A Numbers Game: Mental Effects of Undereating, Overtraining

By Ingrid Worth

Edited by Pat Melgares

Second in a three part series

"The numbers game I was playing was deadly and extremely costly."

Editor's note: Ingrid Worth (pictured above, with hip number 4) was a cross country and track and field standout for Shawnee Mission East from 2014-2018. In 2017, she was the Sunflower League and regional champion in the 3200 meter run, before placing third at the Kansas state meet. In this three-part series, Worth talks about her struggles with an eating disorder, eventually leading to a condition known as Relative Energy Deficit in Sport, RED-S. After a year running at Carleton College in 2018-19, Worth sat out the 2019-2020 season to seek treatment, aided by a registered dietician and a disorder specialist. The first article in the series published on June 3; the third article publishes on June 17.



"This is not how third place is supposed to feel."

As I shakily stood on the podium at the 2017 state track and field championships after the 3200 meter run, I felt numb. I had dreamed of this moment for over a year, and I had thought it would feel electrifying and fulfilling. A bronze medal at state was supposed to make every extra mile, every carefully counted calorie, and every missed social event worth it.

Yet, although third place felt good, the moment wasn't life-changing. Underneath my smiling exterior, I was devoid of emotion, of nourishment, and of friendship.

At the time, I thought my apathy stemmed from my performance. If only I had placed in second or had run a PR, I thought as I stepped off the podium. I knew something was missing, but it would take me three years to figure out what exactly that "something" was.

Ten months before the state track meet, as I entered my junior year of high school, I decided to dedicate myself completely to running and academics. College, once a distant notion, had become an omnipresent force in my life, guiding all my decisions. I knew that when I applied for college, I'd be presented as a series of numbers -- test scores, GPA, and PRs -- on an application for a stranger to read.

I began to obsess over these numbers as a way to exert control over a future that felt uncertain and daunting. As I single-mindedly focused on results, my eating disorder, which had been an intermittent companion since middle school, worsened.

As the cross country season began, I threw myself into training and became increasingly fixated with my diet. What started as a resolution to "eat healthy" became destructive as my diet steadily grew more restrictive. I developed a set of "food rules" as I began to label foods as "good" or "bad" based on their nutritional profile. If I ate outside of my parameters, I felt a sharp sense of guilt that could only be soothed with exercise or further restriction.

By the end of my junior cross country season, the list of foods that I allowed myself to eat shrank so much that I rotated between the same four meals every day.

According to the National Eating Disorder Association (NEDA), my behaviors were symptoms of orthorexia, an eating disorder in which I became obsessed with eating foods I considered "clean" or "healthy." In the past, I would relax my diet during the off-season. However, surrounded by the pressure to lower my PRs for college recruiting, I stayed the course.

As track season began, I was the most food-focused I had ever been in my life. I spent hours planning meals in my head, waiting until I could have my next meal, poring over cookbooks, and baking foods that I would rarely allow myself to eat.

My obsession with food was a signal that my body was not getting enough nourishment, according to an article from licensed clinical social worker Melissa Gerson. My parents noticed and encouraged me to eat more, but I didn't trust them because I was racing faster than ever before. Besides, according to the Body Mass Index (BMI) scale, I was still considered healthy. Furthermore, the professional runners I idolized weighed far less than I did; so, if anything, I thought I needed to be even leaner.

When I looked in the mirror, I could always find some part of my body that looked "soft" or "disproportional" and therefore needed to be changed. I realize now that I was suffering from Body Dysmorphic Disorder (BDD), a body-image disorder in which I became preoccupied with imagined or slight flaws in my appearance, according to the Anxiety and Depression Association of America. In other words, I viewed my body as a project that needed constant attention.

As the track season continued, I increasingly believed that my entire purpose in life revolved around my numerical results in both running and school. Under constant pressure to perform well, I became riddled with anxiety, a symptom that commonly accompanies eating disorders, according to the Anxiety and Depression Association of America (ADAA).

During the 2017 track season, I cried before every meet because I was so afraid of not measuring up to the high expectations I put upon myself. If I didn't get a PR in a race, I would spend the next week feeling like a failure and fearing that my performance was in decline. Even when I ran a PR, I would only feel happy for an hour before my anxiety would reassert itself as I began to think about my next track meet.

It was a miserable existence, but I tricked myself into thinking I was okay because, according to the numbers, my junior year was practically perfect.

I did extremely well in school and set all my PRs during the 2016-2017 cross country and track seasons. However, beneath the gilded exterior, I was crumbling under the amount of effort it took to maintain perfection. My entire life centered around running and academics, to the exclusion of all else.

Both running and school began to feel like jobs instead of activities that I genuinely enjoyed. In spite of all my efforts to maintain control over my life, the numbers -- my weight, my GPA, my PRs -- had begun to control me.

I put so much stock into my results that, when I became injured during my senior year and unable to compete, I felt worthless. My anxiety morphed into depression, another illness that often co-occurs with eating disorders. The detached, listless feeling of depression stuck with me for two more years, becoming most acute whenever I was unable to run.

Fortunately, in the past year, I have received help and have emerged from the darkness of both my depression and my eating disorder. Sadly, many do not. According to an article by clinical psychologist Lauren Muhlheim, eating disorders have the highest mortality rate of any mental illness and one in five deaths from anorexia nervosa are by suicide. The numbers game I was playing was deadly and extremely costly.

As I spent hours training, thinking about food or body image, and obsessing over results, I missed out on so much life. When I stood on the podium at the state meet my junior year, I had the results and measurements I'd always wanted, but I had nothing else. For too long, I was so absorbed with controlling my body and my performance that I was neglecting friendships, laughter, and connection.

At the time, I thought I would look back at my junior year and think of a list of accomplishments, but three years later, my most cherished memories are the moments I spent with other people. The numbers I cared about so much can't define the buoyant feeling of laughter or the camaraderie of talking with a group of friends during a long run. These feelings and memories that are the most unquantifiable have been the most important in shaping my life.

This year, I've been focusing on building connections and, although I'm running more slowly than I used to, I feel happier than I ever did when I ran PRs. After all I've been through, I'd choose life, friendship and real connections over numbers any day.


If you are struggling with an eating disorder and are in need of support, please call the National Eating Disorders Association Helpline at 1-800-931-2237. For a 24-hour crisis line, text "NEDA" to 741741.


NOTE: Information for this article was taken in part from the following sources:

NEDA Orthorexia article link: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

Melissa Gerson article link: https://www.theprojectheal.org/healblog/impact-of-starvation-on-behavior

Body dysmorphia article link: https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd

ADAA Anxiety article link: https://adaa.org/understanding-anxiety/related-illnesses/eating-disorders

Lauren Mulheim, PsyD, CEDs Depression link: