UKC

Am I the only one that feels uncomfortable about the proliferation and promotion of what appears unhealthy in climbing?  It appears a taboo subject but let's discuss.

Carefully though please.

Its not really a taboo, and has had a lot of lime light during the last few years.

There's even a nice (from last year?) documentary available free or charge to look...
https://www.youtube.com/watch?v=thtDQJGrO5s&ab_channel=CarolineTreadway

What's wrong with a big slice of cake after a day on the crag?

Where are you seeing it promoted? 

Or 5 pints and a large pie?

Moderation in all things

Most if not all of the climbing related media I've come across in the last 5 years promote healthy eating to ensure being sufficiently fueled and recovered to perform best. They tend to acknowledge climbing has a power to weight ratio component, but that getting proper nutrition is far better than starving yourself, especially in the long term.

Only one I can remember speaking positively about results of losing weight to gain power was Jerry Moffatt, but that's hardly current.

It's impossible to get to the crux of such a so called taboo subject by skirting around it 'carefully'. It's better to just come out and discuss exactly what you mean with examples. Obviously don't be mean and personal, but you can't talk about something while simultaneously refusing to talk about it.

Very good article from a couple of years ago;

https://www.ukclimbing.com/articles/features/relative_energy_deficiency_in_...

Big discussion on the other channel recently;

https://ukbouldering.com/board/index.php/topic,31096.0.html

Well I can certainly vouch for the fact that fat means shit so perhaps they have it the correct way. And in any case being incredibly slim does not mean you have an eating disorder. Some people are just built that way. 

You might want to fatten this out with some detail.

## The pun was unintentional.

And as I'm editing, as pointed out by others I do not think that this issue is being swept under the carpet at all, in fact there is a decent amount of discussion re. this.  

The problem is that a lot of people are not "built that way " but aspire to be "that way"  for a multitude of reasons  and in all sorts of environments.

Examples?

IIRC Malcolm Smith did some drastic short-term weight loss to help ensure success on Hubble, and John Dunne is well known for his weight fluctuations between off & on-season.

But these examples are short-term or cyclic and so the potential for harm is (presumably) relatively minor.

It's not a new thing, I saw some very unhealthy (i.e. actual medical consequences) problematic under eating for example an elite male climber in the mid 90s. 

True. And some elite female climbers have also expressed themselves on this. Here btw.

I don’t know what the OP had in mind but I immediately read “Laura Rogora” seeing his post. One can not help being seriously worried for her health and future life as a woman… Her feats are impressive but the price at least looks scary.  I remember Charlotte Durif also published a position on anorexia in climbing back in 2014. She said “the shop window is not pretty”.

It’s chicken and egg I think. I knew a couple of high profile climbers in the ‘80s who used climbing training as a vehicle for eating disorders. This was during a period when ‘competitive’ dieting was all the rage among the cellar dwellers of Hunters Bar, so it passed relatively noticed. I think it’s important not to confuse the two manifestations of what looks like the same thing. 

I can recall at least one article by a top flight 90's female climber detailing her struggle with Anorexia and the infamous Pocketz cartoon about female climbers of the day discussing Lentils and Gravel Risotto.

I commented about this a little while ago.  It was made pretty clear to me that discussing specifics wasn't the way to go about it and climbing would prefer to deal with these issues by current and future education/learning.  I am happy to go with this but like you i think climbing has a responsibility to restrict some of its promotional content.  A bit like the fashion industry with its size zero models.

Anyhow, from a positive perspective i can report back on having an impressionable pre teen and now teen girl who is heavily involved in the competition climbing scene.  The help, education and knowledge within the climbing community is brilliant.  She has had direct 1-1 advice from climbing legends, talks on eating & fuelling properly etc etc.  She has had sports nutritionists offer advice.  She has had discussions on overtraining, redS etc.  Even her school Sports Science lessons are proving to be a real benefit.  I am a clumsy bloke when it comes to discussions but i feel the climbing community has really stepped up and made even me aware enough to help.  I imagine sitting me down for a discussion on training and periods wasnt the easiest topic to bring up with me.

