by Marisa Michael, MSc, RDN, CSSD
Author’s note: This blog post is modified from its original version. The author of “Out of the Shadows” reached out to me expressing his anger at this opinion piece. I don’t blame him. I would be angry if someone systematically unpacked my writing. I actually live in low grade anxiety about this almost daily. But after much soul-searching and contemplation, I realized that I am morally and ethically obligated to speak out about eating disorder culture. And “Out of the Shadows” is problematic on many levels and poised to do much harm. It even recommends that coaches practice medical nutrition therapy, which is illegal without a license in many states in the US.
I do not blame or fault the author for writing it. I genuinely believe he has good intentions and seeks to do good. He told me his goal is to “raise awareness and invite positive and respectful discussion.” Same, same. This is also my goal in writing this critique of “Out of the Shadows.” We two authors are on the same team–fighting against eating disorder culture.
I personally think it was quite unfair (And unprofessional? Maybe sloppy?) for the editors of Gym Climber to ask the author of “Out of the Shadows” to write such a piece, when he clearly is out of his element. This piece exposes the lack of professional training and science-based advice that would come from someone else writing it from within the eating disorder field. It’s also a shame that the main nutritionist quoted in the article also clearly lacks eating disorder training. The editors of Gym Climber should have required an eating disorder professional to write, or at least review, this piece. To have a coach write up this piece is really not appropriate. It was way out of his scope.
And I feel badly that he was put in such a position. I looked at his website and can’t tell if he even has any professional coaching certifications or education. He’s an amazing climber, that’s for sure, and looks like an amazing coach, but that doesn’t qualify someone to write about eating disorders. The nutritionist he quoted also doesn’t appear to have any actual nutrition training, let alone eating disorder training. He has a degree in technology and food science, not nutrition. So he appears to not be qualified to be quoted in an article about eating disorders.
If someone asked me to write up an article about training protocols for climbing, I would do a really bad job, even if I researched it a bunch, and interviewed experts. Even though I am a certified personal trainer, I don’t have the skillset or professional expertise to do this. And I bet climbing coaches would read it and shake their heads at how wrong it was, and maybe even email me to tell me it was bad. Because I simply don’t have the education to write an article like that.
Again, I don’t fault the author. He did his best with what he knew. He is genuine and he cares deeply about fighting eating disorders. This whole experience has taught me that people, including me, need to stay in my own scope of practice or we may inadvertently cause harm. I asked him for input and was open to his comments and suggestions, but I did not receive a response from him.
So why did I not just take this blog post down? Why do I not let “Out of the Shadows” sit in peace on the internet? I thought about it. A lot. Maybe I will at some point, because I don’t want to offend. But…
It is problematic when an article claiming to combat eating disorders is imbedded with behaviors and recommendations that promote disordered eating. We cannot prevent or treat eating disorders by recommending disordered behavior.
The climbing community has been trying so hard lately to get it right with eating disorders, and I applaud everyone that is contributing to the discussion. We need everyone’s voices AND we need to correct misinformation around eating disorders. If it’s there, even if it was well-intended, it may cause harm.
As an eating disorder professional, it has been my passion and main focus for the past several years to bring resources to the climbing community. Climbers are suffering, and they don’t know where to turn for help.
As a registered dietitian, I have extensive training and experience in evidence-based practices that qualify me to administer medical nutrition therapy and treat those going through eating disorders. I have made it my mission (hence this website!) to provide science-backed information to climbers. My hope is to start filling that void of good climbing nutrition information.
I started on this journey mainly because most of the nutrition information I saw in the climbing world was alarmingly inaccurate, written by coaches and trainers who really had no idea what they were talking about and were far outside of their scope of practice.
Before we go any further, let me make one thing clear: This is not an attack on the author of the article, the people quoted in the article, or Gym Climber magazine. I have no issues with any of these people, nor do I know them. I think they all are seeking to do good with the platform available to them.
When I read Out of the Shadows, I was immediately alarmed and concerned. I tried to resolve this in a private way before making this public. I emailed the editors of Gym Climber, asking them to either pull the article or print a correction, and outlined all my concerns with the article. They flatly refused to do either. To their credit, they did ask me to write “Is Lightweight the Right Weight?” For their next edition, which I happily did, but they didn’t offer to un-do the harm “Out of the Shadows” is likely causing.
