Funding for this program is provided by The Alaska Eating Disorders Alliance, the Alaska Community Foundation the State of Alaska and GCI.

(no audio) - My name is Holly Brooks.

I am a two-time Olympic athlete, and today, I am an LPC, (upbeat music) which is a Licensed Professional Counselor, and I often describe my work as working at this intersection of mental health and performance.

As a therapist.

I have a few ideologies that I really buy into.

(upbeat music continues) HAES stands for Health At Every Size.

And the idea is this, it's that weight is not the only thing that determines how healthy we are.

We all have a different baseline weight, or body shape or size, where we are the healthiest.

There are all these body ideals that are unrealistic for almost all of us, and we can't put everyone into the same box, and so that's what I'm here to talk about today.

We can't do this to ourselves anymore, and we can't do this to our friends, our family, our teammates, and our kids.

(upbeat music ends) Okay, so there is this great analogy about poodles, (uptempo whimsical music) and it's called poodle science, and just hang with me.

Imagine you go to a dog park, and at a dog park, people pretty much expect to see this, like, wide range or diversity of dog types.

You have your chihuahua, right, which is small, and it might fit in your purse, and that's all good, right?

You have your lab or your labradoodle.

Here in Alaska we have lots of huskies, right?

The dogs that are, like, made for the Iditarod, and just have a ton of endurance.

And then you have like your mastiffs, right?

Or your pugs, which are just, I don't know, it looks like you wanna go up, and give 'em a hug, and take a nap with them.

And here's the thing, you would never tell a mastiff to become a chihuahua, or a chihuahua to become an Alaskan husky, right?

Like that's just insanity.

It's crazy.

(uptempo whimsical music continues) But that is exactly what we're doing to our bodies.

So poodle science is this idea that the poodle represents the thin athletic ideal, and that everyone should be a poodle.

But intellectually, and I mean just common-sense-wise, we know that a mastiff can't be a poodle, a chihuahua cannot be a poodle.

It would die before it became a poodle.

But that's what we're doing to our bodies, and that's what we're doing to athletes.

We're saying this is the ideal become this.

If you're not this, change your body to become this.

If you're bigger, lose weight to become this, and it's unrealistic, and that is what is driving up the rates of eating disorders and anxiety, and depression, and suicidal ideation, because in this society we're told that we're only as good as our performance, our appearance, and it's directly tied to our self-worth.

You know, so much of sport culture is this win-at-all-costs mentality.

Athletes, again, you know, we aren't machines, we make mistakes, we get injured, we have feelings, right?

We have anxiety, we have depression, we get overwhelmed.

Athletes don't want to be their last performance, we deserve more.

(slow somber music) Athletes have a ton of risk factors.

The first thing is that we are so hard on ourselves.

You know, often with athletes we are our own worst enemy.

We're pushing ourselves really hard.

So many athletes are achievement-oriented, have perfectionistic tendencies, and these things are really precursors to things, like anxiety and depression, obsessive compulsive disorder, and a lot of these things feed right into eating disorders, disordered eating, and body dysmorphia.

(slow somber music ends) (uptempo cheery music) - So my name is Yolanda Evans, and my role, I am a physician and adolescent medicine specialist.

The main things that I'm helping youth with are recovery from an eating disorder, reproductive health concerns, gender, and some mental health, including depression, anxiety, ADHD.

Eating disorders are really life-threatening, it is one of the higher causes of morbidity and mortality amongst mental health diagnoses for youth.

And so when we are seeing kids with eating disorders, we're often managing kids who are even in the hospital.

It can be deadly.

The second highest cause of death amongst youth with mental health condition.

Their bodies are still changing, they have really significant nutritional needs, just to continue to develop into adults, and so when a person is malnourished, it literally affects every organ system.

Not eating enough contributes to how you think, and your focus, your energy level, your stamina, it can affect your heart, and how it beats, and how it functions.

Really every part of your body is affected by not getting enough to eat.

(uptempo cheery music continues) Anybody can be at risk for an eating disorder, regardless of your shape, your size, your gender identity, your socioeconomic background, and I think we're often misdiagnosing people, because in our medical environment, we kind of have this idea in our mind about who would be at risk.

For people who identify as BIPOC, or underrepresented minorities, I think also gender plays a role too.

They may have an eating disorder that we're missing, or not diagnosing, and so they might not get picked up as soon, or their behaviors might not be as obvious to others looking outside as some of the other female-appearing people.

(uptempo cheery music ends) - So something that's often not talked about is what's called body dysmorphia.

