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Thursday, July 30, 2015

How Do You Develop or Trigger an Eating Disorder?

When Elizabeth Licorish was 9 years old, she read a skating reference book that revealed that 12 year old Tara Lipinski trained five hours each day, enjoyed a diet rich in spaghetti and marinara sauce, stood 4 feet 8 inches tall and weighed 68 pounds.

When she put the book down, did she ....
(a) Hop on a bathroom scale
(b) Ask Mom to make more pasta with marinara
(c)  Request a longer training schedule.
The answer to this is the subject of this post. 





Apologies for the somewhat longer than intended delay in publishing.  Part I of sorts:  Women, Athletes & Calories -- Does Tara Lipinski Eat Enough?


This post was inspired by a reaction piece in Philly Voice by freelance journalist Elizabeth Licorish entitled:  Dear female athletes: Please don’t follow Tara Lipinski’s 1,200-calorie diet.   In Part I, I tried to limit commentary mostly to answering the question in my title, though I did touch on other topics.  I'm happy to see the post generated some great discussion in comments, and feedback has been generally positive, with much coming behind the scenes as well.   This has helped me flesh out some thoughts going into the eating disorder realm -- always treacherous territory it seems.   With apologies to the guys once again, I'm going to keep this fairly female-centric even though men do develop eating disorders too.




A Gag Order On Information is No Solution


The major nerve that Licorish hit with her article was implying that by merely sharing her diet, Tara Lipinski might somehow trigger an eating disorder in an impressionable young mind.   

Licorish's solution?  Apparently it is to tell all women they need to eat more than is required.  At least we won't have any anorexics that way?   This seems to be the logic underlying her outrage, because she takes it a step further by essentially accusing any woman eating less than 1500 calories/day of having an eating disorder.  How else to interpret a subtitle caption, that comes from the article text, claiming that there's no way any such woman could be living life to the fullest?  

So my main purpose for sharing, once again, the experimental data was to drive home the point that those measured expenditures are real.  For the past several months I've been reading a lot of turn-of-the-century nutrition literature.  The 20th century that is.  The talk of calories and macronutrients and micronutrients was all pretty much centered around providing adequate nutrition.  Harris-Benedict was published in 1918, I hardly think our current grapplings with obesity influenced their scientific methods and reporting.   A small woman is going to have much lower calorie needs than a large man.  Period.  

Saying that some women require only about 1200 calories a day, is NOT a message to all women that they should eat no more than 1200 calories a day.  


CICO and Eating & Activity Disorders:


In the comments section on my last post on this topic, I made an offhand comment to the effect that eating disorders are not about the food.  I've been struggling with clarifying that without going on endlessly, and I fear I shall never be successful.  But more than just the food, there are some who view conscious monitoring of any sort as an eating disorder.   In other words, CICO stands for Calories In-Calories Out which is a process that is infinitely homeostatic and should require no thought, whatsoever, ever.  Perhaps if you are ever back to living a hunter-gatherer-herder-gardner style existence, this may be the case.  And perhaps if you've never "had issues" with weight or food, you'll never understand why more people probably should at least take stock from time to time than do.

Calorie accounting is not the problem, the underlying reasons for drastic manipulations are.

I'm going coin a new acronym -- EADs = Eating and Activity Disorders -- to discuss what are usually termed simply eating disorders.  I do this because many, perhaps a sizeable majority, female athletes with ED really have an EAD.  When most people think ED they think anorexia = starving, and bulimia = bingeing and purging.  Even those distinctions become blurred in the realm of diagnosis vs. behavior with overlapping characteristics.  Without going into too much detail, there are likely very few "pure" anorexics out there -- by that I mean someone who employed only consistent, severe calorie restriction such that their weight falls below the 85% of normal weight diagnostic.  Many anorexics will engage in binge/purge behavior from time to time, and may begin to counter forced intake with excessive exercise or use it to enhance weight loss vs. restriction alone.  Many anorexics will "naturally" become hyperactive, a phenomenon that may have a different driving force entirely, but plays into the calorie equation nonetheless.  Excessive exercise seems more commonly associated with bulimics as a compensation technique, hence the phrase exercise bulimia.   Many will develop disordered eating patterns that don't fit a diagnostic definition.  No problem, we'll call them EDNOS with NOS = Not Otherwise Specified.   So rather than get bogged down in definitions and such, I will simply discuss as one, EAD as the combined eating and exercising strategies/behaviors in pursuit of underweight.  Distorted CI and/or distorted CO.

image link
The term *underweight* is used intentionally here.  The person thinks they are in pursuit of a desirable or normal weight.  But the majority of EADs, I might be so bold as to suggest a vast majority, begin when normal weight girls or women decide they are too fat.

This ... and this alone ... explains why teenage girls are more susceptible than any other group, and girls engaging in activities where appearance, size and shape are more "important" for one reason or another are particularly susceptible.   Gymnasts, skaters, dancers,  childhood actresses and models.

I found it interesting that this article on Eating Disorders and Gymnastics from Vanderbilt University states:
Eating disorders are obviously found in all sports, but athletes participating in activities that emphasize leanness for performance and appearance are at a significantly greater risk. Thus, gymnasts, long-distance runners, divers, and figure skaters are more prone to developing eating disorders ...
I wonder if long distance running does not provide "cover" for EADs more often than not.   In other words, those with EADs may choose to take up distance running moreso than distance runners are likely to develop an EAD.  Just a thought ...

Christy Heinrich was an American gymnast who died from anorexia.  It is said that a judge at a major competition commented on her weight and this set something off in Heinrich's head.  At 4'10" tall and 93 lbs, only at the elite levels of a sport such as gymnastics could the thought of "fat" be entertained, let alone acted upon.  It is scary how often this story is repeated.  I have my own "moment" similar to this, and if you are ever in a position to have to research the topic (perhaps to try to understand and help a loved one) you will quickly realize how tightly this tie binds.  