I private messaged the author on Instagram, voicing my concerns. He was dismissive and and told me my concerns were opinions and theories, even though my concerns are based on mounds of scientific evidence and consensus. He blocked me.
If Gym Climber had run a correction or retraction, that would have been awesome. Since they didn’t, I feel this is the platform appropriate to voice my concerns. As you read this, you may feel strong negative feelings, anger, anxiety, rejection, or confusion. That is ok. This is totally normal when our culture is programmed to think that thin is better, healthy is thin, and eating healthy is virtuous. Some of the things I say will contradict that messaging, and it may feel uncomfortable or even unbelievable. That’s ok. You may think I’m a jerk. I guess I’ll have to be ok with that too.
So, with that background, I take you to my critique of Out of the Shadows–NOT to defame. NOT to attack. ONLY to inform and enlighten, and combat harmful misinformation. Because if we let misinformation stand, we do harm.
My intent is to have a productive way to help people identify eating disorder behaviors and thought patterns. Hopefully you will have a positive mind shift as you read this.
The article starts out with a useful summary of eating disorders and different types. But as you keep reading, there are some key problematic paragraphs.
Read this one:
Why is this paragraph a problem? Sounds reasonable, right? Actually, no. If a coach, fellow climber, parent, or trainer is asked by a climber, “Do I need to lose weight to climb better?” The answer is a firm and definite NO. Even if they are “overweight,” trainable variables like strength, endurance, and skills are much more useful to focus on. We have several studies looking at climbing ability, none of which definitively say that weight is correlated with climbing ability.
In fact, there are over 40 factors that determine sports performance aside from weight. To explore more, I’ve written up a guide for athletes that outlines these factors, plus a ton more stuff around eating disorders, body image, and relationship with food. Yes, there are references.
In my own scientific, peer-reviewed research, I found that climbing ability was more associated with years of climbing experience and hours per week of climbing. Weight is not closely associated with climbing ability, and has been verified by other researchers, as shown in this slide below. There’s also a nice blog post written by one of these researchers on this site.
So no, you do not need to tell an “overweight” climber they need to lose weight in order to climb better. And no, you don’t need to tell a “normal” weight climber that either. Focus on other variables, such as skills, strength, flexibility, and endurance.
“If you tell a climber that body weight makes no difference, then you will lose their trust and respect,” says this article. No.
You will actually have a really cool teaching opportunity to have the climber gain a bit more body positivity and reframe the way they think about climbing performance. Telling them to lose weight objectifies their body and may cause harm. It also ignores the fact that there are so many other ways to improve in climbing.
Instead, reframe the way they think about weight. It is only one variable (and a tiny one at that–researchers estimate weight only explains 1.8-4% of climbing ability). And diet is only one tiny variable of body weight. It’s incredibly difficult to control body weight. To focus on weight and diet in order to improve climbing ability is not productive.
If you want to learn more about the nuances of this, go to my article I wrote up for Gym Climber, Is Lightweight the Right Weight? and one I wrote up for Climbing Magazine Why Underfueling Will Lead to Underperforming.
Here is the next problematic paragraph:
There are a lot of layers to this. Let’s unpack it.
We should never be asking any child about their food choices. Full stop. Food choices are complex. They are dictated by food availability, taste preference, food security, and more. Children don’t often have power over their food choices. To ask a child about their food choices is loaded with all sorts of things the child may not be able to answer and has no control over. This suggestion is just food shaming. This limits the child’s ability to foster a good relationship with food, including viewing foods in a neutral, non-judgemental way.
If a child is going through eating disorder treatment, they may have been instructed to eat “fear foods” as part of exposure therapy. These foods are often considered “unhealthy” to the outside observer. Imagine if a child has a deep fear of Oreos, but as part of their eating disorder recovery, they are bringing Oreos as a snack to climbing practice. Then imagine the coach asking them “Are all your food choices healthy?” I hope I am explaining well how problematic this is. Please stop judging others for their food choices. Eyes on your own plate.
Implying that a child needs to have every food choice be healthy is teaching the child rigidity in food choices, which is a hallmark of eating disorder behavior. Every food choice does not and should not be healthy.
Identifying a child as overweight is not appropriate. Many children gain weight during puberty–which is natural, normal, and appropriate. A child may appear overweight or “fluffy” for a time, and then grow taller. Any coach who thinks they can identify “overweight” or “underweight” is mistaken. No one should be lumping children into these categories. Growth charts, family body types, and health history all need to be considered–which is far outside the scope of practice of a coach.