I am not saying someone couldnt slip through the net and there are always going to be cases of pushing the boundaries but for me i can only sing the praises of the climbing community in general when it comes to educating and caring for its fellow climbers.

I'm glad to hear things are going in the right direction in the competition scene from your perspective, however from my perspective in the general climbing scene we have a long way to go.

I have an adult friend who's being treated for anorexia, but not yet ready to tell friends within the climbing scene about the diagnosis.

Climbing with her at an indoor wall, prior to her diagnosis but whilst her illness was painfully obvious to me, it was very common to hear other climbers commenting on how good she looked, and how fit she looked. 

She also had a climber and fitness coach tell her how impressive her low body fat percentage was - this was after putting some weight on, but still significantly below what the NHS would consider "essential" bodyfat for a female.

It's good that the issues are being highlighted in the climbing media and so forth, in a way that wasn't happening a decade or two ago, but I think we're a long way from a culture where people (women in particular, with their higher bodyfat requirements) with eating disorders are not routinely praised for it, never mind those who might be on the start of a vulnerable path.

Even if young kids are not being directly encouraged to reach unhealthy bodyfat levels, there were young girls at the wall who would see my friend climbing well and hear her being praised for the results of her illness, with those results being associated with the performance.

What they wouldn't see of course, is the training performance gains from getting up to a healthy weight - as nobody is making those connections and therefore commenting on it.

Nice troll OP.

"Here, let me chuck this fizzing bomb in the room and then feck off all day, not contributing to the thread and discussion I started. I'll not bother to cite any sources either cause speculation is better than evidence." paulwood, probably. 

Everyone should starve themselves till they are stick thin and don't have any energy.

Everyone should eat what they want, when they want.

Everything in moderation (individual dietary requirements should be taken into account).

Take your pick, if you need telling which one is correct then heaven help you.

Plenty of podcasts, articles around now talking about healthy diet in climbing. Not heard one promoting unhealthy eating or pushing a particular body image. 

Maybe the real question should be asked of social media apps that allow photo editing to the extent that they do, and the poor body image issues they cause/promote. 

As a community we promote low body fat constantly - we praise those who achieve it, use the fact that we haven't achieved it as an excuse for failing at our goals, etc. 

The nature of the sport means that strength to weight ratio will always be important - and within healthy bounds that's a good thing - but there will always be people in our community who are more susceptible to unhealthy eating patterns than others, therefore we need to keep working on making the conversations around bodyfat as healthy as possible.

That's a wider societal issue that wider society has to resolve.

The climbing community has it's own narrower issue, that the climbing community has to resolve.

The two are of course intertwined, and the wider community solving the wider problem would help, but that shouldn't distract us from focussing on that which we can change most easily.

With regards to what I'm going to assume triggered the OP, I don't think naming names is helpful but I was certainly made uncomfortable by a recent social media post reshared by this site as part of a news item.

It made my friend very uncomfortable, and she commented on how difficult it was not to tell herself this was something to aspire to.

You're right to point out that the photo could have been heavily edited, but regardless of whether or not the athlete in question is below the threshold of 10%-13% bodyfat considered essential for women, the photograph as presented looked way, way below that healthy level - and was associated with pretty much the pinnacle of women's climbing.

Pictures like that, if repeated often enough, will inevitably lead *some* young girls believing unhealthy eating patterns are key to "success" in climbing.

I don't know what the climbing media can or should do about that - any policy on censoring which athletes photos are used in the news would be fraught with problems I imagine - so I am not in any way looking to blame anyone for the publication of the picture, or suggest that they shouldn't have done so.

However I do believe this is a conversation we still need to be having as a community, regardless of what you think of the OP's intentions, if we want to improve the health of those around us.

It's not taboo at all. Yes I agree, too many climbers eat too much shit food and over consume alcohol.

Now what do you propose to do about it?

