“But I’m not lean enough.”
It was the exact phrase I said in defense to my doctor when she told me the reason that my body had been malfunctioning for years because I didn’t have enough body fat.
But those words were pretty much the leading factor for how I got myself in this mess in the first place.
It was a year and a half ago, and I can still remember looking down at my body after hearing her diagnosis and being so confused. At 22 percent body fat, according to any chart I still had plenty of fat in the “healthy” range (ironic, because of my muscle mass I was actually nearing the “overweight” label on the body mass index at 5’4 and 150 lbs). And though all this information told me I was healthy, yet “thick” as I had always been, there was no denying that something was wrong – because among other problems I had chosen to ignore in the pursuit of the perfect body, I hadn’t had my period in three years.
Even with the wealth of information I had at my disposal as a fitness professional, with all the hard training I had done as a high school and college athlete and all the fitness books and magazines I had read – at that moment in the doctor’s office the only thing I knew about women losing their period as a result of sport was that it occurred only in the LEANEST stages of female bodybuilders just before a competition when their body fat was in the low teens and lower, and in aesthetic sports like ballet and gymnastics, or at the Olympic level where hard training took a serious toll on the body.
I wasn’t close the leanest stages at 22 percent, so up until that moment in the doc’s office, I just kept living my life, happy to skip the two weeks of every month that PMS would make me feel even more bloated than I already felt and make me crave carbs and sweets that would wreck my diet. I welcomed this thing that was actually a symptom of an entire system of my body shutting down.
Once I casually mentioned it to my doctor, my delusion was over. Countless tests and multiple doctors (including two cancer scares and one emergency surgery) led to a diagnosis of Functional Hypothalamic Amenorrhea (FHA).
FHA is a condition caused by stress, weight-loss or exercise that causes a women to lose her period for five months or more. Mine stuck around for THREE YEARS.
What I’ve learned since that day is that a woman’s body is sensitive to any environment it deems unsafe to procreate. A situation where it is unsafe to make a new human is one where there is danger (stress) food is scarce (malnutrition) or there is not enough energy to support a fetus (low body fat), the woman will stop ovulating. The result is amenorrhea: an extended time without menstruation.
Now here’s the thing about exercise: even though it makes you feel really good, it’s actually a form of stress on your body. That’s why proper recovery (sleep, good balanced nutrition) and stress management is essential to a full program, whether for weight loss, muscle gain or performance goals. UNFORTUNATELY, these are the things some people skip out on when engaging in a weight loss plan. They pile on the workouts and try to get by on as little food as possible (or not the right foods), and in our overstressed rat race world, sleep is not enough of a priority, and stress is something we accept.
But for some people, including a lot of female athletes, this condition can be worse with the pressure to succeed. Those with the perfectionist mindset, who believe nothing is ever enough, or happens fast enough, who obsess over cheats and skipped workouts, constantly think about their next meal, weigh themselves daily and are often frustrated with the results they aren’t getting because they are not recovering properly.
The combination of mental and physiological stress can have heinous effects on your body, and can cause reactions that will actually release stress hormones that will flow through your body and affect other hormones, like estrogen and testosterone.
If the only problem had been that I just couldn’t have kids at that moment, I would have ignored the diagnoses (I was 26 and focused on making my abs tight, not adding stretch marks and A CHILD into the mix). But losing your period is really only a symptom of FHA. Here are some other sneaky problems I was living with for three years while my hormones raged a war, thinking everyone felt as stressed, anxious and tired (and orange) as I was.
- As a result of my “excessive exercise” and “undereating,” I had other blood tests reveal I had low levels of leptin, the hormone that tells your body you have enough fat. If this hormone is too low, your body will have trouble “letting go” of body fat (no wonder I felt I had to resort to extreme measures to lose weight).
- Ovulation helps women absorb calcium. I went three years without properly absorbing calcium, which means I am now at risk for early osteoporosis (side note: my insurance would not cover a bone density exam to check the severity. I still don’t know how crappy my bones are).
- I was also at a much higher risk for injury because my body could not recover properly with “too much stress” on my body, which explains how I tore my meniscus in the second year of FHA.*
- My estrogen levels were low, leading to problems like low self-esteem and anxiety, excessively dry skin (and my boobs were smaller than they had been when I was 14)
- This one is my favorite: FHA leads to an excess of beta carotene in the blood (the chemical in carrots), which can turn your skin orange. I will never forget my co-workers making fun of my orange-tinted palms, feet and knees, and me chalking it up to eating too much chili and sweet potatoes
- My adrenal glands were so taxed, I was “wired but tired” = which led to insomnia, so to add insult to injury, it was even more difficult for me to sleep and relax
*This phenomenon of high exercise + not enough food = injury risk is actually such a threat in female athletics, it’s nicknamed the “Female Athlete Triad.” What’s funny is, the first I had ever heard of FAD was after the first year of my experience: I actually had a very smart, very caring personal trainer friend inform me about this, but I didn’t believe him because “I wasn’t lean enough” for this to actually affect me.
