This is part of a Q&A series with leading expert in eating disorders and sports, Paula Quatromoni. For more Q&As click here.
Q: My daughter started running and quickly developed a highly restrictive diet. She tries to eat no carbs. She has lost so much weight, but it’s never enough for her. She enjoys running, but I’m afraid she is using it as a punishment and has to do “workouts” in the morning and before bed. I am very worried about her, but she doesn’t want to talk about eating as a problem, because anything that helps her lose weight is a “good thing”. What can I do?
A (Paula Quatromoni, DSc, MS, RD, LDN): You are right to be concerned. This is a place where you have to trust your intuition and continue to observe the warning signs: restrictive eating, food rules (no carbs), substantial weight loss with a continued, strong, driven mission to lose more, and what could be compulsive exercise. This young woman is dieting and exercising, yet is not fueling properly to meet her nutritional demands. This creates a condition called “relative energy deficiency in sport” (RED-S). The consequences of RED-S are far-reaching and put her physical health, her emotional well-being, and her sports performance at risk. The fact that she “doesn’t want to talk about eating” is a hallmark of the denial that anything could possibly be of concern.