Both Staša Gejo and Urška Repušič have spoken out about this issue on Instagram.

https://www.instagram.com/p/CFC7by6jwsl/?utm_medium=copy_link

https://www.instagram.com/p/CUQabPzMvuU/?utm_medium=copy_link

I don't know how anyone can look at Laura Rogora and think she looks healthy. 

Lentils have feeling too......

Beth Rodden's written some great stuff on Facebook too (not just on this subject, although it is one which comes up pretty frequently.

https://www.facebook.com/bethroddenclimb

Staša Gejo is currently pretty vocal on this topic, which I'm glad about.

Youtube video here. Her analysis of the boulders is also really interesting.

youtube.com/watch?v=3apX3IVs4_c&

A series of articles on 8a.nu which I would highly recommend for their insight, though not very enjoyable reads.

https://www.8a.nu/news/stasa-gejo-talks-eating-disorder-part-1

https://www.8a.nu/news/stasa-gejo-talks-eating-disorder-part-2

https://www.8a.nu/news/battle-cat-8c-by-stasa-gejo-and-part-3-eating-disord...

Some selected quotes from the above articles which are particularly disturbing:

"I took out eating dinners and drastically reduced my caloric intake to 1200 kcal. Later I found out that pretty much everybody who was abnormally skinny did the same. Some big names too."

"Unfortunately, I have observed patterns of unforgivable behaviour of those in charge of young athletes, especially girls, when they reach puberty. Girls are being blinded by some 'role models that look like skeletons, in the hope to make them achieve it too."

"Most of the super skinny cases we still see on the competitions somehow pass these regulations*, not sure how exactly." *Lower BMI limit of 18/19 for F/M.

"A friend and colleague confessed to me:˝Whenever I underperform in bouldering, I know that I need to work on my power, coordination, whatever… but in lead, my first thought is – if I lose 5 kg I can beat them all, no problem. It is impossible to think in any other way when you see abnormally skinny people still competing and climbing higher than you. Then I must be too heavy!˝"

I think this insight proves that this is very much a current issue, not one that's disappeared since the 80's when the attitude (from some) was an apple a day then a mars bar before getting on the project.

She doesn't, far from healthy. 

The trouble is that, whatever she is doing, it (unfortunately?) seems to be working spectacularly well for her in climbing terms, at least in the meantime.

I think that this is really the root of the problem for most cases of eating disorders in climbing. Loosing weight clearly gives a big gain in performance (at least in the short term). This is a fundamental fact of the sport and it isn't possible to change it, at least outside on real rock.*

It's to be expected that people at the top of sport/comp climbing (or just people motivated to climb their own project) will deliberately choose to lose weight and go below a 'healthy' cut off line. There are two main problems with this imho.

1. The climbers health. If the climber stays at that low weight for too long there will be detrimental health consequences for them.

2. Impressionable climbers (probably children, but adults as well) look at the best climbers in the world and notice they're all very thin. This leads the impressionable climber to conclude the best thing they can for their climbing is to lose weight. Loosing weight will give them a performance gain and therefore they'll continue to do it until it's unhealthy. This problem is exacerbated if there are exceptionally thin people at the very top of the elite level, even thinner than the just slightly less elite climbers who are a touch behind grade wise.

Obviously eating disorders exist outside of climbing as well, but the climbing world can complicate things.

1. Eating disorders can be hidden from friends/family as a rational attempt to improve performance.

2. Climbing can encourage eating disorders. Lots of climbers want to climb harder for whatever reason. Eating less can help people climb harder. Repetitive cycle ensues. Eventually the gains from eating less go away, but because of past success with the method it continues. People who are already susceptible to developing an eating disorder could easily be pushed in this direction by wanting to climb harder.

I think it's important to accept that elite climbers will always be pushing the lower limits of weight, just as strongmen are pushing the upper end of the scale. I think lots of people get frustrated when discussing eating disorders in climbing if the obvious short term performance benefits aren't openly acknowledged.