Overweight children need to be screened for binge eating disorder (which was described in the first part of “Out of the Shadows”), because the “overweight” may be due to bingeing, which can happen with controlling parents who do not let kids make their own food choices. Are you starting to see why this recommendation in “Out of the Shadows” is inappropriate? The article talks about binge eating disorder, and then says you must ask overweight children if all their food choices are healthy. And yet if their parents/coach are demanding that all their food choices are healthy, the child may be bingeing in secret, causing them to gain weight, and perpetuating the eating disorder cycle.
Categorizing people based on outward appearance is missing the point. Eating disorders come in all body shapes and sizes. An “underweight” child or an “overweight” child may equally be suffering from an eating disorder. Asking an “overweight” child if all their food choices is healthy is assuming they do not have an eating disorder, and likewise will reinforce the eating disorder if it is present. YOU DON’T KNOW IF SOMEONE HAS AN EATING DISORDER JUST BY LOOKING AT THEM. Asking children different nutrition questions based on their weight and body size is inappropriate. They all need to eat adequately to fuel their growth and sporting activities, as well as have flexibility and joy in food choices. Instead, you can encourage the whole team to fuel and hydrate before, during, and after practice without dispensing discriminating nutrition advice based on body size.
- “Processed foods” is a broad and nonspecific, non-helpful term. Baby carrots are processed. So are steel cut oats. Also, what? No one can eat processed foods ever? Again, this is promoting rigidity in eating, which is a key sign of an eating disorder.
- Not only that, but highly processed foods such as sports drinks, gummies, and white bagels have loads of evidence to support their use in enhancing sports performance. Sports drinks are specifically formulated to deliver electrolytes and quickly-digesting carbohydrates to fuel and hydrate during exercise. They are not problematic when used in the context of sports performance, and are actually quite helpful to avoid bonking and dehydration.
- Cooking from scratch and needing to know “exactly what you are eating” is disordered eating. Plain and simple. Perfect textbook example of someone suffering from anorexia or orthorexia. Please, guys, do not promote orthorexia in an eating disorder article.
- Very active children may need more than just a snack. They may need big meals, multiple times per day. Teach them to honor their hunger, not to follow arbitrary diet rules to just have a “little snack” to “tide you over” before the next meal.
- Nuts, dates, or fruit pre-climbing may be fine for some people, or may cause gastrointestinal issues for others. Generally something lower in protein, fat, and fiber than nuts is useful for a pre-workout snack (again, this is backed by a large body of scientific evidence).
On to the next paragraphs:
Ok, again, lots to these paragraphs. Let’s break it down.
- Body composition has very little to do with eating behaviors, especially in adolescents. Also body composition will not tell a coach anything about their bone density status or menstrual status. This is not the way you assess either of these things. Yes, bone mineral density can be measured by a DEXA machine, which also measures body composition, but they didn’t state that here and didn’t explain the difference between these two measurements.
- Coaches shouldn’t measure body composition for a number of reasons: It’s outside their scope of practice, it doesn’t affect how they coach (or at least it shouldn’t! Coaches need to teach skills, flexibility, endurance, strength–body composition is irrelevant), they are not trained measure accurately, (unless they are ISAK certified), they do not have access to growth charts, and they should not be collecting this sensitive medical data, and they likely don’t store the data according to patient privacy laws. As a side note, I am curious what type of coach would want to take on this medical burden in the first place. It seems like it would be overwhelming and opening them up to liability. They are not trained in this, nor do they know how to manage this medical data.
- Measuring for bone density and blood “functioning” (whatever the heck that means) is FAR, FAR outside the scope of practice as a coach. This should be done with a medical professional who has specific training in how to interpret the results, which labs to order, and what to do in the event of an abnormal result. No coach should ever be looking at labs. This is practicing medicine without a license. Again, it doesn’t affect how they need to coach, and they are at risk for breaching patient privacy medical information laws (HIPAA in the US) if they collect and store this information.
- If a coach tries to monitor labs, body composition, or any other medical measurement, and then recommend interventions, this may considered practicing without a license in many states in the US. Even a coach giving nutrition advice is violating the law in some states. Unless the coach is licensed to practice nutrition in states that require it, the coach should not be giving nutrition advice.