And it might happen in conjunction with an eating disorder, or it could be totally separate, and what body dysmorphia is, is it's a preoccupation with a part of your body that you don't like.

It's looking in the mirror, and seeing something in a way that's totally different than other people see it.

We have people who meet the clinical criteria for a diagnosable eating disorder.

You know, we have anorexia nervosa, which is typically characterized by people who restrict quite a bit.

And so, you know, these people tend to, maybe, lose a lot of weight, but not always.

But it's essentially characterized by restriction, and it is the most dangerous of all the eating disorders, and actually eating disorders, anorexia nervosa specifically has the second highest mortality rate of any mental health illness, only surpassed by opioid addiction.

- I'm from Anchorage, Alaska I'm a cross-country and track coach, and I also ran cross-country and track in college.

I was really in high school where I was, like, really in love with running, and it was something for me that helped me, because I didn't have a super great home life.

My parents weren't around a lot, and so for me, running was sort of that escape.

And I got a call from the assistant coach who had seen my times, and had seen me race, and asked me if I would be interested in signing with them, and that's where I realized I can go to school.

No one in my family had earned a degree at this point, and so for me that meant a lot.

It started when, every year, we were weighed in.

So we would show up in our spandex, and hope that your weight was sort of what you were last year or the year prior, because then that meant, well I was successful then, so this is the weight that I should be at.

I was a little bit heavier when I returned that summer, and was actually pulled into the office by the head coach, while the assistant coaches sat there, and was told that I was a a fat piece of (beeps), that I needed to lose weight, and that if I wanted to keep my scholarship, I would do that.

(tense dramatic music) And thinking, "Well, if I can lose weight, I can be faster, I can keep my scholarship, I can do this."

I mean, I wished I could have gone to any other university in the world, and had no scholarship, and just enjoyed running like I used to.

I stopped running immediately as soon as I could.

I severed pretty much all ties with anyone at the university, I boxed up all my awards, I gave them away actually, because they were really hard to look at.

It was really hard to think, at the end, this is what I have.

This pile of medals and awards wasn't really worth it.

(tense dramatic music continues) (tense dramatic music ends) - So that's anorexia, bulimia nervosa is people who eat food and then engage in some kind of compensatory mechanism to get rid of that nutrition, those calories.

So what people know, or most familiar with, is self-induced vomiting, but this can also be, you know, using laxatives and diuretics.

Then we have binge eating disorder.

Binge eating disorder is actually the most common of all the eating disorders, and it's characterized as eating an unusual amount of food sometimes in a, at a fast rate, and then feeling really bad about how much food you ate.

Kind of going down this, like, spiral of shame.

(sloe somber music) - My name is Benjamin and I grew up in Valdez, Alaska.

So I played a lot of sports growing up, not just in high school.

I started wrestling in seventh grade.

Wrestling was a passion of mine, and I grew to love it more than any sport that I played.

(slow somber music continues) When I was in high school, I wrestled at a much higher weight class than was expected to be in college, and when I went to university, I knew that I was going to have to cut weight to be as effective and efficient as possible, and to be as competitive as possible.

(slow somber music continues) A perfect example of wrestling culture is if you come in to practice, and you weigh a couple of pounds over your weight class that you're intending to wrestle that weekend, you automatically refer to yourself as a fatty, and everybody else refers to you as a fatty, like "You've gotta lose that weight, fat boy, come on."

That was just the colloquial way you spoke to each other.

(slow somber music continues) There's a lot of different weight classes that you can be in and you will only go against people that weight, and only one person can win.

I was asked to see if I could make weight to the lower weight class, and I knew I had to make weight Saturday morning, and I still had a few more pounds to go, and I just hit a mental edge, where I was like, "I can't do this anymore.

I can't lose that last little bit of weight."

I remember overindulging in food, (tense dramatic music) and just eating until, not only was I content, but I was physically ill, and because I was so distraught with myself on not being able to make weight, I just gave up mentally, "I'm so fat, why do I do these things to myself?"

And I remember going in, and making myself throw up for the first time, and then about 10 minutes later, just being disgusted with myself, going, "Why did I do that?"

I thought I was doing what wrestlers had to do, and in retrospect, I was bulimic.

I knew it was wrong then, but I didn't talk to anybody about it, or ever say anything about it.

My relationship with food, and how I handled this was not the right way to do things.

(tense dramatic music ends) (slow somber music) (slow somber music ends) - What people don't understand is another compensatory mechanism is compulsive exercise, and so this includes people who go to practice, and then after practice they go to the gym, and spend two hours on the elliptical just to burn off the food that they ate.