In my mind the key thing is to put forward the idea that sustaining a low weight for a long period of time is detrimental to performance in the long term. Lattice are a good example of a coaching company putting this information out there. It would be good to see sponsored climbers talking about this, and some acknowledgement of the fact that during their training time when not focussed on projects they allow their weight to go up.

*I think in comps the modern style boulder setting doesn't encourage particularly low weight in comparison with old school boning on crimps.

The above is all my opinion, not backed up by anything in particular. I don't think it's particularly revolutionary, in fact now that I've written it, it all seems so obvious as to not be worth posting, but it took me a long time to write so I'm posting it anyway!

You have summed up my thoughts perfectly.

One thing also to consider is that most elite female climbers are below average in height. It goes without saying that is easier to be lighter if shorter. However, it also appears to be the case for females that it is easier to maintain a high strength-to-weight ratio if shorter.

My daughter was a pretty handy climber. Part of the reason she decided to quit was that she grew to tall. In order to maintain the level as she grew, she was increasingly having to consider her diet. Even though she was very conscious of eating healthily, I think she realized where it was heading and decided to stop climbing and try something else. 

Agree with most of that. It's also pretty common in a lot of sports to cycle weight on and off to try and drive change. However I suspect climbing is one of the more responsive sports to weight as you point out.

I have always wanted to see data for grades upwards of around 7b to see if weight typically aligns to max grade climbed. I suspect there would be a few outliers but probably not see many 13 stone people climbing 8b.

If that is the case then there maybe a logical argument to start using weight categories for competitive climbing (similar to many other sports). Probably help stop people with naturally bigger frames trying to go too far underweight. Would also help get more pros with different builds in the mags, hence kids see a better split of people in the limelight.

For as long as there is crossover between competition and real climbing, I don't think that would have much appeal; it just wouldn't wash when the gold medallist in one category couldn't touch the projects of an also-ran in another category.

I am personally not sure regards appeal...

Its interesting to debate why some sport use them when others dont. Probably to help stop health issues and allow more people to take part?

The categorisation in weightlifting achieves exactly what you just described? Where the lighter category athletes cant get close to the max weight of the heavier lifters. However I agree, its probably only the max weight category that really appeals to the bigger external audience.

From a real climbing perspective, I find it just as entertaining watching someone less capable struggle there way up an E1, as i do someone repeat an E7...... suppose thats a similar attraction to why people watch both light and heavy boxers (its about the struggle?), without weight categories here there would only be heavyweights i suspect?

Probably enough to debate for a separate thread.... .

100%, weight increase is volumetric whereas strength increase is muscle cross section (therefore area rather than volume) so it’s physically easier to have a better strength to weight ratio at lower heights, you can see this across all sports where it’s an issue such as weightlifting.
 

Also worth noting that the below average height thing is the same for elite males too, Ondra is an outlier obviously but most of his additional height is neck!!

But in weightlifting they don't then go outside and see who can lift the heaviest rocks for fun regardless of category and boxers don't brawl in the street to see who is really the best fighter regardless of category. 

Some of the best weightlifters are dead short, yeah. Heavy though. I believe Ilya Ilyin at his pesk weight was 112kgs, he is 5' 9". Absolute beast (and on an entire pharmacy's worth of gear. Amazing lifter though).

So you could have a 40+ stone category set at say, v-diff?

Some do - stone lifting is their main disclipline.

Well yeah strongmen do, but really no-one cares about the lower weight classes in strongmen, except people competing in them.

More useful I think is what has been individuals personal weight when they’ve climbed their hardest.

My experience has been that has been when I’ve been my lightest though that sort of statement is approaching taboo these days. It’s not a weight I can (lack of willpower) or want to sustain though but an occasional short term hack for performance.

Like you say it is not uncommon to cycle weight in other sports. The health issues (mental and physical) arise when people remain super low for long periods of time. Apart from the general health issues it is self defeating as during the off season or training periods it’s best to carry extra weight to maximise strength gains.

The general social media message being peddled is don’t get light get strong but I think it should be if you feel you must get light don’t do it for more than a few weeks maybe a couple of times a year. 