I am not sure we can prevent such *simple* triggers from ever occurring.  It would amount to walking on eggshells, something I do believe Licorish feels justified in wanting Lipinski to do ... because information about 12 year old Tara was the trigger for Liz?   But it is not the information, it is what one does with the information, and we cannot control this in other people.  Denying facts is no solution either.



Something's Not Sitting Right Here ...


I'm going to repeat myself, because somehow I feel that I must.  Licorish's article really, really, hit a nerve.   Even before she mentioned her own battle with anorexia, I sensed that something wasn't right about Licorish's approach.  Probably for me it was the juxtaposition of the starving girl, with Lipinski, and some leaps of logic that resulted in some most unfair accusations against the former Olympian.  Nothing sat right, beginning with the caption under the title photo and then Tara's image in People.  I have juxtaposed them here.  

Face meet palm.  Someone's head is not on straight here.  Let's begin with the fact that the article actually published in People, the one pictured above right, included 1472 calories ... almost 1500, not 1200.  Some quotes from the article, italics are mine:
... My eyeballs immediately honed in on the vital statistics. They’re well trained for this sort of analysis....
... On this particular day, she supposedly survived on just 1,228 calories. ...
... This is where I take the most issue with her diet advice. ... young women who look up to Lipinski and watch her sports analysis on TV need only look up her dieting advice on the Internet. ...
... publishing your diet in People magazine counts as endorsing your diet for everyone. ...

... To be a successful athlete, you must consume more, not less. ...

... If a young, aspiring figure skater ... were to follow Lipinski’s 1,200-calorie diet, she would not remain active for very long. For her, a 1,200-calorie diet is a starvation diet. ...
... 1,200 calories a day is barely enough energy to keep you alive in a hospital bed.  ...
click to enlarge
There is an undercurrent of anger and blame here, as well as a disconnect.  Because Lipinski in no way, shape or form was even giving advice to others.  She is accused of lying, and in the end leading young skaters down a path to starvation by sharing what she eats today.  There's something not right here and Licorish tells us she was pretty severely anorexic at age 21.  For all her criticism of Lipinski for setting a "bad example", I wondered what her social media presence showed.  So I repeat here a screen capture of her Instagram page, taken a couple of days after I first took a peek.  The image in the top right was the most recent on both Twitter and Instagram when I first looked 


I'm sorry, but it's just bizarre to be going off on a fit and healthy looking celebrity while putting out highly conflicting images on social media herself.  I created a new juxtaposition, this time with Licorish and her friend Hollie in the mix:


It is a mission for her, and I'm referring to this quote in the article:
I feel it’s my moral obligation to athletic young women (especially those prone to developing eating disorders) to counter People’s deadly celebrity diet advice with a reality check: I eat 2,000-3,000 calories a day. So do all of my fit, athletic friends. Anything less, and we’d keel over. 
That's quite a range of calories there, and so the mind goes immediately to an average of 2500 cals/day.  This seems rather more unlikely considering images like this.


This is somewhat of a round-about way of demonstrating that Licorish is:
  1. Not really a serious athlete, and 
  2. Not really all that interested in health
I say this because she prides herself on eating junk food to "fuel" runs that she goes on so that she can eat more calories.  All this while ostensibly "training" for races.   Yet she wrote:
"Body Watch" perpetuates the idea that healthy eating isn’t about achieving health, it’s about attaining a certain body - someone else’s body.
Pity that her social media is an endless stream of images running, modeling running gear, yoga videos, Garmin readouts and polished nails grasping diet ice cream or medals won in local races.  There's no rhyme or reason to it as any sort of athlete's training journal, rather how many calories are expended thus allowing for washboard abs on a junk food diet.  Even there she's a bit "off" because I'm not seeing the Haagen Dazs cookie dough ice cream.

Athlete?  What I'm about to say may be a little controversial, but when is someone who runs considered an athlete?  After all, most able-bodied adults are capable of running.  In school, the athletes are the ones competing on the teams.  As adults, the true athletes are the professionals, or at least the recreational runners who post competitive times to win bigger races.  I know this is a muddy area, and I so get competing in races and such.  But I also get this strange vibe from Licorish who comes off as desperately wanting to identify as an athlete, complete with trophy wall at 30.   The sponsored professionals in her age range are running a 5K in around 15 minutes (record is under that held by Molly Huddle).   Which takes nothing away from Licorish's recent second place finish in her hometown 5K in a smidge over 21 minutes .  It just puts it in perspective.    Licorish appears to have morphed an EaD into an eAD, and remember what I said about the distance runners in that Vanderbilt article?  I think Licorish found a niche in which her excessive exercise and body type are now normal to ideal.

Molly Huddle's college days diet
It's quite odd then, that having left her skating days long behind, she seems unconcerned with what other female runners in her age group are eating, for example the aforementioned Molly Huddle.  In college in 2005 it was kinda erratic.  More recently, October 2014 to be exact:
Molly Huddle grew up in Elmira, N.Y., on what she describes as “the typical American diet” of cereal for breakfast, sandwiches for lunch and meat and potatoes for dinner. This diet fueled Huddle to a fourth-place finish at the Foot Locker High School Cross Country Championship and a national high school record for 2 miles (10:01).
In college, Huddle ate like a typical college athlete. Her dietary mainstays were cereal and milk and bagels and peanut butter. Conscious of the need to consume vegetables, she ate salads “occasionally” in order to check that box. During her four years at the University of Notre Dame, this diet fueled Huddle to nine All-America selections and a runner-up finish in the 2006 NCAA Championships 5000 meters 
Since turning professional, Huddle has increased the overall quality of her diet. No longer will she eat half a box of cereal for dinner. But her diet remains recognizably normal for a 21st-century American. She usually eats whole-grain pancakes for breakfast, a sandwich for lunch, and meat with vegetables and a salad for dinner. This diet has fueled Huddle to nine national championships and two American records at 5000 meters.  
{Interestingly this article what successful runners eat goes on to conclude that runners basically eat what is typical for others in their respective cultures. Perhaps just a bit more.}

