Athlete Mental Health & Eating Disorders - a news & discussion thread

[Sylvia]

Recent IG post by Selmasiri Bella Larsen at her JGP event

Selmasiri Bella Larsen on Instagram: "Today i skated my first ever program at a JGP. That should be enough to make me extremely happy and proud. However, i had to read some really inacceptable comments (among other things about my body), and that was

selmasiri_bella on September 7, 2023: "Today i skated my first ever program at a JGP. That should be enough to make me extremely happy and proud. However, i had to read some really inacceptable comments (among other things about my body), and that was unfortunately enough to make me really...

www.instagram.com

So glad she has a strong mental health component to her training to comment openly on this.

Thanks - Larsen's and Gunnarsdóttir's Instagram posts are linked and discussed in the JGP thread (posts #164 & 164): https://www.fsuniverse.net/forum/threads/2023-24-isu-junior-grand-prix.110722/page-6#post-6465903

As well as Mark Hanretty's reaction during the JGP Istanbul livestream: https://www.instagram.com/reel/Cw9cR_uo1-J/

 

[B.Cooper]

Milestone week for Rachael Flatt last week per her IG feed...

reflatt​

Adding some new letters to my name: PhD! Excited to share that I defended my dissertation this week! It’s been a long 5 years, and I’m so proud of the work I’ve done and the person I’ve become as a result of this experience #phdone​

"Evaluation of Adaptable and Dynamic Approaches for a Digital Intervention for Binge-Type Eating Disorders"

Rachael Flatt on Instagram: "Adding some new letters to my name: PhD! Excited to share that I defended my dissertation this week! It’s been a long 5 years, and I’m so proud of the work I’ve done and the person I’ve become as a result of this experien

139 likes, 22 comments - reflatt on October 1, 2023: "Adding some new letters to my name: PhD! Excited to share that I defended my dissertation this we..."

www.instagram.com

and her thanking her friends and family, her committee etc.

https://www.instagram.com/reflatt/?img_index=1

And she is at Duke Medicine doing her clinical psych internship

Rachael Flatt, MA | Duke Department of Psychiatry & Behavioral Sciences

Undergraduate School Stanford University

psychiatry.duke.edu

amazing list of publications, academic presentations, invited talks and lectures

 

[Debbie S]

Congratulations to Rachael!

 

[PRlady]

Wow. Really impressed by what she’s accomplished.

 

[Sylvia]

Rachael Flatt recently was appointed to to U.S. Council for Athletes’ Health 5-member advisory panel:

Introducing the USCAH Advisory Panel » USCAH

Stay up-to-date on the latest USCAH happenings and upcoming events.

uscah.com

The U.S. Council for Athletes’ Health (USCAH) proudly introduces the newly established USCAH Advisory Panel. As USCAH continues to grow and expand its reach, the advisory panel brings an additional layer of knowledge and expertise to the forefront. Comprised of leaders and experts in various fields of athletic healthcare, including physicians, mental health professionals, athletic trainers, and compliance and risk management officers, the panel will offer guidance on emerging trends and best practices while actively participating in USCAH-sponsored educational initiatives and events.

Morgan Matthews has a Substack (she was inspired to start writing about skating topics after Montreal Worlds) - her latest:

Figure Skating In a Real Body

The language that figure skating coaches use to describe proper technique and to correct mistakes is infused with body hatred.

morganmatthews.substack.com

Her personal story (April 18):

Discover Substack Newsletters

Find great things to read on Substack. Browse top publications, find writers you follow, or search by topic.

morganmatthews.substack.com

 

[Sylvia]

I've since started a thread for Morgan Matthews' Substack writings (includes a link to her recent podcast conversation with "This Week in Skating"): https://www.fsuniverse.net/forum/threads/healing-a-broken-sport-my-story-by-morgan-matthews.111768/

USFS' latest Skater Spotlight article is on Rachael Flatt - by @Jayar (May 8; She "is currently a doctoral candidate in clinical psychology at the University of North Carolina (UNC) in Chapel Hill and is on track to earn her PhD in August."):

Flatt Closing in on PhD, Helps to Make Change in Sport | U.S. Figure Skating

www.usfigureskating.org

Excerpt:

In spite of some of her own experiences, Flatt does see progress in the sport, especially in the way of the athletes having honest and open discussions about their struggles.
“I look back on for my career – I was told many times in media training not to discuss physical injuries and now we're at a point where athletes are not only discussing their physical health but they're talking about these very important topics around mental health,” she pointed out. “The more we are having open conversations about mental health concerns to the degree that they're appropriate and people feel safe and open to share their experience helps them not to be brushed under a rug and stigmatizing them.”

