English half marathon champion Katherine Wood explains how she has been affected by an eating disorder and why she is now seeking help.
2018 – where to start? It was a year of massive highs in terms of my running career, but I failed to take proper care of myself or to acknowledge that cracks beneath the surface were appearing. I needed help and it resulted in me crashing into 2019 in a very bad place both mentally and physically.
Let me introduce myself. My name is Katherine Wood and I’m a 23 year-old endurance runner living in Manchester and training and racing with Sale Harriers.
I moved to Manchester after studying for my undergraduate degree in Biochemistry at Oxford University in the summer of 2017 to start a PhD in the field of Genetic Medicine.
For the last 10 years, my life has been deeply intertwined with mental health issues. At the age of 13, I was hospitalised as an in-patient with anorexia nervosa.
To give some context, I had been a competitive swimmer and runner as a child and a young teenager, but as I went through puberty I struggled to balance my energy output of training with energy input. When this was combined with my perfectionist tendencies, high-achieving nature and extreme determination, I rapidly transitioned from losing some weight accidentally, to suffering from a full-blown eating disorder which was picked up too late.
My periods stopped, my bone density had plummeted and at the time of hospitalisation I had a BMI of less than 14.
While I was never treated as an in-patient again, I had several relapses over the following years requiring out-patient care, the most notable of which being when I moved to Oxford to start studying for my undergraduate degree.
During the first term, I lost a huge amount of weight and without parental nagging, I clearly wasn’t able to cope or manage myself nearly as well as I’d thought. Just before the Christmas vacation, I was told to gain weight over the holiday or I would not be able to come back for the next term and would have to take a break in my studies.
This proved motivation enough to kick me into action and I successfully gained back the weight I had lost over the following few months, this time using my determination and general pig-headedness in a constructive manner to put my everything into recovery.
While depression and anxiety plagued me throughout my time at Oxford, my weight remained stable after this at a relatively healthy level, I was allowing myself more flexibility as to what I ate (it turned out that chocolate in moderation was a fabulous antidote to essay crises and finals’ stress!) and I was able to start running again.
My first half marathon and increased training
My first half marathon was 2015 before and completing my first marathon in October 2016, in a respectable time of 3:20. I felt in control of my eating disorder (rather than it controlling me) and I believed that I would never let myself slip back into my old ways; I had everything to gain by remaining healthy, and so much to lose if I didn’t.
I then joined Sale Harriers in October 2017, and over the next year, I really became immersed in the sport of running. My training volume increased – I was now including double sessions on some days and the purchase of an exercise bike meant I was incorporating more cross-training into my schedule – but I felt great for it.
In 2018, I lowered my marathon PB to 2:49 in Bavaria and I decided to enter the Yorkshire marathon in October, with the Scottish Half Marathon and Robin Hood Half Marathons in September as my training races in the lead-up.
The combination of increased mileage and cross-training seemed to have been successful so far so I continued to up my miles further; I was now running between 90 and 100 miles a week, with double runs every day, a 20-miler every Saturday. I was also doing at least an hour of cross-training and core strength work every day.
But beneath the surface, cracks were beginning to appear. I was aware that I had lost some weight, and that it was lower than it had been for a few years. I had tried (and failed) to come off my antidepressants over the summer, but it had thrown me out of balance and routine, and I was really struggling with my mood.
At the beginning of September, I contracted cellulitis in my lower left leg – the pain and swelling had initially led me to think this was a running injury, but a trip to the physio and then the GP confirmed it was instead an infection.
I was put on a course of antibiotics which helped to clear it, and while the pain was excruciating, I refused to stop training or miss a single run, although I had to forgo running the Scottish Half Marathon.
Winning the England Half Marathon title and a 2:41 marathon
With the clearance of the infection, I decided that I would still run the Robin Hood Half Marathon, which incorporated the England Athletics Half Marathon Championships, two weeks before the Yorkshire Marathon.
In racing terms, it was a huge success. I not only won, but I also ran 77:34 to record a two-and-a-half minute PB.
With the win at the forefront of my mind, the last fortnight of training before the Yorkshire Marathon was now underway. I was aware that my weight had dropped slightly more, but I kept telling myself that things would sort themselves out.