But Lipinski would rather read People magazine -- or is keeping tabs on Tara Lipinski.   Commenting a bit more on her blog, Licorish writes {bold emphasis mine}:  
"This is just a short love note about a piece I wrote for PhillyVoice, regarding the 1,200-calorie (starvation) diet endorsed by former Olympic figure skating champion Tara Lipinski in People magazine."
 Ending with (screen shot to preserve her formatting)


Do you know what happens to runners who underfuel?  They underperform.  They may excel at distances if the field is not too competitive, but most "performers" that have EAD are bingers and the binges fuel the run.    Coaches are not routinely telling girls to eat less for performance.    With all of these flags, I decided I should read a bit more from Licorish before getting too wound up.  Perhaps I should have resisted, because it wound me up more!!



Did Tara Lapinski Cause Elizabeth Licorish's Anorexia? 


That may seem like a ridiculous section heading, but you get the feeling that this is what Licorish believes at some level.  In the current article she wrote:
Before I became a runner, I was a figure skater like Lipinski. In fact, I trained side-by-side with her at one of the most elite skating facilities in the country during the mid-1990s. When I was 10, I looked up to Lipinski, who took the skating world by storm at the precocious age of 12. Back then, I read every book and article written about her. Journalists gushed about how tiny and lithe she was, weighing just 68 pounds. People around the rink whispered all sorts of rumors about how exactly she managed to skirt puberty.
Really? I prayed and cried and prayed some more for puberty to hit me and still I was almost 16 before I got my period. Sure, I was an outlier. But guess what?  EVERY elite level athlete is an outlier in some manner.  Most great talents in sports are recognized as built on a template of genetic giftedness.  Some of that giftedness is merely stature.  Just being tall doesn't a great basketball player make, but it sure helps, and being short can limit the prospects of even the most talented ball handler and rains-em-in outside shooter.  So too, being short doesn't make for a great skater or gymnast, but it sure can help, and being too tall at some point can be detrimental.  Were there really people whispering about Lipinski, or did Licorish simply go through puberty at an earlier age and create her own inner dialogue as to why she wasn't progressing as well on the ice?   I suspect the latter, because I've seen girls who've starved themselves to forestall or reverse puberty, and Lipinski resembled not a one of them.  Licorish continues:
In 1997, just one year before she won the Winter Olympics in Nagano, Christine Brennan published a controversial book called "Inside Edge" that plunged into the empty, ravenous underbelly of the elite figure skating world. "Inside Edge’s" scandalous exposé details desperate accounts of female stars on ice who subsisted on nothing but carrot sticks and mustard. When you’re 12 years old, and you read stuff like this, you eat it up. 
Nearly a decade later, I too weighed 68 pounds. I was 21 years old. My skating days were long over.
That's quite a jump -- flip, axel, salchow, take your pick -- from rumors to carrot sticks and mustard to Licorish as a 21 year old anorexic.   It turns out, that this isn't the first time Lipinski has been held up as an example of all that's wrong in the world by Fabuliz.  In February of 2014, Licorish wrote a HuffPo piece entitled:  The Fallout: Olympic Figure Skating's Love Affair With Little Girls.  I remind you again, that full grown, Licorish is a petite 5'1" tall herself.  
When I was 9, I read a skating reference book which revealed 12-year-old Tara Lipinski trained five hours each day, enjoyed a diet rich in spaghetti and marinara sauce, stood 4 feet 8 inches tall and weighed 68 pounds. When I put the book down, I stood on the bathroom scale for the very first time. I cried when my weight read 86 pounds instead of 68. I stared at the numbers long enough for my vision to blur and erase my shame. I coaxed, then begged the digits to trade places, but the numbers wouldn't budge.
First of all, this was not even a celebrity puff piece!  But did you catch that?  I'm going to repeat the first part three times.  Once in full ...
When I was 9, I read a skating reference book which revealed 12-year-old Tara Lipinski trained five hours each day, enjoyed a diet rich in spaghetti and marinara sauce, stood 4 feet 8 inches tall and weighed 68 pounds. 
Just the facts ma'am ... now, how Licorish read it ...
When I was 9, I read a skating reference book which revealed 12-year-old Tara Lipinski trained five hours each day, enjoyed a diet rich in spaghetti and marinara sauce, stood 4 feet 8 inches tall and weighed 68 pounds. 
... and once more for how it might be read by someone interested in perhaps emulating the skating phenom:
When I was 9, I read a skating reference book which revealed 12-year-old Tara Lipinski trained five hours each dayenjoyed a diet rich in spaghetti and marinara sauce, stood 4 feet 8 inches tall and weighed 68 pounds. 
For women, girls in certain sports and physique-conscious endeavors especially, it's about body size and weight.    It's up to the adults in the room to help these girls, and it's up to the adults in society to help change expectations where we can. 

It's not about the information per se.

Licorish's young mind didn't process the information properly, and it's not her fault either.  It just is.  It's youth, it's society, it's media messages, it's stupidity, it's dealing with relative failure and processing all that involves when there may or may not be "adults in the room" who are aware of or understand the situation.

Why didn't young Elizabeth beg her mom to stock the house with pasta and Prego?

