“All I was thinking about when I was running was how much weight I was losing, how many calories had I eaten that day, what deficit was I in?”
“It’s the tendency to have to be perfect” says Georgie Yuille. She began playing hockey aged ten and soon found herself playing for the Scottish national team. The 2020 Girls’ EuroHockey U18 Championship was on the horizon when the Covid-19 pandemic halted the world.
The competition was due to be held in Chile. “I was one of the youngest in the team, but I really, really, really wanted to go,” she says. Players were sent workouts to do at home during the national lockdown and encouraged to focus on their fitness.
Georgie saw this as an opportunity to earn her place in the EuroHockey squad, but it soon became far more complex than that. “I got into the trap of orthorexia [an obsession with ‘healthful’ eating],” she says. “I was doing loads of workouts a day, far too much, it was really unhealthy. [I was] barely eating anything.”
After school, she was offered a full sports scholarship to study at James Maddison University in Virginia, US. She accepted and made the move, but she was still struggling. “I believe that eating disorder is an addiction. There’s a saying that addicts always try and run from the problem, but the problem’s always going to follow you. I ran and it followed me.”
When she arrived, they were concerned about her size as they hadn’t realised how small she was. “I was meant to be one of the best in the team, but I was weak,” she says. “They were like ‘you need to eat more’ and I was like ‘I can’t do that’”.
She was forced to sit out of training and could earn ten minutes of playing time if her weekly blood test results were good enough. “I feel like I bypassed a lot of that, [but] it was really difficult”, she says. “I also feel like I really let everyone down everybody because they expected so much from me. They were literally paying me to be there and I couldn’t do anything.”
The competitive environment of collegiate sports didn’t help. As suggested by her therapist, she told the team about her struggles, but there was no support from her peers. “I think it’s because they were really in for themselves. In America, it’s televised and sponsored, so all everybody talks about is pitch time. […] There’s no awards for being a team player.”
She returned from the States after three months and played for Scotland Under 21s for a short while. “Then I decided just to stop because I was literally vomiting in the toilet before practice.”Some of her teammates have now made it into the senior national squad. “I could have been there,” she says, “I was told that I was one of the best.”
Research published by America’s National Institute of Health in 2013 found that 13.5% of athletes struggle with an eating disorder. Among college athletes, 84% have at one time engaged in disordered patterns of eating or weight control behaviours. But, while eating disorders are among the most deadly mental illnesses, they are one of the least voiced.
Some athletes, such as England star Alessia Russo, have publicised their struggles in an attempt to start the conversation. In June 2023, Russo opened up about her difficult relationship with her body and food, which reached a nadir during lockdown when she was training on her own.
“I was at a low point with my weight,” she told Women’s Health. “I thought I looked great… but really, on the football pitch, I wasn’t strong enough to compete.”
While some conversations are being had, there is not nearly enough awareness for such a dangerous issue.
In 2019, George Mycock founded MyoMinds, an organisation raising awareness for mental health in the fitness and sports community. “[Exercise] really is a medicine for so many of us, but like with every medicine, we need to be aware of the side effects,” he says.
“One of the big things that comes up with athletes is that your body can much more easily become part of your identity. That’s something I can speak to of my own lived experience.”
The importance of fuelling
Athletes’ nutritional needs are individual and differ from those of non-athletes. “If you’re somebody who’s doing, say cycling and running and triathlon, etc, then you’re expending more energy,” explains Dr Clifford, Reader in Exercise and Health Nutrition at Loughborough University. “You’re burning more calories, essentially, so you will have to eat more to cover that calorie deficit”. But why is nutrition so important?
“It can help you perform better,” he says, “it plays a role in actually augmenting your performance in some way, beyond what your typical physiology is, how strong you are, how big your aerobic capacity is.
“Equally, it can help you recover more effectively. Part of that is it can help you replenish the fuel that you’ve lost, but also it can help stimulate adaptations that could mean that you’re better when you come to do the same exercise task again.”
