When a Coach Suggests Athletes “Drop a Few Pounds”: Q&A with Dr. Quatromoni
This is part of a Q&A series with leading expert in eating disorders and sports, Paula Quatromoni. For more Q&As click here.
A coach of an adult, co-ed triathlon team sent out a training guide offering athletes advice on “top 5 ways to become a faster cyclist.” One of the “lessons”:
Lesson B: Dropping a few pounds
When it comes to biking, we can all stand to lose a few pounds.
Q: How can athletes advocate for themselves and their teammates to tell a coach they are uncomfortable with recommendations being put forth to the team about weight loss?
A (Paula Quatromoni): For several reasons, this is a dangerous message for coaches to deliver to athletes, and it is a dangerous way in which to deliver it.
First, this advice endorses the “thinner is faster” mentality. Bodyweight is not the best indicator of athletic performance, so this advice overemphasizes dieting and weight loss as solutions and oversimplifies the many factors that influence performance.
Second, this coach is making an explicit statement about the culture on his team and his personal value system. By putting this coach-endorsed belief system as a directive to an entire team, this statement sends the strong written message that on this team, “thinner is better” under all circumstances, for all athletes regardless of any one individual’s personal situation.
Further, this guideline makes a clear statement of expectation that everyone needs to lose weight. By using the collective “we” in the directive, the coach is attempting to “normalize” the advice or make light of the situation, as if not intending to target any subgroup of the team or inappropriately single anyone out; but the danger of this is no less than if he/she singled out specific athletes and spoke these words in person. In fact, putting these words in writing as a blanket piece of advice to all athletes is potentially as damaging, with widespread implications for all athletes on that team.
Uninformed Advice
You will note that there is no follow-up statement to this directive to “drop a few pounds.” There is no information that tells athletes “how to” achieve the goal, exactly what the goal is, or who to turn to for help in achieving that goal. This, to me, is the second most dangerous part of this situation. Would a coach ever tell an athlete to “bulk up and get more fit” without an assessment of how the athlete performed on strength and fitness tests and without sending them to the strength & conditioning coach for an individualized work-out plan? I don’t think so. Why should advice on weight and body composition be treated with such indifference and inaction?
Second, only to giving uninformed advice about any individual athlete’s weight or nutritional status that is made without any consideration of how they are performing in their sport, failing to follow up that ill-advised advice with an action plan that includes identification of and contact information for the sports nutritionist on staff or in the local community to evaluate the individual’s needs and guide them in this pursuit is irresponsible. These collective actions put athletes at increased risk for body image dissatisfaction, dieting, disordered eating, relative energy deficiency in sport (RED-S), sports-related injuries, and poor performance in sport. I am quite sure that this is not what the coach is intending when giving this advice.
What can athletes do about this?
When we raise up our voices, there can be strength in the collective “we.” This real-life illustration of the “thin ideal” mentality perpetuated in sport gives athletes the opportunity to come together to discuss their reaction to this advice from the coaching staff to advocate for change. There are several ways to approach this. The advice below is useful not only for adult athletes, but also for high school and collegiate athletes since directives to drop weight are not uncommon in those settings as well.
Team leaders (captains, seniors, or other concerned athletes) can lead a discussion with the team to talk about what it is like to receive this message from the coaching staff. This action normalizes the act of talking about it. With growing attention paid to student-athlete mental health thanks to the NCAA initiative on Mind, Body and Sport, athletes on campuses across the country are asking for opportunities to speak up and be heard on the topics of stress in collegiate athletics. Team leaders can create space and role model behaviors that encourage teammates to seek support from one another to process stressful experiences and negative messaging that is targeted at them. This gives athletes the opportunity to come together to voice their personal concerns, draw support from one another, and re-define the culture on their team from the bottom up. When athletes prioritize their own health and wellness, they can spread a culture of body positivity, acceptance, and emotional support that makes proper fueling for sport a team value.
Team leaders can also take their concerns forward. There are several places to turn for support.