 

[overedge]

I have to admit, I'm a little uncomfortable with USFS celebrating Rachael's openness about her mental and physical health challenges during her competitive career, when USFS had at least some involvement (e.g. media training) with reinforcing the norms that discouraged her from speaking up at the time. Perhaps they could also acknowledge their own role in those past situations.

 

[B.Cooper]

Considering the decade in which Flatt grew up in figure skating (2000-2010), TBH, it was still 'old school' PR training. Athletes never talked openly about injuries, unless it happened at a competition for all to see.

The mental health component for athletes really did not become part of the picture until the NCAA created a best practices manual for schools and their athletes in 2016. Mental health and wellness has evolved as a critical component in the past 8 years or so, but figure skating, for the longest time, has been one of those sports that has so much politics involved that if an athlete mentions a health and wellness issue, they can fall out of favor quickly. The collective effort to keep a healthy athlete in the sport of skating was not always the priority of the federation. I think that is changing.....


The NBA instituted a mental health and wellness program in 2018, and the NFL required that all teams have a mental health professional on staff in 2019. MLB and the NHL have all developed similar resources to both major league, minor league and farm team athletes in the past 4-5 years. The NCAA has continued to refine their mental health programs and many schools now have routine mandatory check ins with all their athletes.


I suspect the 'watershed' moment for professional athletes revolved around a number of very high profile professional athletes coming forward with their individual stories in the past 5 or 6 years or so to list a few...Michael Phelps and his discussions about his depression, Naomi Osaka and her challenges as a professional tennis player, Ben Simmons struggle with fulfilling his contract with the Philadelphia 76ers and eventually admitting that his mental health was compromising his ability to play basketball, and then of course, the start of the pandemic in early 2020, and its contributions to the complete overhaul of athletes' training schedules and in preparation for the Olympics and as well as many other sports....so many of these athletes define themselves by what they do ...day in and day out, and for many of them, their lives revolve around training and competing. With the world on shut down for an extended period of time, self reflection and self evaluation of the role sports plays in the lives of these individuals was met head on. In the past few years since the pandemic, I think there has been an outpouring of stories from athletes about their mental health challenges and probably bc of the pandemic, I think it has become more acceptable to discuss these issues more openly not just for athletes, but for pretty much everyone.

Going back to the time frame when Flatt competed and many decades prior, if your comments were not 'trained', I would hazard a guess that a skater's 'worth' was reconsidered by USFS if they would 'color outside the lines', so to speak. Injuries and mental health discussions just did not happen.

Flatt, to the best of my knowledge in her media coverage, has never discussed the politics of her experiences while a competitive athlete, and I suspect that is a closed chapter in her book. In the article linked above, Flatt acknowledges that she did try to work through years of injuries, but at the time, the federation and the USOPC were not really equipped to handle the mental health component for any athlete. Flatt has has obviously learned from her experiences, and obviously has put those experiences to good use in paying it forward by the work she has pursued while at Stanford, Chapel Hill and now at Duke Medicine. She is contributing on a whole new level, from her work on the USOPC mental health task force as well as her contributions at USFS and her current work at Duke and UNC. Looking forward to watching her career continue to blossom.

 

[Sylvia]

Amber is a wonderfully eloquent advocate: https://x.com/childmindinst/status/1792580239240872208

https://twitter.com/x/status/1792580239240872208

 

[Sylvia]

This link showed up in my Instagram stories recently:

Psychology of Sport and Exercise, Volume 69, November 2023
Maltreatment experiences and mental health indicators among elite athletes

https://www.sciencedirect.com/science/article/abs/pii/S1469029223001176

Abstract

This study explored the relationships between athletes’ experiences of maltreatment and mental health indicators. Canadian National Team athletes completed an online, anonymous survey that assessed reported experiences of maltreatment (psychological, physical, sexual harm and neglect), and mental health indicators of well-being, eating disorders and self-harming behaviours. All forms of maltreatment had a significant, positive correlation with eating disorder and self-harming behaviours, and a negative correlation with well-being. The relationships between maltreatment and mental health indicators differed based on identity characteristics of the athletes. Further work is needed on the prevention and intervention of maltreatment in sport to reduce the behaviours associated with negative health outcomes.

 

[Sylvia]

Copying over these 2 posts that originally were posted on January 4. 2024 in a related Trash Can thread:

... Maybe it's a "cultural norm" that it's somehow shameful for boys to talk about how they keep themselves fit. It's also expected that they have a certain amount of muscles (i did see comments toward pairs men that they "should go to the gym" ). You think these things happen automatically to boys and they don't have to make sacrifices, counting calories, doing extreme workouts and diets or?
Since there's almost no talk about this, how do you wanna know the problem is more widespread in girls?