Think your weight category suggestion is a dead end. Any athlete will be driven to gain advantage whatever their frame - top competitive sport is counter intuitively an unhealthy occupation. Education (especially by coaches) is the answer to ameliorate the destructive excesses of that drive. 

It would be interesting to hear what weight strategys top climbers in this country generally adopt, e.g. Dave MacLeod, Neil Gresham, Steve McClure, Tom Randall, Hazel Findlay etc. Other than brief mentions of one's personal 'fighting weight' it seems to be a subject undiscussed or glossed over by many. You'd think that when tapering for a project, going light would be another trick in the toolbox to make the holds feel bigger, but it's surely got to be emphasised that this should be a very short term tactic (i.e. a couple of weeks)?

It occurs to me that for pro climbers living abroad or with the freedom to travel at will there need not be an 'off season', which could be problematic. Also wonder if this may be less of a problem for bouldering with its greater emphasis on strength vs being light to hang on forever?

I'm not sure what kind of weight loss we are talking about here, but a few years ago I went on a 3 months trip, climbing but intermittent and mostly fairly bimbly, certainly not training, and I lost maybe 3 to 5 kg. I was amazed by how strong I felt on some famikiar bouder problems at the wall when I got back. I also once put on a 5kg weight belt and really struggled on my usual warm up problems. So I think weight makes a big difference bouldering.

Yes but it depends whether you were thin to start off with, how much you could afford to lose and whether you lost fat or muscle (probably not the latter if on a climbing trip).

Could be wrong but I always thought that bouldering favoured greater muscle mass compared to longer stamina routes. So being strong and light is important to both, but the ratios will be different.

I’m surprised you say it is undiscussed as 2 of those 5 (Dave Mac and Gresh) have written extensively about weight management strategies. As for Steve he is a self-confessed chocoholic with an enviable metabolism and there is nothing most of us can learn from him in this respect. 

Off seasons aren’t to do with the weather but to do with cycles of the sort which periodisation models are based on. Top performance at your best all the time is humanly impossible (although Ondra seems to get close!) If you climb year round you would have to pace yourself and still most likely have to take weeks off here and there. Even with the sort of freedoms you suggest maximising potential would incorporate periods of focus on training and downtime. Lattice suggest taking a whole week off once a month and longer still at the start of a focussed training period.

OK. I've read a good deal of Dave's writings but must have missed some of that.

Looks like there is a lot more to come too:

https://www.davemacleod.com/blog/category/nutrition

The ketogenic diet in sport performance - 6 years of experiments and scientific evidence

Right now I am shooting a very long YouTube episode about my experiments with Keto diets. I will be posting the list of references that accompany the video on this blog post shortly. I’m just making this page right now so I can put the URL in my edit. Hopefully I’ll get it all ready soon!

the movie “Light: a film about eating disorders in climbing” addresses a lot of these issues:

youtube.com/watch?v=GZL_JgYDPkI&

If you’ve not listened to it this podcast is excellent too:

https://thenuggetclimbing.com/episodes/my-eating-disorder?rq=Eating

I believe in the recent article about Lexicon Steve Mac said he weighed 57kgs. It's fair to say he is very lightweight. 

MacLeod has said that he's lighter now than when he was 16. I was just curious to know whether they were consistently very light or whether this varied with training/projecting seasons.

https://www.davemacleod.com/faqs

However, I’m happy to say that I have had great results with a well formulated, athlete appropriate version of the ketogenic diet.

There are many different ways to approach this dietary strategy and I am still experimenting to find the nuance of what works best for specific situations. Much of the online discourse on keto diets is sub-optimal for athletes and there are many pitfalls to avoid. Like many, I’ve learned these the hard (best?) way. I am not permanently in ketosis, nor do I think this is important. But the strategy I tend towards most of the time sees me in mild ketosis some to most of the time.