The weight cut crisis
Athletes often face pressure to maintain a certain body weight or physique. A 2010 study in the Asian Journal of Sports Medicine found that eating disorders are especially prevalent in athletes competing in weight category sports, as well as endurance and aesthetic sports. Weight category sports are those which require a weigh-in prior to competition (such as boxing and weightlifting).
Weighing practices are increasingly being introduced in non-weight-class sports. “A lot more football players now will have weekly weigh-ins and weekly body fat measurements and stuff like that,” says Clifford. “I don’t think we yet know what harm that could be causing when it comes to later down the line, disordered eating and disordered eating patterns.”
In 2022, former England international Farah Williams revealed to the BBC that weigh-ins created a culture of eating disorders in women’s football during her career. “You get a fat test every time you go into training camp and, if you’re not under a certain body percentage, you go into ‘fat club’,” she said.
Mycock explains that subjecting players to weigh-ins and giving them weight goals could lead to unhealthy internalisation. “You’re quantifying somebody’s worth to some degree,” he says.
“I might internalise that as ‘the more I lose weight, the better I am as a footballer, but also maybe as a person”, he says. “If my identity is being a footballer, then maybe that’s the same thing for me.”
Clifford warns against such practices. “I think that there’s probably too much focus on it than there needs to be because I don’t think it will make as big a difference to performance,” he says.
An invisible struggle
Eating disorders can take many different forms, including anorexia, bulimia, binge eating disorder and orthorexia. Identifying eating disorder symptoms can be especially difficult in athletes because body image and restrictive eating are often idealised in a sports setting (hyperlink needed?).
“People assume that the only time eating disorders are a concern is if someone is getting as thin and as skinny as possible […] but that’s not always the case”, says Mycock. “[Someone may] present in a body that’s very muscular and maybe even getting bigger and stronger, so people might immediately assume they’re okay.”
Georgie found that her disordered behaviour was sometimes mistaken for motivation. After lockdown, she would get up at 5:30 to go to the gym and join the school coach for fitness before classes began. “At lunch, I wouldn’t sit with my friends, I’d go on a 10k,” she says, “because I was [playing for] Scottish Hockey, everyone found it quite normal.”
“My mum and dad were so proud of me, but little did they know all I was thinking about when I was running was how much weight I was losing, how many calories had I eaten that day, what deficit was I in?”
Suffering for success
The nature of competitive sport is to work hard and push through, but it can be a risky mantra. “They always used to say “push through the wall, push through the wall” until literally people were being sick,” says Georgie, “but then that’s kind of what you have to do to be the best.”
Mycock warns that the attitudes of fitness and sports communities could be harmful to athletes’ mental health. “The values that are pushed are so focused on this idea of dedication and determination and pushing through your limits,” he says.
“My worry about that is how am I supposed to know the difference between something that I just need to push through and something that isn’t going to get better?”
Raising the alarm
“As a sporting culture, as a group of people, we need to do better”
In previous generations, mental health was considered a taboo in the sporting world. Even now, with world-class athletes such as Simone Biles and Tom Daley opening up on the global stage, there is a long way to go in normalising these discussions.
“As a sporting culture, as a group of people, we need to do better at spreading that message that sometimes it isn’t something you need to push through, sometimes it is something to identify, tell your coach about, or speak to someone professional about,” says Mycock.
“Raising awareness is one of the most important parts,” says Clifford. “[Athletes] live in quite a bubble, so they may not even have heard of what an eating disorder could be.
“They could be ruminating a lot on food or problems like that, and they don’t even know that there’s actually diagnoses for these types of things or there’s support available.”
Georgie encourages people to take eating disorders more seriously. “I think eating disorders are very much considered a little girl disease. ‘It’s all about the body image, they’re just obsessed with their body’. But it’s not.”
Georgie now travels the world and teaches yoga. “I’ve learnt that your body is not you, your body is a gift that you’re borrowing”, she says. “Why would I be absolutely torturing something that was a gift to me?”
But life will always be difficult for her. “It’s exactly the same as an addict. Once an addict, always an addict. I’m always going to have to be cautious and always going to have to be thinking about it.”
If you or someone you know is struggling with an eating disorder, you can contact Beat’s eating disorder helpline on 0808 801 0677.