- I was working out multiple times a day.

I was eating nothing, but cantaloupe and lettuce in the cafeteria.

(slow somber music) You know, I would have a couple of slices of turkey meat, and that was the gist of my eating habits for the first two months trying to get down to weight, and doing all of these things, I thought I was competing in wrestling.

- I wouldn't eat breakfast, I would try to get as close to zero as possible, as in how many calories am I taking in, and how many calories am I burning every day?

I spent a lot of time sort of secretly going into the training room, weighing myself before a run, going on an hour, 45 minute run, coming back to weigh myself again just to see if there was some sort of change.

- The other thing that I really wanna shine a light on, it's orthorexia.

(slow somber music) Orthorexia is kind of this pre-occupation with health.

It's I'm doing this to be healthy.

So how it shows up is all of a sudden, you become gluten-free or a vegan, you avoid social situations where you think food might be involved, and you take your own food with you everywhere you go.

And I'm not against making healthy choices, but what happens to these people is their world become smaller and smaller, and smaller, and smaller.

So it's like this moralization of food, and you know, that often is, like, this gateway eating disorder to something that's more, and more, and more serious.

- Teens are spending more, and more, and more time online, and we do see a lot of the teens coming through who are being diagnosed with an eating disorder talk about going on different platforms, and seeing different diets, and different ideas, and different workout plans, and really that's kind of fueling, or leading to a lot of the behaviors that they're trying out, and that they're engaging in.

- And so what I always tell people is to do a little bit of, like, a social media audit, and look at who you're following.

Look at a picture, and ask yourself, how does that make me feel?

If that makes you feel like you're not good enough, if that makes you dive into these comparative toxic thoughts, unfollow them, (tense dramatic music) go through your social, and just unfollow everyone that makes you feel like crap.

- We're seeing like this is what you should look like, this is what you shouldn't look like, and if you wanna look like this, then you should try this diet, and you should do this, and you should do that, and so they're like, it's like you have, like, a 100 birds chirping at you at the same time, telling you all these different things to do, and you're trying to, like, internally listen to yourself, and say, "Well, I'm me, and I don't need to be that, and I can be me, and that's fine."

(tense dramatic music continues) - We all know that social media is everyone's personal highlight reel, but the other thing that's so toxic are filters, and different apps that can literally change the size and shape of your body, that can literally with one brush stroke, take away all your acne.

So it's creating this insanely unrealistic body standard.

- There needs to be more resources for our students, there needs to be more, at the beginning of the season, all of the athletes sit down, and we talk about the hard, hard stuff, because when that stuff comes up, like eating disorders, or drugs and alcohol, you don't know what to do when you're in the moment of it, but when you talk about it before, it at least opens that door just a tiny bit.

- We're so preoccupied with our appearance that people just become obsessed with it, and see themselves in this way that other people might not even see them.

(slow relaxing music) Another really important thing to talk about is what's called Relative Energy Deficiency in Sport, or for short, REDS.

So this used to be known as the the Female Athlete Triad.

And the Triad was low energy availability losing your period, and having low, low bone mineral density.

So it used to be fairly straightforward, and then, we realized, it's actually much more complex than that.

- Often, you know, I'm seeing youth in the clinic with the Relative Energy Deficiency of Sports, right?

They are not so much having issues with their body shape, or size, or how they appear, there's just an energy imbalance, right?

The amount of activity they're doing, the amount of growth and development happening, all of their body's energy needs at once are not being met with the amount of fuel going in.

And so you'll see that their growth is just kind of flat, and their heart rate's in the 30s when they're awake, that is much, much too low.

So those are all things that I'm looking for, and can share with the family to show, like, "Hey, we've got energy imbalance, we need to work on putting more fuel in," and as we do that, these things will start to improve.

- So what I like to liken it to is it's like your body (tense dramatic music) is operating on a low battery all the time.

So imagine this, I don't know about you, but if my phone is on 3%, I'm getting a little stressed, I don't know what messages I'm gonna miss, I don't know if I'm gonna be able to join the next meeting, it's kind of a big deal.

If you're not eating enough to fuel your body as an athlete, it's like having a phone on 3% - After losing a significant amount of weight in an incredibly short period of time.

I noticed at some point (tense dramatic music continues) that I no longer had my menstrual cycle, and was tired, and cranky, and grouchy, and irritable, but my times weren't getting any faster.

It was miserable, it was horrendous.