Coaching staff: Talking with the coaching staff is one viable option. Speaking up to the coach may be easy or it may be uncomfortable for an adult athlete; but it can be extremely challenging and anxiety-provoking for a student-athlete. This is where counseling and work in therapy on interpersonal communication can really benefit an athlete who has difficulty expressing his/her concern and being heard. Depending on interpersonal dynamics, an Assistant Coach may be easier for the captains or an individual athlete to approach than a Head Coach. The sex of the athlete and the sex of the coach may also play a role in these interactions. There are some coaches who believe, “I coach guys; I don’t have to worry about eating disorders on my team.” That is a fallacy. There are others who think it is OK to give this advice to male athletes because “they can handle it” but would never even mention weight to female athletes. Again, that is a stereotyped belief that only contributes to the “man up” stigma that eating disorders are a woman’s disease.
Athletic Trainers: The sports medicine staff should be made aware of coaches giving blanket advice to teams of athletes to drop weight. The AT staff is trained to know that weight loss advice is counter-indicated for most student-athletes, and they have enough training in eating disorder awareness and risk assessment to know that this is an action that puts athletes at risk of dieting, disordered eating, relative energy deficiency in sport (RED-S), and sports-related injuries. It is a professional responsibility for ATs to intervene to reduce this risk within their department of sports medicine. If there is an Eating Concerns Team on campus, the AT will be involved and can bring this concern to that team on behalf of the athletes. In the high school setting, the school nurse is another potential advocate.
Counselors: In the collegiate setting, there are usually counselors in the Student Athlete Support Services who act as a liaison for confidential support when athletes have concerns to voice that they might not be comfortable raising directly with the coaching staff. On our campus, it is called the Student-Athlete Life Skills program. This is the department that coordinates a variety of support services for student-athletes including allocating funding to on-campus programming and educational initiatives. These counselors have a direct line to Athletic Trainers, coaches and athletic administrators. Similarly in a high school setting, athletes can seek support from the guidance counselor who is trained to support student mental health. As counselors, these professionals can protect anonymity when representing student-athlete concerns up the chain of command.
Sports Psychologists: If available within the Department of Athletics or Sports Medicine, it would be most appropriate for a student-athlete to communicate his/her concern about the global weight-cutting advice a coaching staff is endorsing to an entire team. Whether it is a personal reaction to this advice or an overall concern for the well-being of their team, an athlete can confidentially bring this concern to the sports psychologist for guidance and support on how best to address the situation, knowing intimately the personalities of the personnel involved.
Nutritionist: If available within the Department of Athletics or Sports Medicine, it would be very appropriate for a student-athlete to communicate his/her concern about this to the registered dietitian (RD). The dilemma is that only the biggest Division 1 collegiate athletics programs in the country have a sports RD on staff (only 7% of all NCAA universities). Some have part-time consulting RDs while most have no RD inside Athletics at all. This reality only worsens the problem and escalates the risk of coaches giving even well-intended advice to student-athletes to drop weight.
SAAC representatives: The Student-Athlete Advisory Council serves an essential function to hear and represent student-athlete concerns to athletics administration. These student leaders are empowered to be agents of change on campus by mobilizing student-athletes and other resources across teams to address common issues and challenges. SAAC leaders also have a voice at the conference level to advocate for mental health support services and eating disorder awareness initiatives across member schools, making these issues conference-wide priority response areas that can be targeted for allocation of resources.
~
Paula Quatromoni, DSc, MS, RD is a registered dietitian, academic researcher, and one of the country’s leading experts in the prevention and treatment of eating disorders in athletes. Dr. Quatromoni is a tenured associate professor of Nutrition and Epidemiology, and Chair of the Department of Health Sciences at Boston University where she maintains an active program of research. She publishes widely on topics including clinical treatment outcomes and the lived experiences of athletes and others with and recovering from eating disorders. In 2004, she pioneered the sports nutrition consult service for student-athletes at Boston University, and in 2016, she led the creation of the GOALS Program, an athlete-specific intensive outpatient eating disorders treatment program at Walden Behavioral Care where she serves as a Senior Consultant. Dr. Quatromoni is an award-winning educator. She earned her B.S. and M.S. degrees in Nutrition from the University of Maine at Orono, and her Doctorate in Epidemiology from the Boston University School of Public Health.