You see what I'm getting at here?  Licorish is all up in arms when a 33 year old retired skater's diet is revealed to the world.  She's ostensibly afraid that young girls are going to follow suit and starve to death.   And yet, when she WAS that impressionable young girl and read about the diet of an actual skater around her age, what did she do?   She went on a diet.   Because at 10, Elizabeth already weighed 86 pounds, more than Lipinski's 68, and THIS is what resonated with her in a sport where smaller gives a "leg up" (pardon the pun) on the competition.

The above paragraph is followed by:
My 10th birthday was riddled with grief. I wasn't a little girl anymore. At Delaware, there were 6-year-olds who could jump higher and spin faster than me. At 10, it felt like the ice was melting. At 10, I was washed up.
It probably didn't even register to her at the time that Lipinski was likely shorter (not sure how tall Licorish was at the time, in another article she says she was full height by the 7th grade).   It turns out that the writing was already on the wall for Licorish.  In 1995, at the event called Skate Wilmington, held annually at the elite Delaware rink where Licorish skated side-by-side with Lipinski, then 10 year old Elizabeth finished fourth ... behind three names I doubt anyone would recognize.  Elite sports are cruel this way, and I read in one piece that there are some 200 skaters training at just that Delaware rink at any given time.  This means that for every champion to emerge from training there, there are hundreds nobody has ever heard of.

Sadly skating may well be the worst thing to get your kids into, because unlike virtually everything else, there is no NCAA Skating (check out limited collegiate "club sport" opportunities available here).  Even gymnasts can at least go to college and compete.   At age 14, Licorish pops up on the radar in a 2000 article discussing a transition to pairs ice dancing alongside Jonathan Toman (who skated at 2006 Nationals, no time to study his whole career, hope you understand!).  All of a sudden there's talk of going to Nationals, something not in the cards for Licorish as a singles skater.  But that trail seems to end abruptly.  Perhaps this is when the eating disorder took hold. Perhaps Licorish didn't consider ice dancing an athletic enough a pursuit. Who knows, I didn't search endlessly though 5th and 6th place finishes in ladies singles turn up in 2004.  These competitions don't square with some of Licorish's timelines, but perhaps she'd rather put it behind her.  It's quite possible that anorexia derailed her skating career, she tried to come back following treatment, and realized it wasn't going to happen.  It is understandable that she may misremember or not even want to remember.   I don't know.

What is clear is that Licorish felt, however misguidedly, that she could compete at a higher level if only she were a smaller skater.   She may have been heavy enough at some point where 5 or 10 lbs may have slowed her spins or held back her jumps, and perhaps even a coach along the way suggested just that.  But "the adults in the room" know better early on.  Coaches know which skaters have the potential to be champions, and which just lack something.  It really comes down to innate talent at some point for most athletes in most sports.   Hard work can only go so far.  

Licorish  read that Lipinski:
  • trained 4-5 hours a day
  • ate a diet "rich in" spaghetti with marinara
  • weighed 68 lbs
Licorish did not become a pastafarian, and she doesn't mention this inspiring her to train longer hours.   That reference book article did not say that Tara subsists on carrots with mustard to maintain her petite figure and sustain her through hours of grueling practice sessions.  It said the opposite.   What moved Licorish was the 68 lbs.    Back then Licorish didn't start wolfing down spaghetti thinking it would make her weigh as much (or as little) as Tara.   That would be the "logical" progression of looking to one's idol for a recipe for success.  Eating disorders are rarely logical.



I Interrupt This Portion With Two Important Stories of Developing Eating Activity Disorders ...


... well, I'm not sure how important we are - grin - but I think this topic is such an important one that it bears repeating other examples to drive the point home.  What I just discussed about Elizabeth Licorish -- however trivial it may seem to some reading this -- is repeated in the "how I developed my eating disorder" accounts of countless women who've developed them, and countless more who struggle with "disordered eating not bad enough to diagnose".

The Information:  

Pediatricians and school officials used to check height and weight (and other stuff) long before there was an obesity epidemic or eating disorder "awareness".   This tracking was for a variety of reasons that many of us don't really consider, including identifying kids that may not be getting enough food at home.  More recently the aim has been identifying kids who are at risk for obesity -- I have very mixed feelings on this aspect!   But long before we become fully "body aware" we are aware of our size relative to others, and it was a simple matter of course to be weighed and measured periodically throughout elementary school.  There were/are all manner of charts for normal weights for a given gender and height and body frame to which this information can then be assessed and compared.

The Reality:

When most girls go through growth spurts and puberty, they get "fatter".  It's *unfair*, but most boys go through the same thing and get thinner.  Girls are, for whatever reason, going through puberty younger these days, and for a variety of reasons, girls seem to become aware of their bodies, size, shape, and society's expectations at younger and younger ages.  Well before puberty, children go through different phases that on an adult might be seen as "fat", yet are perfectly normal for kids.  I'm talking things like that pot belly many have -- tell me you know what I'm talking about?   


Amy Kubal, The Paleo RD


I would appreciate if everyone here would watch this.   This is Amy Kubal, "The Paleo RD" and Robb Wolf's ring leader, discussing her anorexia. 


It is a similar story for so many:  (1) I'm fat, I want to look like that (someone generally very thin or small)   (2) I ate less    (3) I lost weight   (4) "Success"!     (5) Keep going ....
Kubal tells of a book she got in the mail, in the 6th grade I think,  that showed three bodies: a larger, medium, and smaller build, and how the smaller figure had 1200 calories over it.  Since she wanted to be the small one, she figured she'd eat that many calories.  