This is something that I have trouble with. I agree that it feels like the message I see being pushed is "don't get light, get strong". I think this is an unhelpful and disingenuous message. If people try getting light (as those who are predisposed to eating disorders are likely to do) they will find that it works i.e. makes them climb harder. This could easily make them look at the "don't get light, get strong" message and think "well that was boll*cks, I got light and it worked". Then the credibility of the original source is called into question and more to the point I'm not sure if it's actually helped anyone? There are lots of examples of very thin top climbers and a message of "don't get light, get strong" appears to fly right in the face of obvious evidence to the contrary. The benefits of being lightweight have to be acknowledged for discussion on this to have any credibility imo.

I would much prefer it if the general message was "Getting light will help short term performance. However, it will be detrimental to health and long term performance if sustained for a long time. Getting strong will have longer lasting performance benefits. Loosing weight for performance should only be used as a short term tactic." Possibly with the addition of "If you know you have a disposition towards eating disorders, loosing weight for performance is a serious health risk and would be best avoided." I think this message would be more helpful, it is more honest and more likely (I think) to encourage genuine engagement with the topic from people for whom it is likely to be an issue. Particularly from children/teenagers/young adults, who aren't stupid, and if instagram says "don't get light, get strong" without further discussion and then they look at someone like Laura Rogara who is clearly very very thin and held up as the pinnacle of women's outdoor sport climbing, there is clear conflict.

Of course, this is all based on my impression that "don't get light, get strong" is the common message on social media and on my completely unprofessional thoughts on how people react to that message. Obviously there are people out there who discuss weight and it's relationship with climbing in a constructive way, but that doesn't seem to me to be the overriding message.

Yes, it is definitely glossed over by many (not all). Which is quite disingenuous imo. Obviously it's a difficult topic, and very easy to say the wrong thing, so I can see why they'd rather avoid it. I can give my views here with no real thought as to how it will affect my career, they cannot.

Agree on both points. The lack of an obvious 'off season' unlike other sports is perhaps a worry. The point on bouldering vs lead is fairly well backed up by looking at the differences in top competitors in the world cup lead vs boulder comps. I wouldn't be surprised if someone like Rogara could get further than any of the male competitors on an infinitely long 20° overhanging wall with only relatively closely spaced 10mm crimps.

The crux of the issue. Being super light is very unhealthy BUT being super light also allows you to climb very hard. I wonder if the IFSC and/or sponsors will eventually require athletes to be certified by doctors as healthy before they are allowed to compete (in the vein that modelling is going down in some countries). I wonder if someone high-profile will have to die of malnutrition first.

Dropping this here from a few years ago in case it helps any parents/young people:

https://www.ukclimbing.com/articles/features/growing_pains_-_the_weight_of_...

On this page under "Addressing Actual Issues In Consideration Of Health" are the relevant BMI limits that the IFSC adhere to, along with some other info around the topic.

https://www.ifsc-climbing.org/index.php/2-uncategorised/57-medical-anti-dop...

I maybe wrong, but I get the sense that any high-profile competitor would be forced to drop out of the running due to related physical and mental health consequences sometime before the deaths door phase of malnutrition. 

Perhaps a death caused by continuation of the disorder after they've left the competitive scene, but I can't see a malnutrition death while actively competing and performing well at the top level.

The IFSC info Arms Cliff linked has a critical BMI listed as 18 for females, while mild anorexia would start at ~17. They seem to have at least some systems in place to prevent such a thing occurring. It would be in no-ones interest to allow an athlete to die of malnutrition while competing.

But that is not applicable to real climbing. Or is there not seen to be a problem outdoors?

Was responding to that particular point re the IFSC letting someone die. I would assume that World Cup and Olympic climbers also consider what the do as ‘real climbing’.  

By the time malnutrition sets in, you'd be long past he point of being able to compete. And yes, there have been cases where climbers have stopped competing because of eating disorders (no names for what i hope are obvious reasons). There is active monitoring of athletes and their health, which is a good thing, and i think the knowledge of its existence also helps prevent potential health issues amongst those who might be tempted, but it clearly will never prevent every case. 

Oh, they have limits already, that's a good step in the right direction.