- Adolescent athletes should not be measured or weighed regularly by their trainers. Frankly, neither should adults. Trainers should train, that is it. An eating disorder is a mental illness. You cannot recognize an eating disorder by height and weight. Weight is a private medical measurement that does not and should not be collected by a trainer or coach. And again, it tells the coach nothing about how to train the athlete. It does inform safe belay practices, but this can be done without taking a specific weight. If a kid is smaller than another kid they are belaying, just anchor them into the floor. That’s it.
- In order to keep athletes safe, you can implement an annual screening protocol where they need to get a sports physical by their doctor before training or competing. Leave the measurements, screening, and labs to the doctors. All the coach needs to know is if the doctor medically cleared the athlete for training. This protects both the coach, the climbing facility, and the climber from liability.
The coach should never assist in a weight loss program. NEVER. Even if the coach has some nutrition training, this is still wildly inappropriate. Coaches are not trained to do this type of intervention. If they are attempting it, harm will most likely occur, particularly in adolescents. It is not appropriate or necessary for adolescents to lose weight in the vast majority of cases. If an adolescent does need to lose weight, this should be managed by a pediatric dietitian and pediatrician. Again, the coach may be violating the law if they attempt this.
A coach does not have the skills and tools to do this. I, as a dietitian of 19 years with numerous degrees and certifications do not have the tools to do this. I get potential clients that ask me to do this, and I refer out to others that have the specialty training.
Coaches CAN and SHOULD participate in helping the climber develop a training and exercise program, because that is precisely what coaches do!
This may be a good time for a sidebar: The Dunning-Kruger effect
This is where a person has a little bit of knowledge, and then thinks they are an expert. This is “Mt. Stupid” on this graphic. This is the case with a lot of people. You read one article on a topic, think you know a lot, and then start telling other people about your knowledge. The problem is, your actual knowledge is very low but your confidence is high. I see this over and over again with coaches, physical therapists, and doctors who have a little bit of knowledge or training in nutrition, but it is so little that they really don’t know what they’re talking about, and end up dispensing bad nutrition advice. I did this the other day with paddle boarding. I have been doing it for years and feel like I know a lot, but found out something simple that I really should have known a long time ago that was totally new for me. Dunning-Kruger effect. Happens to everyone. Image credit mysportscience.com.
Ok back to the breakdown: Burrows is wrong that protein has the least amount of calories per macronutrient. Protein ties with carbohydrate at four grams per calorie. But again, this article misses the point. If you really want to lose weight, you need to be in a calorie deficit. Thankfully, this article didn’t talk about that, because discussing weight loss in an eating disorder article is certainly not appropriate, as many eating disorders are triggered by weight loss attempts.
If they are making recommendations for a kid, which it sounds like they have been, then telling them to eat large quantities of vegetables, paired with protein, is not supported in the scientific literature. Kids and adults alike need carbohydrates, more than what is offered in vegetables. Active people need an increased amount to fuel their sport. In addition, fiber and protein are very filling. An adolescent could sit down and eat a plateful of chicken and vegetables and walk away feeling stuffed, but they are not getting adequate calories if they are too full. This puts them at risk for relative energy deficiency in sport.
It’s also not ok to tell someone that eating a “more healthy diet will improve their performance.” Because diet is only a teeny, tiny part of performance, and “more” healthy is subjective (Where did their diet start out? Already pretty healthy? Is “more” healthy now an eating disorder?). This statement lacks nuance and is not appropriate.
Ok we’re at the end. Thanks for sticking with me. I hope this opened up your eyes a bit to the dangerous things we may say that do harm when we don’t intend to. Again, this is not to shame anyone, this is to provide useful information and reframe the messaging we receive around weight and climbing performance.
Some thoughts for how to not cause harm:
- Try to have weight-neutral conversations with fellow climbers
- Do not give unsolicited advice about their climbing performance relating to weight (see this excellent article in Climbing Magazine by Caroline Wickes to see how this can be a bad idea)
- Do not comment on others’ food choices
- Stay within your own scope of practice
- If you suspect a problem, refer to a competent medical professional trained in eating disorders.
- National Eating Disorder Association hotline: 1-800-931-2237
For more information:
Dr. Lanae Joubert’s published research on prevalence of ED in elite climbers
Dr. Kate Bennet’s interview on climbing and eating disorders on the TrainingBeta podcast
Caroline Wickes on climbing and eating disorders on the Power Company podcast