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Sara Seiwald On Navigating Long Term Consequences of RED-S.

If I Can’t Become a Pro Distance Runner, The Least I Can Do Is Try To “Look Like” One:

I’ve always have had a strong appetite for movement. My movement started out innocent and I moved my body for all the right reasons. For instance, I played soccer in high school  because I loved running on the field with my teammates. Once it became clear I was fast chasing the ball down on the soccer field, cross country and track was brought to my attention. Running shortly after became the love of my life. I quit soccer to focus solely on running. My junior year of high school, I decided I wanted to run in college, especially at the division-1 level. I managed to become a walk-on at a competitive Big 12 D-1 school in the Midwest.

My freshman year of being a student-athlete is where my RED-S journey starts. I was by far the slowest on the team upon arrival to college and had a a lot of learning and training to do if I wanted to be on the travel team. So I did what I thought was right. I over-trained and undernourished myself. Each week my college coach would write out my weekly training program and weekly mileage. As most distance runners are, I have a type-A personality and was an over achiever. My type-A perfectionist traits made me become an un-coachable athlete and not a very healthy teammate to be around.. I ran up to 90 miles a week without telling my coach and worked out on my own as well. By the beginning of my sophomore year, my “hard work” paid off. I was thin, fast and made it on the travel team. My college coach was stunned by the progress I made from freshman year to the beginning of my sophomore year. My happiness depended on my workouts, my weekly mileage and race times. I was artificially happy. About mid-way through my sophomore cross country season, things took a turn for the worst very quickly. I wasn’t running fast anymore and felt like death even on my easy runs. I didn’t take days off from running, I took “easy days”. So, I thought well, raising my mileage to 100 miles a week and cutting out “unhealthy” foods that I labeled “unhealthy” would make me fast again. Drastically cutting out whole food groups and becoming a slave to running high mileage did work for me in the past. My teammates, athletic trainers and coaches caught on to my unhealthy relationship with running and food. Long story short, I was kicked off the team in the beginning of my junior year because my presence on the team became toxic. I became a selfish teammate and only thought of myself when I raced in meets.

For most of my life, being a runner was my one and only identity. My self-worth revolved around being thin and being a runner. I was devastated when I got kicked off the team. I decided to leave the school all together and transfer to the state university in my home state. I wasn’t a student-athlete at my transfer college. I wasn’t allowed to compete in the NCAA anymore.

Before I transferred to my new college, I was forced to go into an inpatient eating disorder treatment center in Utah because I was severely emaciated and clearly was suffering from anorexia. I couldn’t remember the last time I had my last menstrual cycle, I experienced horrific GI issues, I was diagnosed with osteoporosis, had bradycardia and I wasn’t eating. The list goes on. Even if I were to try to eat intuitively, I couldn’t because my body didn’t have hunger cues. I would be following the wrong intuition when it came to eating because of how malnourished I was. I went through the motions of recovery. I only went so I could please my parents and so I could go back to college to graduate. I said what I was suppose to say in treatment and white-knuckled my way through the meals. By no stretch of the imagination was I there for myself. Upon discharge at the treatment center, I immediately relapsed. I still thought the only thing I have to offer in this world was running and being slim. I started running half-marathons and running back up to 90 miles a week. I graduated college with a bachelor’s of science in sociology and severe anorexia nervosa.

I knew I was never going to become a professional distance runner, so I thought if I can’t actually become a professional distance runner then the least I can do is “look like a professional runner” . To me, the image I had in my mind was a very slender runner. My outlook and thought process was very disoriented because how malnourished my brain was. I was not slim, I was once again emaciated and did not look like an athlete because of my muscle atrophy. My primary care physician strongly advised me to seek inpatient care again.


I’ve been around the treatment block before and ultimately the block never helped me or I didn’t let it help me. There is no intellectual deficit with people who have anorexia . I knew going back to treatment wasn’t right for me because I could just about teach the classes myself. I knew the basics of nutrition and I read every Brene Brown and self-help book there is out there.

My parents were tired of fighting the anorexia. My anorexia affected their life as much as it did mine. I missed out on family functions because my addiction to exercise was more important than family. The day my parents sat me down and told me that they would be ready to plan my funeral because they weren’t going to force me into treatment again or force me into choosing life, was the day I decided to choose recovery. My parents accepted the fact that I was slowly killing myself and could die instantly. The thought of my parents having to bury their only daughter made me come to the conclusion that I want to recover from my anorexia and exercise addiction for myself and of course for my loved-ones as well.   From that day on, I realized that there is more to life than running.

I read Nicola Rinaldi’s “No Period, Now What” book, Jennifer Gaudiani’s “Sick Enough” “Brave Girl Eating” by Harriet Brown and “Roar” by Dr. Stacy Sims. I unfollowed negative social media accounts and started listening to podcasts. I think the more professional distance runners dismantle the beliefs and stigmas of what distance runners should look like, the more society will start  to understand there is no “one size fits all” approach to being a professional distance runner. Hypothalamic Amenorrhea is prevalent among athletes across the spectrum, as it was for me and for so long I believed a loss of a monthly menstrual cycle made me fit the mold of being a “real” and “serious” athlete.  Listening to high profile athletes share their journey not just about running but with their identity outside of their sport,  I think humanizes them more and allows runners like me to believe there is life outside of running. I am just as much as a runner as they are and takes the pressure off of trying to conform to these unrealistic expectations society has placed on athletes and society as a whole.

Presently, I am no where near where I want to be in recovery. With that said, I am much more attuned with my body. My behaviors are more congruent with my recovery goals. I’ll always identify a part of myself as a runner because at the end of the day, if I could choose any sport and knew that it would not alter my weight or body composition, it would still be running. I am learning to move my body with the right intentions. I suffered from RED-S for so long, my body is still reaping the consequences in recovery. With the help of multi-disciplinary which consists of a registered dietitian, therapist and a physical care physician who specializes in the treatment of eating disorders, I am safely returning back to running and regaining my life again. I am a strong advocate for “there is no one size fits all approach to distance runners” and athletes must fuel for the work required.

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