I'm not sure why bmi is being used though, body fat percentage would be a much better and more useful measure of when light is getting too light, particularly because in a sport like climbing, the weight of muscle really skews bmi results.

Didn't Kai Lightner say in that documentary someone linked that a doctor told him he was on the verge of liver failure? It's not clear if this was while he was competing but liver failure is certainly life-threatening.

He's also pretty short - 5'6"-5'7" - and 57kg at that height falls in the healthy range for BMI.

BMI is a terrible measure of health for athletes due to their higher % muscle.

Targeted Ketogenic Diet? Cyclical Ketogenic Diet? Other?

As you know i've used a ketogenic diet from 2006 or so, but within a year i realised hard training needs fuel - hence a return to CHO and I ended up on what became known as a TKD.

It's been sustainable. Most of the people i know who started on Ketogenic diets back then ended up coming to the same conclusion.

I don't think we should name names on this thread when it comes to opinion.

Indeed; the Italians have been measuring athlete build / health / bmi etc for longer than most; During the summer, someone (of this parish, if memory serves) did some analysis of the heights etc of the olympic qualifiers; Laura was 7 -8 cm shorter than any other climber; she is just tiny, but likely to be healthy.

Yes. Whilst she might look unhealthily skinny in photos that doesn’t mean that she is actually is unhealthy. It may prove to be the case that there are issues but as a coached Olympic athlete it would be scandalous if there was, so my starting assumption is that Rogora is checked out by health professionals and generally in good hands unless anyone knows different? (Maybe I’m too trusting of professionals?)

Everyone knows naturally skinny people (don’t they?) whose eating is (or seems) far from disordered - Steve Mac for example. On the other side of the coin Mina had a healthy looking physique and ate healthy foods but clearly wasn’t healthy but it took blood tests to determine that.

Looks might be the starting point of investigating whether there is a problem but other genetic factors could also be at play. 

I don’t know about clinicians involved in climbing, but a lot of clinicians in sport struggle with a real conflict of interest. They are ultimately contracted to look after a club/team’s financial interests and get athletes back onto the field, which doesn’t always align with what is best for the athletes long term health. If a doctor is too quick to say people aren’t fit to perform, or are too conservative with treatments, they may find themselves out of a job.

On the athlete’s side of things, someone with disordered eating that they see as necessary for performance is probably going to be pretty resistant to changing that, and no athlete is going to want to be excluded from comps. In many sports too much time out for health reasons will get you dropped from the team, possibly ending your career. That will all influence how people engage with health professionals. I know that in some sports athletes often coach each other on the “right” answers to give to doctors on certain topics.

Eating disorders are difficult conditions to treat at the best of times, never mind with the complicating factor of high performance sport. Things have definitely improved over the years in most sports, but there are a lot of pressures which might mean health problems are overlooked either knowingly or unknowingly. On the other hand, with responsible and compassionate leadership you are right that people are more heavily monitored in sport and therefore there is an opportunity for problems to be spotted more quickly. 

Great points. Sounds like you have personal insight on the subject

That was a problem with concussion/HIAs in rugby. As I understand it, the decisions are removed from team doctors (certainly in tournaments), to ensure protocols are followed and athlete welfare prioritised.

It's been stated already, but worth emphasising IMO - BMI is not a useful measure of an athlete's health.

It is useful measure of things like obesity levels within a population, but it's a terrible measure to base individual health decisions on (beyond raising a flag to potential issues perhaps).

The scale is designed for the "average" person, and the average person does not do elite level strength dependent sport. If you are carrying a higher than average amount of muscle, then ill health due to low body fat will occur at a "healthy" BMI.

The climber I know who is in recovery from anorexia would have passed the competition threshold of 18 BMI whilst suffering symptoms of her illness such as irregular periods, constant dizzyness (would regularly get up off a seat and immediately crouch down on the floor to prevent falling over), inability to heat her extremities and chronic constipation (despite a high fibre diet) as her body tried to hold on to every calorie going through the system.