- If a person's not getting in enough nutrition there is a part of our brain that sends signals to our different organs, including, like, ovaries, testes, like the gonads basically, and it affects hormone levels, so if you're not eating enough, if you're somebody who would be going through puberty as a male, it'll drop your testosterone levels.

If you're someone who's going through puberty as a female assigned at birth, it'll drop your estrogen levels.

So really, really important to, again, get enough nutrition and then, we can see that sometimes that that is something that might be desired.

If there is a fear of going through puberty or misalignment with, like, the puberty someone's going through, and their gender identity, for example, we can see sometimes that that is contributing to the disordered eating behavior.

- I'm Jessie Diggins, I'm 30 years old.

I'm a professional cross-country skier, and I am recovered from an eating disorder.

If I could go back and tell my 16-year-old self, one of the most important things, especially in relation to body image and self-confidence, I would say that first of all, you don't have to be perfect, people love you because of you, and because of who you are, not because of how you perform on a test at school, or in sport.

(upbeat music) Your self-worth isn't dependent upon your latest result.

You just have to be you and show up, and do your best, and that will be enough.

It's okay to ask for help.

That doesn't mean that you are a failure if you aren't taking good care of your body right now because of your eating disorder, that's not your fault, and it doesn't mean that you are a bad person.

Bad things are happening to your body and to your brain, because of your eating disorder, and that's why you deserve help.

- If there was one thing that I could tell my 16-year-old self, and all the other 16-year-olds out there is to be kind to yourself and others, to be patient, it's to eliminate body talk, and to find the people that make you feel good about yourselves.

- As a high school wrestling coach, if I was to give advice to middle school, high school, college-level athletes, to make sure you take the time (upbeat music continue) to educate and communicate on what you're doing to become the best.

There are no shortcuts.

The second you start making shortcuts, and deciding that there's a faster way, it's the second you start compromising your beliefs, and you start compromising what your body is telling you.

- Really, I feel like we're going through this whole movement where we're having to realize the athletes are people first.

These athletes are human beings, who participate in sports, but that's not how our society sees them, and it's this toxic sport culture that's win at all costs, it's not working, and finally, you know, athletes are taking a stand, they're claiming their voice and saying, "This is enough."

- I have had more success coaching my athletes by treating them like people first.

It really shows, it's just been a, like, beautiful process to see them grow as, like, young adults, and hopefully be lifelong active human beings in this world.

My coaching works clearly, because the girls are winning every single thing they can possibly win.

We won State in Track recently, it's really exciting (chuckles).

And we also won cross-country just the past year.

- There are lots of things that we can actually do about it.

We can stand up against diet culture, we can stop making body-related comments.

And this even includes an agreement to stop making comments about our own bodies.

There are so many other amazing things we can talk about, and as athletes, there are so many other things that we can focus our energy and effort on to improve in our respective sport.

Your training plan, your balance, your coordination, your endurance, your strength, your coachability, your relationship with the team, and the team culture, and we need to expand the dialogue.

- With kids, they're really at this critical window of energy use.

They're using so much energy just to grow, develop, think, get up, go to school, like the day-to-day (upbeat music ends) - When we're going through puberty is when we're creating our bone mineral density for life.

And we are setting the stage (slow dramatic music) for what our bodies will be for the rest of our lives.

And so, if we don't let that happen, there can be some really harmful things that happen not only in the short term, but also in the long term towards our bodies, and our performance, and food is more than fuel, right?

And there are lots of ways to be good at your sport beyond manipulating your weight, shape and size.

So if you don't care about the long term, here's how it can affect you now.

It can cause electrolyte imbalance, which can lead to fainting or cramps, can make you bloated, it can make you irritable, or just the inability to actually absorb your training.

And ultimately it can cause losing all the joy from something that used to be fun.

The truth is, if you are in an endurance sport, or a weight-class sport, and you lose weight, you will potentially get faster (upbeat music) for this long, and then your body will crash.

So it's really hard, because the positive reinforcement is there for a split second, and then it ends.

- The other thing I've learned is I really don't have to be perfect.

Hey, if I try my best, that's okay, and the people in my life are still gonna love me.

So I think that's, it's been a really cool feeling, a lot more confident, a lot more positive.

I'm definitely at home in my body, and being able to have a good relationship with food.

So that's something to look forward to, and a huge reason to do the work of recovery.

- I am passionate about mental health, because I am sick and tired of seeing so many people struggle.

(upbeat music continues) We need to work together to destigmatize it.

We need to work together to pull back this curtain of secrecy.

We all have our mental health, and you know, it's part of my life's work to talk about it, and destigmatize this issue.

(upbeat music ends)