From the National Eating Disorders Association

Statistics & Research on Eating Disorders - National Eating Disorders Association

Home

www.nationaleatingdisorders.org

Some basic statistics with regards to athletes, both men and women with much of the data for NCAA and high school elite level athletes (and all of this information has the associated journal articles and research sited with each stat)

• In a study of Division 1 NCAA athletes, over one-third of female athletes reported attitudes and symptoms placing them at risk for anorexia nervosa.
• Though most athletes with eating disorders are female, male athletes are also at risk—especially those competing in sports that tend to emphasize diet, appearance, size and weight. In weight-class sports (wrestling, rowing, horseracing) and aesthetic sports (bodybuilding, gymnastics, swimming, diving) about 33% of male athletes are affected. In female athletes in weight class and aesthetic sports, disordered eating occurs at estimates of up to 62%. (Draw your own conclusion on those numbers in figure skating)
• Among female high school athletes in aesthetic sports, 41.5% reported disordered eating. They were eight times more likely to incur an injury than athletes in aesthetic sports who did not report disordered eating.
• One study found that 35% of female and 10% of male college athletes were at risk for anorexia nervosa and 58% of female and 38% of male college athletes were at risk for bulimia nervosa.
• The prevalence of eating disorders in college athletes is higher among dancers and the most elite college athletes, particularly those involved with sports that emphasize a lean physique or weight restriction (e.g., figure skating, wrestling, rowing).
• Among female college athletes surveyed, 25.5% had subclinical eating disorder symptoms.
• In a survey of athletic trainers working with female collegiate athletes, only 27% felt confident identifying an athlete with an eating disorder. Despite this, 91% of athletic trainers reported dealing with an athlete with an eating disorder. 93% of trainers felt that increased attention needs to be paid to preventing eating disorders among collegiate female athletes. 25% worked at an institution without a policy on managing eating disorders.
• A study of female Division II college athletes found that 25% had disordered eating, 26% reported menstrual dysfunction, 10% had low bone mineral density, and 2.6% had all three symptoms.
• Female high school athletes reporting disordered eating were twice as likely to incur a musculoskeletal injury as athletes who did not report disordered eating.

Now, take the training load into consideration for figure skaters...you can only imagine that with disordered eating habits and its associated physiological repercussions due to loss of muscle and bone mass, in addition to electrolyte imbalance, ie sodium, potassium, calcium, chloride, magnesium, etc... and the associated organ and cellular membrane dysfunctions that can occur...and the list is pretty long....cardiac arrhythmia, kidney dysfunction, blood pressure irregularities, cell to cell signaling (central nervous system dysfunction)...the list goes on...and this is just on top of decreased skeletal strength and potential broken bones, tears in musculature, and the general fact that the body can NOT recover sufficiently after a training day because of the lack of metabolic resources.....and this occurs over a period of years with poor nutrition, overloading training by coaches and subsequent chronic injury cycle because the body does not have time to recover.

So, yes, eating disorders affect both men and women in sport, and esp in figure skating. And it is not just your "typical" eating disorder like anorexia or bulimia but it also includes ARFID (avoidant/restricted food intake disorder), binge eating, bullying/body/weight shaming, co-occuring disorders (many times obsessive/compulsive orders, depression, etc are co-diagnosed with EDs); compulsive exercise, diabulimia (EDs combined with insulin restriction); the list goes on......


A troubling note was that many trainers felt uncomfortable or insufficiently educated to help talk to an athlete about eating disorders. And, with the coaches essentially "running the show", one can only imagine that at the elite athlete level, open conversations about the overall health and well being of the athlete is not always the priority of the coach..bc of course they want the athlete to return to action if they are injured.

Many coaches only see the "obvious" injuries...a torn ACL, broken bones, bruises, severe concussions....it is the hidden aspect of disordered eating which contributes to a greater extent to athlete injuries, especially chronic injuries in conjunction with training loads, that the metabolic component contributes to every system within the human body and sadly, leads to long term damage of the body.

 

[Sylvia]

@Debbie S (thank you!) just posted this Ting Cui feature article by Patrice Hutton in the U.S. Women's news thread and it's VERY topical for this thread and so I am sharing it here as well:

Ting Cui is a different skater as she makes her 3rd trip to nationals

The 22-year-old has surprised herself by qualifying for nationals, this time earning her spot by winning the Eastern Sectional singles final.

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