I spent my late teens and early adult life "clinically underweight" by BMI despite eating like a horse - because I had a very fast metabolism and didn't do much sport, and at the other end of the scale, in a workplace where we were offered free annual medical checks, a colleage of mine was told he should think about going to the gym to lose some weight as he was well into the clinically obese category - he was in the gym six days a week pumping iron, and ate very healthily, so had a very healthy level of body fat.

Body fat percentage is a trickier thing to measure than BMI, but it's what counts when assessing unhealthy eating.

Yeah, I think rugby has generally been a reasonable good example in terms of positive changes.

I think dealing with things like disordered eating is always going to be trickier though, since diagnosis is dependent on clinical judgement and history taking, rather than it being an acute injury with more concrete diagnostic markers.

True.

What we should eat and 'how' we should eat has a volatile history on UKC threads. It's not easy defining 'normal' eating - one person's "intermittent fasting" is another's eating disorder and, calorie counting seems highly questionable when it comes to 'normal'. Meanwhile "everything in moderation" is vacuous logic based on circular reasoning.

Throw in body dysmorphia and eating disorders become a hell of a problem to address.

Better to replace the speed round with boxing match in the combined event.
Jan Hoer for gold, Klem Lostock to make a return to competition. 

A small amount through some fleeting involvement in professional sports clubs, although really my job is just standard community healthcare.

I agree, it's easy for people to draw conclusions and make judgements based on appearances alone. 

An alternative explanation for Laura Rogora's low weight may be that she has celiac disease, going by this instagram post:

https://www.instagram.com/p/CU-Xx-WDIQp/?utm_source=ig_web_copy_link 

From the wiki page on celiac disease, a common symptom - "Malabsorption of carbohydrates and fats may cause weight loss"

There are genuine issues with EDs in climbing, but sometimes it seems like thin shaming has become the acceptable replacement for fat shaming in some circles. 

Absolutely. It's a complicated beast. I think it is helpful as well to separate out "eating disorders" as a clinical diagnosis, and "disordered eating" where there might be some worrying and quite rigid beliefs and behaviours which aren't having the clinical and functional impact of an eating disorder. Obviously the boundaries between these, and between 'normal', are very very blurry. 

I think that arguably unhelpful beliefs and habits surrounding food are quite common among climbers. These might not be causing someone any problems right now but are fertile ground for more serious problems to develop. I know that I have at times had some quite rigid thoughts about where my weight "needs" to be and perhaps a skewed perspective of how important it is to climb a certain grade - I was still healthy and well (although my partner says I wasn't much fun to be around at that time) but it's the sort of thinking that can spiral under the right (wrong?) circumstances.

At the same time, there are loads of ways in which sports like climbing can be a really positive influence on body image and satisfaction. E.g. a focus on personal development rather than competition or comparison, and loads of opportunities to spend time focussed on how the body works and feels rather than how it looks. Leveraging this is part of a solution to my mind.

Again, I don't think it keeps to concentrate the conversation on an individual. But when it comes to coeliac disease, I've only known a couple of people with a medical diagnosis of coeliac disease and neither of them struggled to keep up a healthy level of body fat (not that my limited experience proves anything of course).

Whereas I've known a lot of people who have self diagnosed as gluten intolerant (some of who called themselves coeliac despite the lack of formal diagnosis, or the severe reaction to gluten that I've witnessed in one of my friends who was medically diagnosed).

Some of them appeared to me to have disordered thinking around food, and a couple have since told me that they ended up seeking help for eating disorders.

One of the signs of an eating disorder is excessively restricting the types of foods that you eat, and convincing yourself you are intolerant of certain foods is a good reason to restrict them.

No individual should be shamed for being thin or fat, but equally the health dangers of being under or over a healthy body fat range shouldn't be ignored 

Well, having been diagnosed with celiac disease some 20 years ago. I can say, that prior to following the gluten free diet, I certainly had lots of problems to get enough nutrients to operate. Once the diet is followed, then there really isn’t any difference at all.