a gymnast at her university. Throughout high school, she worked hard to manage her weight, and now that she is in college, her focus on weight control has increased. She appears to be under-eating for the amount of exercise she does and her teammates have noted they hear her say that she is afraid food will make her fat. Not only does she work hard during practice, but she spends at least two hours a day in the gym, primarily doing cardio activities. She is often exhausted during practice and a bit withdrawn. What can you say to help Molly realize that she is allowed to eat and needs to fuel her body?
1. As a first step, it is important to sit down with Molly and have a heart-to-heart chat about eating and weight. There are many sources of misinformation, especially for the athlete who is trying hard to keep weight low.
It is important to explain that the body needs a certain number of calories just to survive, to fuel the basal metabolic rate. Very simply, this would be body weight (pounds) x 10. Molly weighs 115 pounds, so assuming she did no physical activity at all, her body would require 1,150 calories per day. Because she exercises strenuously six or seven days a week, Molly actually requires at least the equivalent of body weight (pounds) x 17 daily, or 1,955 or more calories per day.
2. Suggest that Molly keep a food and activity journal for a few days to get an idea of her daily energy intake, activity, and exercise. This way, Molly can see in black and white what she consumes compared to what she expends.
3. Make changes slowly. It can be overwhelming and incredibly scary for someone who has restricted for so long to eat more liberally. Give her the permission to eat, but one bite at a time. If she is currently consuming 1,000 calories per day, the goal is to get her to increase to 1,100 for a week, and then 1,200, etc. Even though she needs about 2,000 calories per day, if she went from 1,000 to 2,000 calories immediately, she would see a change on the scale that might upset her. Granted, this is probably water weight, but it would be very discouraging and chances are that she would immediately return to restrictive eating.
4. Add protein first. With her restricted intake, she has probably lost some muscle mass, which she needs to replace. Protein sources lower in fat such as nonfat yogurt, skim milk, lowfat cottage cheese, tuna in water, and chicken are good suggestions, and she doesn’t have to eat a lot. Any of the following are approximately 100 calories: 6 ounces of nonfat yogurt, 8 ounces skim milk, one-half cup of lowfat cottage cheese, 3 ounces water packed tuna, or 3 ounces of skinless chicken.
5. Be there to provide support. Expect her to be resistant, because she is scared. Ask her to log not only what she is eating, but also how she feels. She may notice that she is less tired, not as cold, or happier. These changes cannot be measured on the scale, but will certainly impact her quality of life. If she is not able to change her eating habits or continues to seem withdrawn, do not hesitate to refer her to a mental health professional trained in helping athletes with eating disorders.