Here’s the thing that gets me the most: I bet as a “regular exerciser” you’ve never been warned about Female Athlete Triad or FHA. And here’s my other point: With so many women, including teenage athletes, on birth control, how would you have that telltale sign that enough is enough for your body? Remember, lack of menstruation is just a symptom of overtraining (or rather, under-recovery).
Here’s the real kicker – like I mentioned before, according to popular fitness culture and even the knowledge of fitness professionals, I was doing “everything right.” Twenty-two percent body fat is not considered low. Six workout days a week is not considered extreme and 1,600-1,800 calories a day is not considered undereating.
I tried to argue with the neuroendocrinologist at Mass General, saying there was “no way” I worked out too much or didn’t eat enough. He looked me dead in the eye said, “This is my diagnosis.” He recommended I work out less and eat more. I was devastated, and even more so when I blew up 10 pounds in two months.
I was angry. It didn’t make sense to me that this could be true for me, when after years of pushing I only had the slightest ab definition (in my mind, still plenty of fat leftover to work with). To be honest, from the beginning of my own fitness journey I always felt like I had to work extra, harder than others because I was naturally a “chubbier,” curvier athlete. That’s what drew me to working in fitness – I believed in the power of transformation, of the power in the choice to make the most of the cards a person was dealt. I wanted to help other people find their own power when they felt helpless. Ask anyone who’s ever made a lift, finished a tough race or seen their muscles in the mirror – feeling strong on the outside sure does wonders for feeling strong, powerful and confident on the inside.
But the source of my “work ethic” – always fighting my naturally thicker body – was actually what made me an exception to that “12 percent body fat or lower” kind of rule. I told myself, I truly believed that if I worked hard, I could have the body and the status-symbol abs I wanted. But all I did was work hard – there was no balance. Everything I did was about my pursuit of being my best, in and out of the gym.
That go big or go home mentality never stopped, and it created the perfect over-exercise+undereat+stress storm for the FHA: I worked out twice a day, I was a carbo-phobe and counted calories. I would not eat grains, cheese or other foods that were not “clean.” I would feel seriously guilty after eating anything like this (later a dietician told me this made me an “orthorexic”)
The stress/obsession that I believed was bringing toward my goals – get that dream career, don’t waste time or money – was actually ruining my life. I thought nothing of working four jobs at a time, often working 13 hours a day. I avoided places like the movie theater because it was a place you sat down and “wasted” two hours. I beat myself up for not writing enough, not working out enough, for every cheat. Then of course I felt even worse for beating myself up. I slept awful because I couldn’t shut my brain off, and would gratefully lose sleep for an early morning fasted workout.
I just thought I was driven. I thought I needed to sack up when I felt tired. I thought if I kept PUSHING, I would get what I wanted, because that’s what we are all taught. I told myself to stay consistent, I’d see my abs.
But then my gynecologist dropped a bomb on me. I had taken her advice, I gained weight and I was miserable. I asked her, when could I start losing again? I explained to her that I was a trainer, that people looked toward me to be an example of fitness, and that I’d need to get back into even better shape than I was before.
And then she sighed, looked at me sideways with a shrug and explained that not all bodies are the same, or have the same threshold for body fat. That my body is “sensitive to weight loss” and that I may never safely be as lean as I desired.
And if I hadn’t already fell apart, that was what really got me.
It seemed like a sick joke given my “go hard” mantra that I had come so close to my ideal body that I could taste it, only to find out my body couldn’t tolerate it. Being forced to slow down, everything kind of hit me, and the slowness and heaviness I felt matched the heaviness of the shame and secrecy as I tried to appear like I had it all together. In reality, it threw me into one of the deepest depressions I’ve ever experienced. The huge influx of calories, less cardio and crazed hormones put the 10 pounds right on my gut, and I hated how I looked and felt. Shamefully, I admit there were days I didn’t even want to shower because I didn’t want to see or feel my body, to look down and see the mess I had made of myself. I hated that as a trainer, with so much knowledge of weight loss, I wasn’t allowed to do anything about it.
Nevermind being overweight and not being sure how to lose it, or not having the will or the discipline – my problem was that I had all that discipline in spades.. What I didn’t have was permission. So I had to go on, just sitting in a suit that didn’t like mine, feeling like I was being punished for trying to do my best.
My job as a trainer was my happy place, but it became torture to be in a place of fitness where everyone was trying to pursue their perfect body. I was paranoid all the time that people would look at me and think I didn’t know what I was doing, or think I had let myself go. I wore long sleeves and my loose jacket on 90 degree days to hide my belly. I wanted quit my job and go somewhere far away where I didn’t have to march around pretending that I hadn’t broken my own body.
And here’s the part of the story where there’s a happy ending and I tell you how I solved my problems, right? No.
The stress of the ordeal, the shame, the depression eventually got to be too much to handle. It took a long time for my body to heal, and I was tired all the time. I avoided the beach so no one would look at me and say, “Isn’t she a trainer?” I realized I was spending a lot of time inside on the couch, in my sweats, eating kale chips and watching TV, and during one of these days I finally ripped off the bandaid and emailed a therapist.