My performances were improving and I thought my body was coping well and responding to the amount of training I was doing; I would sort the weight out after the marathon.
Despite what my fellow runners were telling me, I decided not to bother with tapering for the marathon; I couldn’t bear the idea of lower mileage weeks and I went into the marathon on the back of an approximately 80-mile week.
As with the Robin Hood Half, things couldn’t have gone better. By mile 20, I knew I had several minutes on Julie Briscoe and although I was beginning to really feel the cold and wet, I pushed myself on to cross the finish line in a huge PB of 2:41:33. It was the biggest running victory of my life.
Soon afterwards though things would take a turn for the worse. I was on such a high that I didn’t give myself any sort of recovery or rest and I was back to a normal training week the day after the marathon.
Furthermore, Liz Yelling had also agreed to coach me remotely, something I was over the moon about.
My health was declining, but I couldn’t stop training
However, two weeks later, I found myself back at the GP being prescribed another course of antibiotics as the cellulitis had returned on the other leg. As recurrent cellulitis is quite uncommon in young, apparently healthy females, the doctor questioned why this might be happening and suggested it may be a consequence of my low weight.
After standing on the scales for her, which indicated I now had a BMI of just 16, she told me that she was referring me to the NHS eating disorders service and requested several blood tests. When these came back, they indicated that my immune system was not functioning particularly well and my creatine kinase (CK) levels were elevated, a mark that the muscles in my body were breaking down.
We were now into November, and yet again I resolved that I needed to sort myself out in order to keep training and performing to the best of my abilities. And yet, despite the racing calendar coming to an end for 2018, I continued to train – now I felt like a failure if I wasn’t running 100 miles a week, doing an hour each night on the exercise bike and at least 30 minutes of core exercises per day.
Repeated blood tests showed the CK remained high and my weight was continuing to go down. I knew my diet had become far more restrictive again and I was worrying far more both about what I ate and how my body looked than I had for many years.
When December came, my fiancée and I went on a holiday – that was booked months in advance – to New York, but the trip was dominated by running and worries about food and on my return to the UK, my weight had dropped considerably more, giving me a BMI of just 15.
Christmas 2018 has to have been one of the loneliest and most difficult periods of my life so far. Hugely worried about Christmas dinner and that I might not be able to do all my training sessions. Christmas Day was certainly no rest day – I pushed myself to run a half marathon distance in the morning just in case I ate more than I wanted to later, but halfway round I felt something twinge in my hamstring and the rest of the run was a painful hobble.
Despite this pain, I continued to run and run and run. My hamstring was now very bruised and my whole leg was swollen and painful. The pace I was able to run was getting slower and slower, and I just felt completely alone and lost.
Enough was enough
I remember so well the day I decided to make a change. It was December 29th, and I had just read an article on Fast Running about another young female suffering from RED-S, and how, with the renowned sports’ and eating disorder specialist nutritionist, and founder of the #TRAINBRAVE campaign, Renee McGregor, she had been going through a long and difficult, but ultimately successful, road to recovery.
By this point, I knew I had to do something. My situation felt desperate and I realised that I couldn’t do this alone. Liz Yelling had some idea my weight was a bit lower than ideal and was aware of my history, but I hadn’t told her what was going on, my parents clearly didn’t know what to do (while I hadn’t owned up to how much weight I had lost, they could very clearly see how bad things were) and while extremely supportive, my partner was also at a loss.
Ultimately, I had to make the decision to change and act upon it – nobody else could recover for me. So I made contact with Renee and arranged a Skype consultation, and in the meantime, I wrote myself a 3000-calorie meal plan to follow, with the intention of continuing to train while gaining weight.
The day of my consultation with Renee finally arrived. I was anxious about talking to her, but since starting my high-calorie meal plan my weight had increased slightly and I was hoping that she would be able to provide me guidance on how to improve the meal plan while still training.
I think deep down I knew what was actually going to be said, but I was adamant I was doing the right things in terms of making positive changes towards recovery.
Of course, one of the first thing that Renee said was “I want to work with you and help me, but I will only do this if you agree to stop running or doing any exercise immediately”. I was absolutely devastated – I had put on some weight while still running, so why couldn’t I carry on this way?
