Eating disorders and professional cycling: the thin end of the wedge

Many pro cyclists are suffering in silence with eating disorders – and a worrying number of amateur riders are too. We examine cycling’s hidden health crisis and explain how to protect yourself from danger

Jo Burt / Immediate Media

Published: January 31, 2022 at 5:00 pm

Former Slovenian pro Janez 'Jani' Brajkovič raced in the Tour de France, the Vuelta and the Giro, but in private he was battling a series of harrowing eating disorders. As a bulimic, Brajkovič would routinely make himself sick after eating.

He also suffered with orthorexia – an obsession with healthy food, which meant he couldn’t permit himself even a crumb of cake.

But Brajkovič is not alone: a recent study in the Journal of Eating Disorders found that a significant 17.1 per cent of cyclists experience disordered eating.

“It might sound unreal, but during my career I was with the best teams – Discovery Channel, RadioShack, Astana, Bahrain and UHC (United Healthcare), and in every team, if there are 30 riders, there are at least five or six riders that have the same problem,” reveals 37-year-old Brajkovič.

“After spending a few hours with them, or doing your first race, you figure it out. When you’re suffering yourself, you can smell them. And the really bad thing is that you know they know about you too. And that’s a very uncomfortable situation.”

In his youth, Brajkovič had spells during which he would eat only one type of food, such as bread and Nutella, but his problems exploded during his first years in the high-pressure arena of pro cycling, around 2004 to 2006.

“When I started to have expectations from the outside world – and from myself – things went really sideways,” he says. “Food is important for performance, so you’re walking a thin line. It’s soon hard to say whether you are eating for performance or you have an eating disorder.”

This feature was originally published in issue 388 of Cycling Plus magazine.

Quest for control

Cycling: 111th Il Lombardia 2017 Janez BRAJKOVIC (SLO)/ Bergamo - Como (247km) / IL / (Photo by Tim de Waele/Corbis via Getty Images)
Brajkovič won the 2010 Critérium du Dauphiné and finished ninth at the 2012 Tour de France, but for years he was suffering with bulimia. - Tim de Waele/Corbis via Getty Images

Brajkovič's bulimia was driven by a desperate search for control over his body. “Ice cream is a sort of liquid and therefore easy to throw up, so I would eat a litre of ice cream and then throw up,” he says.

“In the beginning, you’re excited because you think: ‘I can control my food. I can eat what I want and then I can throw up’. But with time you realise you’re not in control. The food controls you.”

Brajkovič won the 2010 Critérium du Dauphiné and finished ninth at the 2012 Tour de France, but for years he was fraying at the seams.

“At the 2012 Tour de France, I was fine for a month but I was anxious and suffering. When I got home, I threw up. Your family is suffering because your day is structured around food: I have to eat this much and then go to the toilet and do my thing.

“I always prolonged training, so instead of three hours, I would do six, just to stay away from food. You finish training, you eat and you throw up. Every day is the same. It’s misery. I tried everything and nothing worked. A few years ago, I realised this is probably going to kill me.”

An eating disorder cost Italian pro Davide Cimolai, who now races for Israel Start-Up Nation, the first few years of his career. The 32-year-old blames the ignorant advice of old-fashioned coaches and the grim culture of self-starvation in the pro peloton.

“At an amateur level, I won races easily, but when I tried to follow my teammates, to eat the same food as them, I had no energy,” Cimolai explains.

“Every day, I felt tired. I knew this was not good. I needed one person with experience to explain to me: ‘Hey Davide, this is wrong, it is better to do it like this’. But I had to learn what I know now by myself. At amateur level, the mentality is old and what I see is crazy. You can’t do long training then eat only jam or salad.”

Molly Weaver, a former British pro who raced for Team Liv-Plantur and Trek-Drops, also suffered with bulimia. “When I moved to a new team, the pressure to be light was a lot greater,” explains the 27-year-old, who is now retraining as a paramedic but still races at amateur level for Epic Cycles.

“I’d been pigeon-holed as a climber, which I didn’t really see myself as. I was more of a classics rider build but, if I lost weight, I could climb with the best. So that’s what they wanted me to do. But the problem is that weight is an incredibly measurable thing. You can weigh yourself every day, and if you think lighter is better, it’s very black and white. If you lost weight, you’d get instant gratification. And it very quickly spirals into a fixation.”

Weaver believes that cycling has a serious cultural problem, with skinniness celebrated by coaches, in clothing adverts, on social media and among fellow cyclists. “I’ve never been on a team where there haven’t been others with an eating disorder and, even with the blatantly obvious ones, it was almost seen as success,” she explains.

“And you are also celebrating them because that is the culture. Even that feeling of going to bed hungry, and somehow getting to sleep, is something you would feel really proud of.”

The thin RED-S line

But the consequences of eating disorders are grave. RED-S (Relative Energy Deficiency in Sport) is a dangerous condition in which low calorie intake leads to menstrual-cycle disruption, low bone density, impaired immunity and heart issues.