Two very important points:
  1. The book likely showed roughly how many calories each of those body frames needs.   It was Amy who interpreted that in her mind as "eat 1200 to be the little person".  
  2. Amy didn't eat 1200 calories, she ate less, and progressively less.
See the similarities to Licorish?   It's not the information about calories.  It's not the calories themselves.  It begins, for so many, with the body image.   Kubal started counting calories, but that was not the disorder, the disorder was restricting calories excessively.  The restriction was driven by a distorted body image and desire to be smaller.  It sounds like her severe calorie restriction began early on and was near starvation.

Her story is chronicled in a bit more detail in this 2004 Article in the Rocky Mountain Collegian.  At age 24 she was considered recovered, but Amy was always open about her new obsession.  Running.  Amy became an athlete.  After discovering paleo, Amy will relapse again.  As she tells Danny Lennon at Sigma Nutrition (transcript),
I’d always been high carb, low fat. Never, from the time I was 11 until paleo time, which was about 5 years ago, and so then I got into a more paleo swing and then its like ,oh my gosh now I'm eating to much carbs, and I can't have gluten, and I'm still scared of fat. So it added to my restriction instead of treating up something, because in my mind adding fat was not something that I was going to do in a large amount, and I had to some how get rid of my carbs, so it added to the fat and the same can be said for me into what's (inaudible 16:46) it was ok, I'm enduring, I run marathons and now its supposed to be good, but I don't want to quit running so I'm just going to add this to it, and so it grew, the problem just got bigger for me, so in that sense it [paleo] did feed [the eating disorder]
Interestingly, though she stopped blogging on her own in late 2011, Amy's personal blog was Fuel as RX, with the tagline FOOD: THE MEDICINE YOU NEED FOR OPTIMAL PERFORMANCE. BECAUSE - "YOU CAN'T OUT-TRAIN A SUCKY DIET." -A 'GENIOUS'   Practically up until the day she "came out" on Robb's blog you could find her tweeting and bragging about her "hollow leg" -- where did she put all that food?  She ate more than Keith Norris ya know!! -- and I was told she didn't have an eating disorder, she was running off all of her calories to complete, and life-threatening, emaciation.   Hers seems to have always been an EAD.  Even if true that calorie restriction was not part of it this time (by her own accounts this doesn't square) her disorder was still one of not eating to fuel activity.  She was active, at least in part, to burn off whatever fuel she took on.

In the above video Amy was roughly 8 or 9 months into treatment, when Paleo f(x) manipulated the heck out of the whole deal with hours of discussion on eating disorders and whatnot that had very little if anything to do with paleo and scant little more about ED.   Last I saw in a random tweet, she has moved back to her home state of S.Dakota and she's no longer a member of the Paleo f(x) team.   I sincerely hope this is good news to share.


Yours Truly


My eating disorder began with gaining some weight as I went through (late) puberty.  Like Amy I was used to knowing my height and weight in elementary school, but as the second shortest in my class, my concern was wanting to be taller, therefore  I remember heights and disregarded the weight, though it would have been on the low side anyway.   I didn't even realize how "tall" I had gotten since elementary school until lining up for a 10th grade gymnastics team photo and found myself in front (tall) instead of in the back of the line.

I was long aware of my body's differences with those around me.  Around age 13 the vest and pants sets were all the fashion rage, there was no fitting my overdeveloped thighs and underdeveloped bust into the same size, not sold separately.  The unisex Levis sold by waist size would never fit either, by the time my legs fit, the waist gapped like six inches.   I knew I was getting a bit pudgy at around 16 but didn't pay too much attention as I was happy to finally have some boobs!  Then our coach told our team we all needed to lose at least 5 lbs except for one particularly lean girl.  I stepped on a scale and recall that it was like 139 lbs (I cannot be exactly sure, I perhaps blocked the memory, all I know was the dial came too close to that 1-4-0).  Yikes!  I had been prepared for the 120s, but almost 140?  I took to the charts and measurements.  Whereas Amy looked at calories, I looked at weight and for my height, the tables said from 110 to 150 depending on build/body type.  I did the wrist and distance between the hip bones measurements and concluded I had a small frame.  This was actually true at the time, but the tables didn't account for muscularity.  It wouldn't have mattered I doubt, I decided that I needed to get to the low end of that range.

I went on a reasonable diet.  Lost 5 lbs then 10, and felt lighter and speedier and jumpier in volleyball.  As I slowly approached 120, I cut my intake as leotard-wearing gymnastics season approached.  I was getting lots of positive feedback about how good I looked *now*, which translated into "OMG how fat had I been?"   When I got to 115 -- at or close to the lower limit on more recent tables, for example --  I took measurement stock.  Losing weight hadn't fixed my "problem" thighs, and 110 became more fixed in my head.  It further seemed "normal" because models as much as six inches taller than me weighed that!  But the pounds stalled.  So I cut calories more.  Threw all advice never to go below 1000-1200 right out the window.  You will note that even the "irresponsible" People people put that in their articles.  No, 700-800 was the goal ... met most days.  It worked.  But 110 didn't make me "normal", those damned thighs were not cooperating, so I tried to lose more weight.

