What Tri Coaches Need to Know About Disordered Eating

Simon Heller had been coaching a particular client for about a year when he noticed a dip in his mood coupled with an emerging trend in the training data. “No matter if we planned a build week or a recovery week, he had been adding anywhere from 10 to 15% on top of the total volume.” When he asked the client about it, he didn’t get much more than a shoulder shrug. However, Heller had to get tougher when he saw even more changes that couldn’t be found on Training Peaks. “I was getting one-word answers for most questions, he was pretty irritable, and had clearly dropped weight. I finally had to confront him because I couldn’t stand to see him on this spiral–not when I know how hard he worked for the last year. I just don’t think he could see that he was throwing it all away.”

The relationship between an athlete and a coach is special. Equal parts guru, teacher, drill sergeant, therapist, and friend, a coach becomes an important part of an athlete’s life. Add in the sheer amount of quantifiable data the average coach has access to via training and readiness apps and a coach ends up knowing more about the athlete than almost anyone. They are therefore in the unique position to notice when the athlete is showing signs of disordered eating and help them to make better decisions. But, are coaches armed with the tools?

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Recognize that disordered eating is a part of the triathlon community

Some coaches might be reluctant to acknowledge that part of the triathlon community is suffering silently. There is so much data on the prevalence of disordered eating (DE) and eating disorders (ED) in endurance sports like triathlon that there is no way to include a representative sample here. It is, however, important to know that there is evidence of DE and exercise addiction in non-elite athletes, evidence of EDs like orthorexia in endurance athletes, and plenty of evidence of ED with signs of Relative Energy Deficiency in Sport (RED-S), specifically in male endurance athletes. As much as triathletes are associated with being healthy, their real-life eating habits may be anything but.

Bevan McKinnon, Ironman certified triathlon coach and the host of the Fitter Radio Podcast, gives athletes the benefit of the doubt at first. He says that some DE might be due to a lack of education and it makes sense that tri newbies, for example, might be so excited about training that they don’t fully understand the energy costs. He bridges the gap through teaching. “I typically start by educating athletes around the concept of energy availability. Although assessing this can be fraught with error due to inaccuracies of measuring self-reported dietary intake and energy expended during exercise, I find that it becomes a good place to start the broader conversation.” Once the athlete has a better concept of the minimal amount of nutrition they need to be taking in each day just to live, it can be easier for them to conceptualize just how much they need to eat to support training too.

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Mental health and ED in athletes: It’s not about the food

Of course, for some athletes DE will persist, and even progress into ED. The reality is that for some athletes, no amount of nutritional education alone will address the internal struggles with body image, mental health, or life stress that they believe will be fixed by dieting and/or increasing training. It’s easy to see why these beliefs emerge. Research shows that restrictive eating can give people a false sense of control in times of stress, therefore the perception that athletes are doing something “right” by under-fueling, cutting out food groups, or fasting will likely persist. Studies also point to the mood-managing and even tranquilizing effect of ever-increasing amounts of exercise which will further encourage athletes to seek out that extra calorie burn through higher training volume.

Coaches need to know that all of this creates the powerful perception in their athletes that diet and exercise are necessary for survival, and that weight loss or body composition changes will solve a myriad of problems. Of course, this could not be further from the truth, since the combination of under-fueling and over-training will likely lead to energy deficiency and subsequent injury, illness, and endocrine dysfunction as associated with (RED-S). No matter how much an athlete comes to believe that there is no limit to how hard they can push themselves, the realities of physiology will prove otherwise.

RELATED: Despite Increased Awareness, RED-S Still a Major Problem in Endurance Sports

Counterintuitive signs of under-fueling in endurance athletes

With continued poor nutrition, physiological and psychological symptoms will start to show up. Contrary to what we might think, the first signs will likely not be performance-related. One of the first signs that an athlete is not fueling adequately is that they become moody, irritable, and have a short temper. Coaches may find their athletes are grouchy, anxious, and even rude or arrogant. The athlete will also likely have trouble sleeping and recovering between workouts, facts that can be ascertained through certain readiness apps. Performance will then become an issue and they’ll either be unable to hit a planned level of intensity during workouts or will find themselves at a plateau.

Also contrary to what a coach might expect, the under-fueled athlete is not likely to appear weak or tired. Research shows that these athletes may have an extra high pain tolerance and will likely be able to push on even when they are hurting. Additionally, studies on energy output of people with ED show that they have an intrinsic drive to move, possibly appearing to be full of energy and more than capable to go the distance.

Assessment and care: A coach’s tools for success

It is unlikely that athletes themselves will be able to make objective decisions about their training in these situations, but a coach can provide that trusted voice of reason. Instead of focusing on hard data, a coach is in a unique position to ask the athlete questions about non-training life that might contribute to the overall drain on their energy. They can then help steer them in a healthier direction where rest and recovery build strength.

“It’s important to develop ways of monitoring subjective feedback around sleep, mood, and motivation. External stress outside of training has a massive part to play, so sometimes we just have to have a conversation. It’s the best way to develop open and honest lines of communication,” McKinnon said. The research supports his hypothesis, showing that athletes who enjoy a close relationship with a supportive coach feel less stress and exhaustion as a result.

Coaches must also know when it’s time to suggest that the athlete seek advice from a registered dietitian and/or mental health practitioner. They should cultivate a list of professionals that they feel comfortable referring to when the situation might be beyond their expertise. The only way to be a healthy triathlete is to first be a healthy person. With a good coach on their side, they can be both.

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How do you know your athlete is struggling with disordered eating?

• Increased irritability, moodiness, short temper
• Poor sleep, poor recovery
• Increasing volume in addition to planned training
• Reluctance to take rest days
• Cutting out food groups, dieting, weight loss

What can a coach do to help an athlete with disordered eating?

• Create a trusted relationship with athletes
• Use subjective measures to monitor athlete: mood, motivation, etc
• Ask questions, be conversational to uncover hidden life stress
• Educate about energy requirements, need for recovery, etc.
• Refer the athlete to a Registered Dietitian, mental healthcare practitioner, or both

RELATED: Mental Health Resources for Triathletes

Jill Colangelo is a writer and researcher of mental health and ultra endurance sport. She has a BA and ALM in psychology and is a former triathlete and ultramarathoner.