When I heard about the six female athletes who recently alleged that the focus on body fat percentage within the University of Oregon’s track and field program led to their disordered eating, it was shades of Mary Cain, the 25-year-old Nike Oregon Project track phenom who was so pressured to become thinner that it eroded her performance, her health and her bones. To think that similar scenarios aren’t happening throughout athletics is naïve.

Monica Van Winkle, sports dietitian for Pacific Northwest Ballet and Seattle Pacific Athletics, and owner of Nutrition in Action, said this focus on body fat stems from data on average body fat percentages for different types of athletes, but she knows of no study actually equating body fat to performance. “I’ve seen athletes with higher body fat be fastest on their team, I’ve also seen athletes with lower body fat be fastest on their team.”

Van Winkle, previously a sports dietitian for the Mariners and University of Washington athletics department, said she no longer uses body fat calculations. “In our disordered eating culture, people are prioritizing appearance over performance, and that can derail an athlete’s career,” she said, adding that many of her athletes are already on the cusp of low energy availability — when the body doesn’t have enough fuel leftover to support all physiological functions — so focusing on these numbers can put them over the edge. “There’s a place for it, but it’s completely overemphasized, and we’re losing the aspect of just talking to the athletes and seeing them as human beings.”

Kara Bazzi, clinical director and co-founder of Seattle eating disorder center Opal: Food + Body Wisdom, said overemphasizing weight as a key factor in athletic performance is missing the boat, given that so many performance factors — such as genetics, sleep, training, diet, coaching, stress level and mental health — are not weight-related. “More importantly, metrics related to the body are not neutral because we live in a weight-biased society,” she said. “We cannot assume that athletes will use this information as just ‘science’ and helpful data. That is being ignorant of the meaning and impact of the data. And, as we’ve seen in the recent reports of the University of Oregon situation, it can be incredibly problematic.”

Unfortunately, body-shaming of athletes isn’t limited to the college and professional levels — it’s starting in adolescence. A coach telling a 12-year-old girl that she can only eat cake on her birthday. A middle school cross-country coach giving students a list of “DO NOT EAT” and “acceptable to eat” foods, claiming this would help the team win every race they participate in.

“Once you pathologize someone’s eating, you can’t take it back, and you could be setting them up for a potentially fatal eating disorder,” Van Winkle said. “Kids look up to their coaches for everything, so you need to be careful. That’s when their bodies are going through puberty and they’re coming up on their peak bone-building years, and you can’t get that time back. I’ve seen so many athletes have osteopenia [low bone mass] at a young age. It doesn’t take that long to set in.”

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Seattle registered dietitian Amanda Bullat, owner of Alpine Nutrition, started running cross-country when she was a high school freshman. The seeds of her future eating disorder were planted when her coach performed bioimpedance scans. “I remember being fixated on the fat mass number and thinking I better be leaner to be a better runner,” Bullat said. Despite getting a new coach the following year who focused on training and team-building rather than body size or composition, she was running enough on her own that she stopped having menstrual periods.

Then, as a University of Portland sophomore, Bullat ran her first marathon — qualifying for the Boston Marathon, earning a junior year walk-on spot on the school’s cross-country team, and getting compliments on the weight she lost while training. “That was where the lifestyle behaviors started to change towards disordered eating and a disordered exercise relationship,” she said. “That was another way for me just to validate that this is what it takes to be a collegiate Division I athlete.”

Because Bullat wasn’t a recruited scholarship athlete, she flew under the radar while watching her teammates restrict their food intake to try to retain their competitive edge. By her senior year, she was running faster than the scholarship athletes, who were too stressed and injured to perform well. “Even though I was still in a disordered place with food and exercise, I wasn’t as disordered as the girls that had been feeling pressure from the university to perform a certain way — and my body wasn’t injured yet.”

Van Winkle said that when an athlete starts restricting food, they often feel faster and perform better — which makes it hard to reach them. “They’ll feel fine in their sport, but underneath the surface, all their systems are breaking down. They’re running towards the cliff and eventually they’re going to fall off.” Then their athletic performance diminishes, they lose their joy for their sport, they’re malnourished — and they require a lot of time to heal.

Bazzi said even when coaches aren’t focusing on body fat and weight, staying silent is a disservice to their athletes. “I’ve heard coaches say, ‘We don’t have a problem on our team so there’s no need to talk about it.’ Or, ‘I’m afraid of saying the wrong thing and making it worse, so I figure that not saying anything is better than saying the wrong thing.’” She said that even if athletes don’t have diagnosable eating disorders, they’re still navigating the pressures of diet culture, so it’s important for coaches to talk about these issues with their teams — even if their wording isn’t perfect — to help prevent future problems.

Ideally, Van Winkle said coaches help athletes focus on performance, not appearance. “The beauty is in how our bodies can move, not what they look like.”