Soon binges ensued, which in retrospect were probably the only reason I was able to summon any energy to compete as we transitioned into lacrosse season.  I ran a lot in those practices, ran on the weekends, and ran home from practice many days.  My "classic" bulimia was short lived, ipecac was gross, perhaps I didn't have the stomach for it.  Instead I became the exercise and fasting sort.   All in all, I maintained 110 for a year or so .... plus/minus 8 or so lbs.  Technically I was not anorexic, but I was underweight for my frame/body type for a long while.  I have a few pictures -- no doubt taken when I occasionally flirted with 100 lbs -- where I get "the look".  Then my body decided it couldn't handle the fasting any more.   Thus began lifelong struggles (not always unsuccessful as my detractors would like you to believe, but struggles) with overweight and obesity.  So to summarize:
  1. The weight charts listed what was normal, I decided which numbers were "normal", and I picked the lowest published number at the time.
  2. I blew right through any calorie amount cautions.  Whatever the basement "don't go below" was, I ignored it early on. 
  3. It was about body image/size, not food.
It was scary ridiculous how I went from having a totally normal relationship with food to the obsession and struggle that was my EAD.  I got to a point my freshman year in college where I couldn't even eat a "diet", I fasted, and when I tried to eat a "diet" I ended up bingeing.  Rinse, repeat, with copious exercise.  The social and fun aspects made it a muddy distinction, because I didn't really play volleyball every chance I got to burn calories.  I did run around the "bowl" in the gym for that though.   It wasn't pretty, but I share some glimpses because I absolutely DO know the mindset of the EADed ... how lines get blurred ... how what is not disordered for some, may well be for others.  

Important Questions:

  • Does the fact that some fall into an inappropriately restrictive pattern of eating mean that we shouldn't discuss the appropriate caloric intake for a person?
  • Does the fact that some will continue to try to weigh less or maintain too low a weight mean that we shouldn't discuss the appropriate weight for a person?
I don't believe either should be the case.  The focus needs to be on those susceptible to receiving this information and distorting or even "divining a message" from that information.  Why did Amy hone in on the 1200 calorie figure, why did I seize upon 110 lbs?  Why did both of us go or try to go below these values?



Back to Our Regular Programming - Licorish's Writings on the Topic:


I found Licorish's "Fallout" article rather uncomfortable to read.  It screams "issues", however cliche that term is.  It also sounds rather selective and revisionist, as only someone grappling with their own identity and distorted body image might turn out.  Beginning with how she dreamed of skating in the Olympics, 
After college, maybe: in 2010, when I'd be 24, or 2014, when I'd be 28.
This is deluded.  The oldest champion from her childhood would have been 23 year old Katarina Witt defending her gold in Calgary.   
1994 went down in history as figure skating's most sensationalized, media-crazed season. Yet, to me, 1994 stands out for a very different reason. It marks the end of an era, the age of sophisticated, full-bodied, adult athletes, of Dorothy Hamill, Katarina Witt, Debi Thomas and Janet Lynn: women with hips, breasts and high school diplomas. In 1994, during those tense weeks leading to Lillehammer, America's skating fans divided into teams Nancy and Tonya. Yet, neither woman took home the gold medal. 16-year-old Oksana Baiul won instead.
Alright then, you got me.   Tonya Harding (5'1", 108 lbs) was 24 and Nancy Kerrigan (5'3½", 115 lbs) was 25 in 1994.  Did Licorish cry tears for 23 year old Nancy when 19 year old Kristi Yamaguchi (4'11½", 93 lbs) beat her out in 1992?   I do see a lot of high school diplomas around, maybe even a few hips, but breasts?  Not so much.  You can all go look at images for yourselves ;-).   Even Katarina Witt (5'4½", 120 lbs) was smaller in her earlier competition days than Licorish probably remembers her.  But Nancy was "robbed of gold" by Oksana Baiul (5'2½", 95 lbs).
Oksana had hyper-extended elbows, the kind that bend backwards in elegant wingspan. She was decorated in full swan regalia. Her tulle skirt lifted around her, like a sail or a paper fan. Her plume neckline plunged between two halves of visible ribcage. Downy fluff shaped an illusory bust.
It's hard to discern who Elizabeth dislikes more at this point.  Oksana had a little bit of an awkward factor to go with her bendy elbows but she wasn't emaciated either.  I could almost understand the ire were Lipinski some buxom "giant" who couldn't outrun her hormones.   But she wasn't and she isn't.  
Baiul's victory ignited a teenaged Olympic champion streak. 16-year-old Sarah Hughes and 15-year-old Tara Lipinski soon followed suit.
Actually it was Lipinski followed by Hughes, but who's keeping track?  Ahh Sarah Hughes (5'2½", unknown weight) .... how I relish the opportunity to share her long program.  I remember watching this and just WOW, oh wow.  We taped it on the VCR.  I watched that many times until accidentally taping over it.  Thank Gary for YouTube!  


Please watch this.  I beg you.  It's just that good.  In a high-necked, bust de-emphasizing, relatively simple costume no less.  Can ANYONE dismiss this as the product of some perverse preoccupation with youth in figure skating?  And yet with a stroke of her cyber pen Licorish did just that.  Do I need to add that she beat out 18 year old Sasha Cohen (5'1½", 95 lb), 22 year old Michelle Kwan (5'1½", 108 lb) and 23 year old Russian Irina Slutskaya (5'2½", 108 lb)?  There had been two more Olympics before Licorish wrote her article in early 2014.  Teeny tweenagers ruling the roost?  Nope.   In 2006 the gold was brought home to Japan by 24 year old Shizuka Arakawa (5'4½", 110 lb) ... the oldest women to do so in 80 years. She was followed by another "tall" skater in 19 year old Kim Yuna (5'4½", unknown weight).   The Sochi gold would go to an 18 year old Russian Adelina Sotnikova (5'4", unknown weight).

My purpose for going through this is that -- duh -- due to the nature of the sport, skating tends to be populated by younger, shorter and lighter women.  Were the gold medalists predicted or predictable based on age or stature?  No.    As a 10 year old in 1994, Licorish could have chosen Nancy Kerrigan or even Tonya Harding as a role model.  Before the controversy and learning of Harding's role, she was the "underdog", US National Champion despite lacking the pedigree, and the first US woman to land a triple axel in competition.   Being "old and fat" didn't stop her!!