Now a year later from the summer of my secret shame, I still struggle with this on some level everyday. I’m still sitting at a higher weight than I was in March 2016. I still have to be careful with how aggressive my workouts are, and recognize when to scale back. It’s still hard to see other people finding their best bodies and watching celebrity trainers flaunt their abs on Instagram, but I’m learning to take the pressure off my own.
And instead of living in shame, I am using “what happened to me” to be a better coach. I’ve learned so much about nutrition, recovery, and the relationship to the parasympathetic nervous system on my own. I completed a nutrition coach certification with Precision Nutrition to be that change I want to see.
I believe this story needs to be told.
When I think of how angry I was that this had happened to me, I realized I was really pissed off because there was nothing out there in popular fitness content that warned or informed women, coaches, and trainers of how easy it was to get to that “too much” line.
I think of my history as an athlete – I had years of poor performance because I wanted a coach to like me so bad that I under-ate and worked out after practice to get “faster.” When it backfired, I blamed myself and pushed harder.
Which is why EVERYONE should know about the risks of under-recovery. We are at an amazing time in history where women are accepted as professional athletes, when female muscles are sexy, and we encourage our girls to get out on the field in any sport. But that’s exactly why we need to educate on the importance of athletes eating for performance, not weight loss. It’s why we need to check ourselves on the pressure we put on young women to play three school sports, plus weekend club teams with all-day tournaments, plus strength training, advanced homework, tutors, after school jobs and volunteer work, not to mention a social life. Add to all that pressure the ready access to social media, where these student-athletes are constantly comparing themselves to “Fitspo” Instagram stars and hardcore female athletes (by the way, those ladies make it their JOB to get enough sleep and eat enough so they can perform right). How many girls do you know with bags under their eyes, who are falling asleep in class or have crippling anxiety for fear of failure? This is an example of a body and mind on the brink.
It’s why we need more articles in magazines about the specific dangers of stress and anxiety related to the “gotta have it all” and “fear of missing out” mentality – how it won’t take you to where want to go, but 10 steps backward.
It’s why YOU need to check YOURSELF if it’s truly necessary that a 4 a.m. run is followed by a two cardio classes that evening, or if cutting carbs is actually something you should be doing, or if you down four coffees a day and “I’ll sleep when I’m dead,” is your daily mantra.
Because it’s not just girls: just because a man can’t experience that telltale sign I had that told me something was wrong, doesn’t mean there aren’t guys that are obsessed with losing body fat to unseen extreme, or guys that are working two jobs and sleeping four hours while doing all they can in the gym, and so frustrated they throw money at supplements to get them out of the hole. Remember guys, low testosterone can happen to you, too, and it has it’s own host of problems that could leave you battling your body.
No one can burn the candle at both ends.Striving to do your best is an amazing thing, but being obsessed with perfection is dangerous. And you won’t know how bad it is until your body starts shutting non-vital system down just to keep itself running.
It’s fine to lose weight and get healthy, but cutting out food groups, sleep and things that make you happy is not healthy. Restrictive diets for weight loss are not healthy beyond three months for most people.
After what I’ve been through, I have made it my job to make sure that in helping my clients adopt a fit lifestyle, it’s a balanced program. I learned the hard way that nutrition, sleep and stress management are as crucial to a healthy body and healthy body fat as what happens inside the gym. Just like in anything else, cutting corners in any area – even constantly choosing the gym over fun with those you love – will lead to consequences in the end.
Of course, achieving balance is easier said than done. Changing my life over the last year has been one of the biggest challenges of my life, because I had to rewrite every instinct that told me to workout no matter what, to avoid bread, to ignore a tired body to get done what I needed. I had to relearn how to sleep eight hours a night and that I wasn’t going to ruin my whole diet if I ate a lobster roll. I constantly fought with my own voice that told me I was a terrible trainer for letting this happen, and that I should just give up and travel so no one would see my depression and my weight gain as my hormones bounced trying to heal themselves.
But I got through it. I’m getting through it by using by experience to get this message out there.
HOW DO YOU KNOW WHEN IT’S “MUCH TOO MUCH?” How do you know when it’s enough?
Having been through it, here’s my answer: when the pursuit of feeling strong inside and out turns into a pursuit of perfection, that’s when the battle begins. At that point, you are chasing something you cannot catch, and it can drive you absolutely insane. That applies to fitness and everywhere else, really, but that’s fitting if you think of how we really hurt ourselves: in the 22-23 hours outside the gym. When we choose to under-eat, under-sleep, and convince ourselves resting is for the weak.
Well I’ll tell you what: if you don’t rest, you will be weak. You will hurt your body. And you won’t know how much is too much until it’s too late.
Check out my coming post on the importance of stress management in a workout program, including an explanation on how chronic stress can kill your progress and how to stay chill in this rat race world.