Syracuse Online


Dr. J. on Running

Women's Athlete Triad

Anorexia, Amenorrhea, Osteoporosis

Published September 3, 2001 in The Post-Standard.

By Dr Kamal Jabbour, Contributing Writer

Every morning in America, 80 million women wake up unhappy with their bodies. Fifty million of them struggle with diets aimed at bringing their bodies towards computer-generated ideals that elude all but a few. This consuming obsession and the resulting eating disorders know no social boundaries, and runners are not exempt of their destructive effects.

On the contrary, a study by the National Collegiate Athletic Association found that women accounted ninety-three percent of eating disorders among college athletes. Anorexia or self-starvation, and bulimia or self-induced vomiting after meals, lead the list of eating disorders among distance runners. In fact, cross country has the highest number of athletes with eating disorders of any NCAA sport.

The desire to weigh less is a functional consideration for distance runners. Even to the casual observer, it is evident that the faster runners tend to weigh less than the stragglers. The underlying science is elementary: it takes a lot more energy to move 150 pounds 10 kilometers than to move 100 pounds the same distance.

Last month's world championship in track and field provided significant data for a statistical analysis. While the 1,500-meter race showed no correlation between the weights and finishing times of the runners, the 5,000 meters showed a positive correlation of 0.15, which increased to 0.30 for the 10,000 meters and just over 0.40 for the marathon.

Despite the narrow spread of weights in the women's marathon - from 88 pounds to 118 pounds - it was evident that the top third weighed under 100 pounds, and the bottom third over 110 pounds. An athlete's height played no role in the equation. Comparing the finishing times to the body-mass index showed virtually no correlation. Thus, total weight, not percentage fat, affected performance.

Unfortunately, this drive to run faster by weighing less creates a triad of problems for women athletes: eating disorders, amenorrhea and osteoporosis. Disordered eating is a direct result of cutting back on food intake. As a woman's body fat drops too low to safely carry a pregnancy to term, hence the body reacts by stopping ovulation and menstruation.

In turn, amenorrhea disrupts hormone production and results in the loss of bone density. This early onset of osteoporosis and the intense training invariably lead to stress fractures. Studies rank women's cross country on top of the list of sports injuries, even higher than men's football. Those injuries deprive athletes from a natural calorie-burning mechanism, pushing them to eating even less, and exasperating the problem.

So, what price are we willing to pay for victory? Certainly not the health of our children. I implore parents and coaches to play a proactive role in protecting our daughters from a lifelong of obsession with weight and speed I urge coaches to refrain from discussing their athletes' weights, and I urge parents to withdraw their daughters from competition if they stop menstruating, and to seek medical help. In partnership, we can break this epidemic cycle.

Kamal Jabbour runs and writes on the hills of Pompey, New York. His RUNNING Column appears in The Post-Standard on Mondays. Dr.J. created, webcasting live Every Lap of Every Race. He receives email at

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