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disordered eating eating disorders lea red-s under fueling Oct 24, 2022

The following content will discuss underfueling, disordered eating, eating disorders, and their possible outcomes and symptoms. If you or someone you know is struggling with an eating disorder, contact the National Eating Disorder Awareness Helpline at (800) 931-2237. Please take care. 


By Amelia Perry 


I have worked for Feisty Media for less than a year. I have never been an athlete or understood the problems that female athletes face specifically. Coming into this space from an outsider's perspective, I am continuously and overwhelmingly shocked by the number of female athletes we have on our platforms that open up about their personal experiences with eating disorders, underfueling, and disordered eating as a whole. It is constant. And heavy.

And that’s not to say I haven’t had my own personal struggles with disordered eating. I have. From calorie counting to skipping meals, I’ve been there too. But I guess I always believed that athletes were exempt. They exercise, eat “healthy”, and the ones that I saw in the public sphere always had the so-called “perfect” body composition. And maybe this is where the problem starts. If no one thinks there’s a problem how do we create change? We need to crack open this conversation, remove the shame, and talk about the pressures female athletes face specifically regarding undereating. 


Up to 45% of all female athletes will struggle with an eating disorder at some point in their career. That is almost HALF. This number could be much higher, however, due to cultural stigma many women don’t feel comfortable talking about their experiences.

Let’s change the narrative. Here at Feisty, we want to have all of the messy conversations. Opening the door for a shared experience helps all of us feel heard and seen. Let’s dive into what underfueling is, its outcomes, and how we can make a change. 


What is underfueling? 


Underfueling can be defined as not eating enough, or not eating suitable types of food to fuel your athletic performance. It’s important to note that many athletes can be underfueling without being aware of doing so, and without a related eating disorder or body image issue. It’s extremely common for athletes to follow nutrition advice from reliable apps, coaches, trained professionals, peers, etc. that in actuality is hurting their performance. Sometimes it’s just very challenging to keep up with the caloric demands of training.

What is RED-S? 

Red-S stands for Relative Energy Deficiency in Sport. This refers to the impaired physiological functioning that results from not eating enough food to fuel your personal energy demands. More succinctly, this means that you are using all of the calories you’ve consumed during training, and don’t have enough energy left over for basic bodily functions. 


What is the difference between an eating disorder, and disordered eating? 


This one can always be a bit confusing. But let’s break it down: An eating disorder is specifically a mental illness that is often diagnosed based on an extreme obsession or concern with one's body image, eating habits, and body weight. 

This is different from disordered eating which lies on a broader spectrum that includes any kind of disordered relationship with one's body, eating habits, and/or exercise as a whole. 


How common is underfueling? 

With 45% of all female athletes struggling with an eating disorder, it is VERY common. And if you really take a second and think about it, is this that surprising? On the IronWomen podcast, Elizabeth Inpyn recalls her experience as a young athlete looking at her competitors and thinking, “well I may not be able to be as fast as them, but I can unhealthily diet and get thin and maybe that will help get me there”. 


The overwhelming majority of disordered eating patterns and beliefs occur in the early teen years. We’ve all been there. Starting high school, going through puberty, and the deeply rooted pressure to look like a Victoria's Secret Model. 2.3% of non-athlete teens have eating disorders. That is in comparison to teenage athletes, whose prevalence rate is 7%. MORE THAN DOUBLE that of the “regular” teen population. Finally, 35.4% of high-school-aged female athletes have disordered eating patterns. 

How will underfueling affect my performance?


Okay, let's make one thing very clear. In order to perform to the best of your ability, your body needs to be adequately nourished with foods that make you feel GOOD. And, okay let's make two things clear, anyone that tells you that in order to perform better you need to eat less, is probably wrong. Here's why: 


LEA and its outcomes


Low Energy Availability (LEA) and underfueling are two in the same. As Dr. Heidi Skolnik puts it in an upcoming episode of Hit Play Not Pause (look out for this on Wednesday!),” When you aren’t taking in enough calories you have energy available to workout but low energy availability for the rest of your physiology. That’s low energy availability”. She explains further, “You may not feel fatigued, especially in the beginning. But we still have our physiology we need to feed. We have to feed our organs, our heart, our lungs, our kidneys and support our growth, repair, and recovery”. A recent study conducted on elite cross-country runners found that 79.5% of female elite XC runners were at risk of LEA. 


If you aren’t taking in enough energy to fuel your basic physiological functions, you can’t expect to have a peak performance. 


Underfueling may or may not be related to intentionally undercutting one’s caloric needs. As we know from the statistics mentioned above, underfueling can be related to disordered eating. It can also be due to high-volume training, appetite suppression, leading a busy lifestyle, not eating enough calorically dense foods, the list goes on. LEA can then lead to RED-S which has a whole host of symptoms. While menstrual dysfunction and poor bone health are most commonly discussed, there are many other possible symptoms, like fatigue, poor mental health, weakened immune system, slowed metabolism, etc... 



(Photo credit: The British Journal of Sports Medicine)


Menstrual Dysfunction. 


Often, when women consistently underfuel, a telltale sign is having an irregular period or the complete loss of their period (amenorrhea). Sometimes, due to a variety of factors, it may be challenging for women to know if they are experiencing menstrual dysfunction. For example, if you have never had a period, you may not know that you are missing periods. Further, if you take a birth control pill or have an IUD that suppresses your period, it can be extremely difficult to know if you are in amenorrhea.

It is not normal to lose your period. Losing your period can be a  signal that your body is not getting enough calories to perform basic functions - like your period. 

Impaired Bone Health. 


The hormonal changes resulting from being energy deficient put major stress on your bone health. Estrogen works to keep your bones healthy and when estrogen dwindles due to not eating what your body needs, your bones take a major hit. This can result in injuries such as stress fractures, shin splints, and a higher risk of osteoporosis. 


With all of this being said, the negative outcomes outlined, and the impact of RED-S right before our eyes, let's think about this: 44% of all high school-aged female athletes believe that losing their period is a normal part of training. 


The pressure on female athletes to look a certain way in order to perform well is often unrelenting. As a community of active, performance-minded women we need to flip this script. We need to come together and collectively oppose the current body ideals for female athletes. Beauty is NOT defined by thinness. Athleticism is NOT defined by thinness.  By opening this dialogue and educating those around us,  we can help our peers fuel better, and feel better. Fueled IS fast! Fueled IS feisty! We need to eat all of the yummy foods in order to fuel our active and badass lifestyles. 


This week, let's challenge ourselves to talk about our own experiences, check in with the women we love, and fuel ourselves in the way our bodies need.  Share this article with other female athletes, and if you feel like you are struggling with anything you read here, one thing is for certain - you are not alone. Reach out, ask for help, and always remember - fueled is fast. 

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