Strong Enough

by Joanna Rieber

STRONG ENOUGH

Many of you know me as a 52kg CPU/IPF lifter. Some of you know me as a mom and as a physician. Not many of you know my history with food and eating disorders. Now given that I’m 40, we are talking about almost ancient history. However my past gives me an interesting perspective on a trend I’m seeing more of in powerlifting. To be honest, I was somewhat surprised to find disordered eating lurking in the corners of the powerlifting world. From the outside the sport really does embrace women of all shapes and sizes; women who all share a passion for lifting heavy weights. It doesn’t immediately appear to be a place where what you look like matters. And truth be told, on the platform it really doesn’t matter. But in the shadows it seems to matter more and more.

 

The lifting world has changed dramatically even in the short time since I began lifting in 2013. It has grown immensely in size and popularity, which are accomplishments we should embrace. But there has also been a notable change in how female lifters are viewed, especially in social media.  It seems to have started initially as “strong bodies are also beautiful”, which is a very positive message that  most would strongly support. The message seems to have slowly shifted to more of a “ this is what a powerlifting body should look like”;   if your bum isn’t shaped like a peach and you aren’t extremely lean sporting six pack abs then perhaps you are doing something wrong. The hashtags for females in powerlifting generate a hyper sexualized image not seen to the same degree in any other female sport. While I embrace the popularity social media has brought to our sport, I’m not so sure I embrace the message. We should be proud of our strengths and accomplishments in the sport without that being trumped by what our bodies look like.  Shouldn’t being strong and athletically accomplished be enough?  

I’ve been privileged to meet many other lifters who have shared both privately and publically their own experiences with eating disorders of all forms and as well as their struggles with recovery. You’d be surprised how many of us there are in the world of powerlifting. Or perhaps it’s not that surprising. I see it in the faces of this sport in many forms, most often in shades of grey.

So what exactly is disordered eating and why should we care? While there are specific diagnostic criteria for both Anorexia Nervosa and Bulimia Nervosa, many people either go undiagnosed or fall into a grey area of simply disordered eating. An abbreviation of the formal DSM-5 criteria is described below:

 

“Eating disorders are serious and common psychiatric conditions. Anorexia Nervosa is characterized by an intense fear of becoming overweight (despite being underweight), body image distortion and denial of low weight, refusal or inability (via disordered eating behaviors) to maintain normal body weight and amenorrhea. Bulimia Nervosa is more common and the central features of this condition are regular and frequent food binges (often very large quantities and consumed in a rapid, out of control manner), typically followed by a compensatory purge (often self-induced vomiting) and there is a morbid dread of fatness. Sub-clinical forms of either disorder or a mixture of the two conditions are especially common and usually called Eating Disorder not Otherwise Specified (or EDNOS)”

I can tell you from own experience as a patient, an athlete, a former athlete (gymnast) with an eating disorder, and a physician, the consequences can be dire. To make a very long story short, I spent the better part of two years of my life in and out of hospital trying to learn how to eat again. At my lowest I weighed just under 70pds  - to put this in perspective I now weigh around 115pds. Every moment of my day revolved around food and calories and fat grams; my mood completely dependent on the number on the scale and how few calories I could subsist on that day. I rarely slept and I have no idea how I continued to function in school. I became withdrawn and depressed, and actually had to attend my grade 12 graduation and prom on leave from the hospital. I missed my first year of university all together. My hair fell out, my menstrual cycle disappeared and my bone density dropped to dangerous levels.  Even years later, I still suffered from stress fractures undoubtedly related to years of under nourishing my body, one of them almost ruining my powerlifting career before it really began. And I was lucky. Many suffer much more serious and long-term health consequences, including heart and kidney damage. The death rate for eating disorders ranges from 3-9.9%, certainly not insignificant. Athletes with disordered eating are also more vulnerable to injury and impaired performance.

In recent years many studies in the area of sports medicine have found an increased incidence of eating disorders in female athletes. In one of the larger studies, a significant increased prevalence of eating disorders was found in three groups of sports: endurance, weight category and aesthetic sport. However, as I’ve alluded to it can be difficult to distinguish ‘athletic’ from ‘disordered’ eating  - It’s a grey zone with no clear cut off point.

“Major studies have consistently reported higher prevalence rates in in sports where weight has a significant effect on performance. There are three principal reasons for this. Firstly, in endurance sports such as long-distance running, leanness is related to performance for obvious physiological reasons. Runners who are several kilogrammes over their optimum performance weight will perform less well. Secondly, in weight category sports such as judo, boxing and wrestling, athletes will not be allowed to compete if their weight is above the upper limit for that category. Athletes have had to return from the Olympic Games without competing for this reason. This can create considerable pressure to achieve the necessary weight loss and often in a very short period of time. Thirdly, in sports such as gymnastics and high board diving, an aesthetic evaluation is attached to a particular body composition which is then promoted and encouraged in competitors.”

In a world where weight classes matter, cutting weight is a necessity, and counting macros is the new normal, I worry about the vulnerability of some of our lifters, and about the message we are sending. While I agree whole-heartedly that proper nutrition is a huge factor in athletic performance, I wonder sometimes if the line becomes blurry for vulnerable athletes. I am not a nutritionist, nor do I claim to be an expert in sports nutrition or macro counting; in fact I hesitate to comment on macro counting at all as I’ve never done it. Yes I have cut for meets, but I’ve always shied away form macro counting as it reminds me too much of the years of strict calorie counting. I know many fellow lifters who do macro count, and I’ve see that some athletes seem to be able to take it in stride.  For some macro counting truly is a means to an end for weight class maintenance; others though seem more susceptible. Have we created an acceptable way to normalize disordered eating for some?  Is daily weighing and measuring and putting everything you eat into an app on your phone every single day of your life really “normal” now? I don’t know the answers to any of these questions. And I do realize I am perhaps over sensitive to these issues because of my history.  But it is interesting “food for thought” coming from the background that I do.

What I can tell you is that one thing all women with disordered eating of any kind have in common is low self – esteem. And in a sport that I believe can do wonders for self esteem, its dis-heartening to see an increased emphasis on what our bodies look like as opposed to what they are capable of doing athletically. Although this may seem counter-intuitive, I would be willing to bet that many who make such posts are in fact also suffering from low self-esteem. I’ve been there. I’ve done it. Both the eating disorder and the posting. And I can tell you it comes from a similar place.

We should be proud of our bodies as athletes, for what they can do, for what we can accomplish. Why isn’t being strong enough?

Joanna Rieber is an anasthesiologist and mom who lives and trains in Hamilton. She has been powerlifting since 2013 and has competed at multiple international events.