Many women run to lose weight – but how do you know if you’ve gone a step too far?

Anita Bean explores the link between running and disordered eating.

Most of us would like to be slimmer. But for some women, being thin is more than just a desirable target – it can become an uncontrollable and potentially dangerous obsession. In the world of running, attaining a healthy weight can lead to an improvement in performance, but as the weight falls off, it can be easy to become obsessed with losing the kilos in an effort to further improve your performance and appearance. Lots of studies have revealed that female runners have higher-than-average body dissatisfaction and are preoccupied with their shape and weight.

In extreme circumstances, the compulsion to lose weight can develop into an eating disorder. The two most recognised are anorexia nervosa and bulimia nervosa. Anorexia nervosa is an extremely restrictive eating behaviour, in which the individual continues to restrict food and feel fat in spite of being 15 per cent or more below an ideal bodyweight. Bulimia nervosa refers to a cycle of food restriction followed by binge eating and purging. But there’s a third type of eating behaviour – disordered eating – which experts think is becoming an epidemic in the UK, with potentially disastrous effects on your health.

Disordered eating is anything outside of normal eating. Normal eating is when a person eats when they’re hungry and stops when they’re full, and has a varied and balanced diet. But when someone consistently ignores feelings of hunger or fullness, or severely restricts their food choices, then they are regarded as having disordered eating. Runners often engage in disordered eating behaviour in an attempt to lose weight or maintain an abnormally low bodyweight.

Crossing the line

Many runners admit to having an addictive nature. Running further and faster requires a high level of drive, but there’s a fine line between self-motivation and obsessiveness. In fact, the personality characteristics needed to become a top athlete are also common in people with a predisposition to eating disorders. These include perfectionism, competitiveness, obsessiveness and a high level of self-motivation.

Surveys of elite female runners have found many to be obsessive kilojoule counters who follow restricted, repetitive and nutritionally deficient diets, and consistently exaggerate their reported food intake. An American study of 265 recreational female runners found that 25 per cent had attitudes to food suggestive of an eating disorder, while a 2001 study of 181 leading women distance runners, carried out at the University of Leeds, showed that 16 per cent had an eating disorder, a figure at least eight times greater than average.

Experts believe that, in most cases, disordered eating is a response to an emotional problem. Low self-esteem is a common factor, particularly when combined with poor body image.

Warning signs

Very few people can describe their diet as perfect, but when does eating cross the line from being normal to disordered?

One of the most common symptoms is an intense fear of gaining weight, even though your weight is normal or below normal. Disordered eaters are preoccupied with food and kilojoules, often fantasising about what they’d like to eat or feeling guilty about what they’ve eaten. They often impose strict dietary rules and exercise excessively. Binge eating is common, although the size of the binge is less than that of a bulimic.

Secret eating is another symptom of disordered eating. Some women will eat normal meals in public, but may binge when alone, while others severely restrict their food choices in the name of health, using running as an excuse to explain their eating behaviour, stating:”‘I can’t eat anything high in fat because I run,” or “ll have lunch later because I’m going for a run.”

Health hazard

While there may be a short-term gain in running performance – it helps to be light when running – the long-term effects of disordered eating can seriously damage your health and cause a dramatic reduction in performance. If you’re not fuelling your body with enough kilojoules, you’ll soon lose energy and experience extreme fatigue. Your performance will suffer, your running times will slow down and your aerobic capacity (the ability to take up oxygen during exercise) will quickly reduce. You’ll become more susceptible to illness and injury, and your recovery time will be longer, too, because without enough protein to maintain and repair your body, there’ll be a loss of lean tissue and strength.

One important cut-off between “healthy” and “unhealthy” thinness in women is the presence of regular periods. If your periods have stopped (secondary amenorrhoea) or never started (primary amenorrhoea), you risk bone-density loss. Without enough oestrogen to maintain and increase bone mass, the bones get weaker, lighter and more porous. This may result in premature osteoporosis, where calcium and other minerals in the bones dissolve and are washed away in the urine. Bone density lost during puberty and early adulthood is never regained.

Breaking the pattern

If you’re worried you may be displaying some of the symptoms of disordered eating, the next important step is to identify the emotional issues behind your eating behaviour. You can then start to learn new ways of coping with them. Try keeping a “food and mood” diary for a couple of weeks, recording what you eat, when and where you are, and how you feel as you eat. Start to choose a wide variety of different foods from each food group, and include adequate calcium to maintain bone density. Be sure to eat three to four daily servings of dairy products or other calcium-rich foods, such as almonds, tinned sardines and tofu.

You should also be realistic about your goal weight, as you may be striving to attain a low weight that’s inappropriate for your genetic body type. If you have weight to lose, don’t crash diet, and seek advice from a nutritionist or dietitian if you’re struggling to balance food intake and exercise.

Are you a disordered eater?

If you’re displaying three or more of the following symptoms, you could be suffering from disordered eating:

You constantly think about food.
You often ignore hunger.
You believe you are fat when others insist you are slim.
You often eat past the point of fullness. 
You often feel guilty after eating.
You often avoid certain foods, even though you want to eat them.
You eat normally with others, but often overeat when alone.
You often feel stressed or guilty if your normal diet or exercise routine is interrupted.
You often decline invitations to social occasions involving food, in case you have to eat something fattening.