Stifling Lipinski this long after her competition days won't change a darned thing about eating disorders in the skating world.  What will, will have to involve coaches and parents and people who work with the eating disordered to find a better way to relate to these girls, and help them make decisions on attaining reasonable goals.  As the Vanderbilt article cited earlier touched on, sports like skating, gymnastics and diving are body conscious because there is a subjective aspect to judging.  Weight generally cannot change proportions, it certainly can't make your legs and arms longer!  Lipinski looks long legged, short waisted for her height, Licorish looks long waisted, short legged (like me).   Lipinski's "lines" would be better at any height than mine could ever be.  It's just the way it is.



Of Girls and Women in Sports


[Note:  I wrote this early on, considered trashing the whole thing, but decided to include it here rather than create yet another post.  Apologies for the disjointed nature of it all.  If you wish to get back to Licorish, browser search on "Some Concluding Thoughts"]

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For those not aware, I am in my early 50's.  This means I was born in the early 60's and grew up in an era before the evil Dietary Guidelines.  An era when they were allowed to call them Sugar Frosted Flakes, bologna on Wonder bread was a staple in lunch boxes, and fruit rolls, Hostess cupcakes and Premium saltines were common snacks brought to elementary school.  I was a young elementary school gymnast myself when Olga Korbut tumbled onto the scene in all of her 4'11", pig tailed, 17 year old glory.  That's right, 17.   It was still not enough to unseat the graceful almost 20 year old woman who had dominated gymnastics at the time, Ludmilla Tourischeva, from the all around gold. 

Ludmilla was boring, Olga was exciting.   Just like Nancy was a snooze and Oksana was captivating.

It had nothing to do with love affairs with small girls per se.  Back then, gymnastics was done on regular mats, vaulted over a "horse" that resembled the torso of real one from a spring board that resembled some Ikea furniture, and on uneven bars set so that as you hung from the top, the bottom bar hit just below your hips where your legs bent.  Young girls such as myself could even aspire to do most of the tricks elite women of the day did.

That was still somewhat the case when four years later 14 year old Nadia Comăneci wowed the gymnastics world with perfect 10s.  That was so exciting to watch!  But unless you were already in a top tier by my tender age of around 13 at the time, it was a no brainer -- even back in the dark ages my dear Elizabeth -- that elite women's competition was not in your future.  I remember "feeling Nadia's pain" in 1980 when she returned to defend her titles, "only" 18.  The announcers at the time repeated endlessly how she had grown up -- aka gone through puberty and developed! -- and added 4 inches and 20 lbs to her frame.  Ummm ... sound familiar?  She still performed admirably, tying for all around silver and taking home gold on beam and floor, and though retirement wouldn't come for another four years, that was pretty much the last most heard from her.  But everyone had that image of her at 14 in their minds ... and she seemed so slow in comparison.  No surprise to learn Nadia struggled with eating disorders.

Mary Lou Retton had serious thighs.  She was my hero ;-)

Gymnastics as a "women's sport" has undergone many growing pains along with those of its athletes.   After Nadia came more acrobatic gymnasts and the perfect 10s became more commonplace and there were many tied scores or ties broken by hundredths of a point, more critical than split second race finishes given the subjectivity of judging in international competitions.   What to do?  Gymnastics changed its scoring rules, factoring technical difficulty into the maximum score a routine could earn.  This could prevent a "safe but pristine" performance from upending the difficult if imperfect, but it favored more difficult routines and vaults.  Somewhere along the line, the floor is spring loaded, the bars set high and wide for full length swings, and who knows what kind of trampoline-in-disguise propels gymnasts over something that looks more like a giant Today sponge than a horse.

Skating has undergone many of the same growing pains, though springy-yet-spongie ice is not likely so is limited in other ways.  The realities of these two sports are quite clear and they are a matter of biology.  The horse is out of the barn on the acrobatics of both, there is no putting it back in while retaining the audiences they garner either.  Those audiences benefit not just the sports, but the athletes in the form of sponsorships and careers as coaches, analysts, and commentators (like Lipinski & Weir!).   

To the outsider, raising the minimum age for "women's" competition seems a no brainer.  But older, taller, larger Nancy and Tonya were around in Licorish's day and she didn't aspire to be like them.  With the Olympics at 4 year intervals, it is really a question of if chronological age should be some ultimate dividing line -- set it at 16, and then if you don't make the cut at 15 years and 10 months, you may well be too old at just shy of 20 years old.  To my eye, gymnastics has gone through this in pendulum swings and come back to something that is workable, hardly perfect, and will never please everyone.  Skating as well.  Both sports have the careers of would be champions in the record book graveyards due to misfortunate timings of birth.

Believe it or not, this maturity thing has been something considered for female athletes long before any scandals of sorts at the elite level.  But both of these sports have always dealt with it using the artistic/presentation score -- with "maturity" comes a beauty that the cutie usually can't compete with.  For what it's worth, when I was in the 8th grade I was invited to try out for the HS varsity gymnastics team, but was deemed ineligible as I had not yet menstruated.  My dashed spirits would have to wait until the 9th grade when menstrual status was no longer an issue.  Do we want to go back to that line?  I mean amenorrhea is a very common "side effect" in female athletes -- a highly relevant fact to the discussion of eating disorders, as "losing ones period" is often the first red flag that there's a problem.  

