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Stanford University School of Medicine

‘Eat a bleeping Dorito’: An elite runner and Stanford medical student addresses disordered eating

Somehow, Megan Roche balances her roles as a fourth-year Stanford medical student, wife, athlete on the Nike trail running team and, according to her Twitter profile, an ice cream connoisseur. Balance is an underlying theme of her recent article on disordered eating in Trail Runner Magazine.

Disordered eating isn't quite the same thing as an eating disorder. Many people suffering from disordered eating do not meet the criteria of eating disorders, which are psychiatric illnesses. However, the abnormal thoughts and behaviors of disordered eating can lead to serious health problems, including developing an eating disorder. Both disordered eating and eating disorders can affect people of any size or gender.

Roche writes:

We live in a culture of fad diets and fad exercise philosophies. You can choose to be gluten-free, vegan, Paleo or even fruitarian. You can log 120 miles a week on Strava, do CrossFit until you pee blood or do hot yoga until your core temperature and skin texture resemble a Thanksgiving turkey.

Some of these actions have become socially acceptable. Heck, some have made champions. So how do we draw the line? When does disciplined eating morph into disordered eating, and when does disordered eating slip into a life-threatening disorder?

She explains that it is important to understand the warning signs of disordered eating, which can include:

  • Chronic yo-yo dieting
  • Fasting or skipping meals regularly
  • Avoiding social events where food is served
  • Rigid compulsive exercise routines
  • Self esteem that is highly based on body weight
  • Preoccupation with food, body and exercise that causes distress

Roche offers the example of Kara Goucher, who overcame disordered eating as a collegiate runner before competing in the 2008 Olympics in the 10k and the 2012 Olympics in the marathon. In a video, Kara describes the moment she realized she had an eating problem. While on a date with her boyfriend (now husband) Adam Goucher, he offered her some Doritos as a snack since she was too hungry to wait for dinner. When Kara repeatedly refused the chips, Adam said, "Eat a bleeping Dorito" -- a now oft-repeated quote among elite runners.

Roche focuses her piece on the pervasiveness of disordered eating within the running community, which often associates weight loss with faster times. She argues that trail running requires strength and resilience, whereas disordered eating weakens musculoskeletal strength and increases the risk of stress fractures, soft-tissue overuse injuries and depression.

"These issues are common for runners, and confronting them head-on is the best way to get healthy and stay healthy long-term," she says in her piece. She later adds, "The only way for us to squash the stigma (and possibly save running careers and even lives) is to practice consistent empathy, as individuals and as a unified community."

Previously: Dispelling myths of eating disorders and healthy eatingMedical student Megan Deakins-Roche runs and wins long distance trail races and Eating disorders in college athletes highlighted in NBC Bay Area story
Photo courtesy of David Roche

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