Renee explained to me that I was putting myself in great danger, that my heart could give way at any moment, my bone health was probably very poor and that I was very unwell. I was so caught up in the eating disorder that I couldn’t see those home truths, but deep down I knew I had no choice; I had approached Renee for help and if I didn’t do what she asked or work with her, I probably was either going to be hospitalised or die.
Renee suggested that she and Liz work together to support me, and reminded me that I was not alone in this and that I couldn’t do this without any help and expect to recover long-term.
The day of the consultation was one of the bleakest days of my life; I cried and cried, many things were thrown across the room in anger and all I wanted to do was to curl up in a ball and hide away from the world. But it was also one of the most important days of my life. I had made the very positive step of reaching out for help and had approached arguably the most qualified professional in the field. Things could only go up from here.
It’s been a whirlwind
Over a month has passed since that initial consultation, and things have been a bit of a whirlwind. The mental effort to stop myself from training has been hugely draining, and I have found it unbelievably difficult emotionally to cope with eating a huge amount and not exercising.
On the positive side of things, I have managed to gain several kilograms of weight, and as a result, I am now allowed a couple of short runs a week, a little bit of exercise biking, and I have started doing yoga and pilates.
I am hoping that by doing things like pilates (which are extremely good for runners anyway) that when I do get back to training and racing properly, I will go into things in much better shape and come back stronger than ever.
I have also been using the extra time I now have to try new things and be more balanced – I’ve been proactive in meeting friends for coffee, finding craft projects, baking, my partner and I got a pet snake, and I even managed to brave a pub quiz.
On the more negative side, all the evidence suggests my body is really struggling, far more than it did when I first got ill a decade ago, probably to be expected given how long I have been ill and not providing it with the nourishment it needs.
My blood tests are still showing elevated CK, my lymphocyte count is very low meaning my immune system is very compromised and as a result, there are signs that I have had an acute infection in the liver. Additionally, the DEXA scan I had has shown very poor bone density, putting me well inside the osteopenic category, likely an effect of very little oestrogen production.
The likely outcome of this is that I will be going on hormone replacement therapy (HRT) to provide an oestrogen ‘boost’ until my body starts producing enough naturally due to my long history of illness and menstruation problems.
Wider problems and lack of support
One thing that has really shocked me is the availability (or lack thereof) of services in the NHS. After waiting three months for my NHS Eating Disorders Unit initial assessment, I was told that this appointment was to decide which waiting list to put me on to receive the appropriate treatment.
When I asked about the waiting times, I was told that because I had been put onto the fast track system due to my low BMI when I was referred it should be less than 12 months, but if I had been on the general waiting list the waiting time could be up to two years.
For someone with an eating disorder, two years is far, far too long – at least 20% of anorexics die prematurely, with suicide and cardiac arrest being the two highest contributors to this figure.
The lack of funding and support for people with eating disorders and mental health problems in general is shocking; I am extremely fortunate I have a family who can support me financially to see a private specialist, and while the work Renee does through TRAINBRAVE is outstanding, there simply isn’t enough money to offer help to everyone in situations like mine.
While still in an early phase of recovery and it will be a long road ahead, I am determined to succeed and overcome my eating disorder this time. I want to be the athlete I know I am capable of being without nutrition or my weight being a limiting factor.
I would not wish any of this on my worst enemy – anorexia and sports-related disordered eating has ruined the last decade of my life, I have missed out on so many things in life because I have been ill for so long, and although I know it is wrong to feel guilty or blame myself, I feel a huge burden on the people around me who have supported me and whose lives have been turned upside down because of my illness.
All I can say is that if you have even the tiniest shred of worry that a fellow athlete is over-training or under-fuelling or becoming obsessive, do not ignore it or push it under the carpet until it is too late. This is my motivation for sharing my recovery. If opening up about my own experiences with disordered eating and sports helps one other person – who might be going down a similar pathway and hasn’t yet reached out for help – then sharing my story is the right thing to do
We need to break the taboo around the subject of RED-S, anorexia and sport if we are to tackle this issue head-on.
This week is Eating Disorders Awareness Week and one charity that is doing great work to build awareness, provide resources and offer support is Beat, the UK’s leading eating disorder charity. Further information and advice can be found here.
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