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Gymnastics, skating, ballet, and I'm sure a few other physical endeavors will always be different for men and women.  I watched a compelling Jason Brown skate video I was linked to in an email the other day, and they kept saying "and he's only 19".  A woman nailing such a performance will likely be accompanied by "what an amazing way to go out on top, she's unlikely to return at 23".   This means that while Jason is an eligible-to-be-drafted-to-fight-war adult making decisions if he gets injured, has a family tragedy, wants to pursue other careers, etc., Tara was just out of official childhood-dom at that stage in her career.  Exactly 20 years after Bella Karoly brought Nadia to the Olympics, he brought Dominique Moceanu in stars and stripes.  Dominique, at 13, according to my stats source was the pintiest of pint sizes -- only 4'6½" tall and 75 lbs.  The story of that US Gold Medal Winning team was not Dominique, it was Kerri Strug, who at 18 made the decision to risk permanent disability to vault on her injured ankle.  Things have a way of working out.   

I think that Licorish will always see Tara Lipinski, 12-15 years old, 68 pounds (though she was 79 by that time) captivating everyone and "stealing" the gold.  Does she see Dominique Moceanu in the same light?  The "failed" gymnast?  Note the quotes, as she was hardly a failure, but there would be no return in 2000 for a 17 year old Dominique, and she fell far short of the expectations heaped on her small shoulders.  Did she inspire eating disorders in older gymnasts?  Did older gymnasts like 20 year old (in 1996) Dominique Dawes (5'2", 119 lbs) and who medaled at 24 in 2000 "register" in opposition?   Interestingly, one of those to beat in 1996 was Svetlana Khorkina -- an outlier in her own right for competing at age 21, and returning in 2004 at an ancient 25 to capture the silver in the all around!  Interestingly, her 5'4" (listed as 5'5" on Wikipedia) height was often cited as being tall!  Khorkina had that relatively long-limbed grace factor, and perhaps matured as a gymnast after she'd matured physically, whereas for Nadia, who ended up being a similar height, such physical changes were detrimental.  

The bottom line here is that the purists who may believe that "women's" sports should all be for college age and above adult women, but they are kidding themselves with certain sports like skating and gymnastics.  There was a time when tennis seemed to be trending this way as well, but it has trended back a bit.   Where the focus needs to be is why women in these sports tend to be so highly susceptible to developing eating disorders, and finding ways to detect and intervene, and support the athletes AND their parents.   


Some Concluding Thoughts ...


So now we get to the part where I try to wrap this up and I've been struggling with this for a couple of days.   I do believe that there are some things amiss here with Ms. Licorish, and it comes through in her writing and her advocacy.  I knew the name sounded familiar, but I couldn't place it.  She was the former Lululemon employee who "blew the whistle" on the "plus sizes" scandal with the company that made waves in the so-called body positive movement a couple of years ago.  She wrote an exposé on the company for HuffPo herself not long thereafter:  Lululemon's Cult Culture: Get Fit or Die Trying .  There are things that don't add up in 2015, but it's not really my place (nor do I have the time) to discuss it.  Let's just say that those who've gotten to know me a bit, know that I have a freaky memory, and details stick in my head, and inconsistencies just gnaw  Whatever the depths of Licorish's eating disorder, it lingers with her still.  There's considerable evidence that it has merely taken on another form.  Whatever's going on with Licorish, it plays out publicly with her touchy overreaction to various "scandals" of the day.

Like this Lipinski thing, which really should be a non-story, but has made the rounds in various health and fitness circles on the internet.  And now Serena Williams, though I don't think it will have many legs beyond showing that JK Rowling knows how to slam a troll with wit.





Licorish took to her PhillyVoice podium complaining that Rowling's "sexualizing" of Williams may not be the best approach?  Excuse me?  This is the crazy schizo diet, fitness, fashion, celebrity, feminist world.  I just can't even.   If I didn't hear this sort of bizarre reaction every day on the internet, I'd stay mum.  Anyone who thinks Serena is built like a man is baked in the head.  Pointing out that she's not is not "sexualizing" -- it's throwing it back in the idjut's face in fine fashion with a good bit of humor to boot.  Congratulations to her.  She rocks.  Licorish is really mad at Sharapova anyway.    
Sexy men are dominant and powerful. Sexy men win. Sexy women are slinky and diminutive. Sexy women don’t have to win, so long as they steal our hearts.
But pointing out that "non-diminutive" Serena is a sexy woman is bad ... how exactly? 

This very much ties into the whole internet diet-fitness-body-positive etc. realm of which what I call the IHC is but a small part.  On the one side you have the ultra restrictive diets hiding under the cloak of ad libitum intake -- so long as you don't eat any food beginning with A or ending with gluten.  Oh, and fructose.   You have your classic Jillian Michaels/Bob Harper types and obsessive Food Babe types in the mainstream, and folks who want to counter this by accusing anyone who passes up the ice cream of an eating disorder.  And apparently there are some people who've gone bananas and actually believe that if you can't eat 2500 calories a day, you have an eating disorder.    Don't get me started on the eat more, move less folks and those who believe the overweight and obese got that way by eating less and moving more.  Therapeutic methods for recovering anorexics do not apply to you.  This is an issue of appropriate intervention for an individual's needs and situation.   Even worse, the Healthy At Every Size (HAES) movement has gone from rational body acceptance and being your healthiest at your size movement, to one where anyone who dares skip the breadsticks at Olive Garden is accused of having an eating disorder.  If you're Holley Mangold, you absolutely cannot please a soul.

Licorish believes that eating 2000-3000 calories a day is what makes you a "normal" person even if you're running 250 miles a month and probably not eating like that.  Meanwhile, if you're a former elite athlete who has moved on to other endeavors in life and  what works for you, that is #eatingdisorderawareness time irresponsible ... it might negatively influence some young woman?




When Elizabeth Licorish was 9, she read a skating reference book that revealed that 12 year old Tara Lipinski ate a diet rich in spaghetti with marinara sauce.   She did this to fuel long skating practice sessions.  


It looks like twenty years later, Elizabeth is finally taking her diet advice.  Well, sorta ...

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