“A lot of female riders don’t have their period and that’s not even mentioned, and almost seen as good,” says Weaver. “And because you’re under-fuelling, you’re just hungry all the time.”

Dietitian Renee McGregor – an expert in eating disorders – says that under-fuelling is a serious issue. “When there is not enough energy in the system, the body will prioritise movement and down-regulate the metabolic response,” she explains.

“This means processes like digestion, immune and bone health, and hormones all get depressed and in some cases completely supressed. And when hormones get down-regulated, this has a direct effect on adaptation from training. Less serotonin is also absorbed into the brain, so this starts to impact mood.”

Women face additional problems. “The effects are the same as with a male cyclist, but will probably show up a lot earlier as the female body is much more sensitive due to its role in reproduction,” explains McGregor.

“Menstruation gets affected fairly early on. Initially, it might just become lighter or a bit erratic, but eventually it will stop. This is a sign the body is under stress and won’t benefit from training. But more importantly, it is hugely vulnerable to injury, low mood, poor digestion and lowered immunity.”

Illustration depicting eating disorders in cyclists
Many athletes seem to have personalities that are particularly prone to developing eating disorders. - Jo Burt / Immediate Media

But eating disorders are not limited to the pro cycling arena. McGregor has noticed an increasing number of amateur riders approaching her for help. “There has probably been an increase in awareness regarding eating disorders, in both professional and amateur cyclists, which means more are becoming aware that their behaviours are dysfunctional,” she says.

Whether competing in category races or just striving to excel on club runs, amateur cyclists can quickly become obsessed with their power-to-weight ratio. “I’ve seen a lot of amateur riders where it starts as a hobby, but all the joy gets sucked out of it because they are so obsessed with their weight and numbers,” says Weaver.

Sam Woodfield was one of those riders. A muscular personal trainer, Woodfield caught the cycling bug in 2015 and was soon chiselling off every unwanted kilo. Within a year, he had moved to Thailand and was competing in high-profile races.

“I was told: ‘you’ve got an engine but you need to lose weight’,” recalls Woodfield, 30. “It was all about getting the weight down because the power will rise. I remember lots of long, fasted rides for three to four hours. I’d ride until I bonked.

"And I’d try to push the day out as long as possible without eating. That was the anorexia. Then the orthorexia started. I had to eat super-clean food, gluten-free and dairy-free, and cut out food groups. If I ‘failed’ a session, I wouldn’t eat, or I’d just have a protein shake or salad because I didn’t deserve food.”

The power of the mind

Woodfield, who has now regained his optimal weight, is concerned about the way amateur riders try to ape pro riders’ habits, whether real or exaggerated. “I see a rider put a photo of two eggs, an avocado and salad on an Instagram photo from a Tour de France rest day, but you don’t see his bowl of pasta or porridge at the side because it is just mind games (with their rivals),” he says.

“Or you see photos of Bradley Wiggins looking miniscule at the Tour. He had to work so hard. He had no life. These guys are only at that weight for four to five weeks. They are lifted onto the team bus. Their protein shakes are shaken for them. They are genetically insane and have everything done for them. You can try and live like that, but it will be horrible because you don’t have all the support, the blood tests and the doctors looking after you.”

Woodfield’s own eating disorder cost him his job and his relationship of four years. “Essentially, the eating disorder broke up the relationship,” he admits. “And I had to stop work because I got so ill. I couldn’t walk upstairs.”

Might there be something in the mindset of athletes – both amateur and professional – that makes them vulnerable to eating disorders? Studies suggest athletes have a 20 per cent higher risk of eating disorders than the wider population. “Athletes do tend to be a certain type of personality,” says McGregor.

“They are usually focused, determined, motivated, perfectionist, compulsive, obsessive and self-critical. While some of these traits are helpful, many are not, and they have to be managed.

"When you put this personality type into a competitive environment, without any support or understanding on how to manage expectations, these traits can become dysfunctional.”

Education, education, education

If performance pressures, body-image issues, cultural ‘norms’, misinformation and personality traits can be potential triggers for eating disorders, what are the solutions? McGregor believes that the key is self-education. “Healthy eating for a cyclist means that you eat enough to meet your energy needs,” she insists.

“Our society is obsessed with moving more and eating less, but this doesn’t fit with how the body physiologically works. Humans are hard-wired to prefer to achieve energy balance and to be in a slight positive energy balance.”

It is also vital to zero in on the underlying issues. “An eating disorder is a mental illness with biological consequences,” she explains. “It isn’t about food or body weight. But these are the media that people use to deny uncomfortable and difficult emotions. A common notion is that they are not enough or doing enough. Food becomes the focus because it is something they can project onto and use to contain their difficult emotions.”

Jani Brajkovič, who says he is now in a “good place” after years of self-education and therapy, agrees that the issue usually stems from childhood trauma, external pressure or a lack of self-worth.

“A lot of cyclists have been told that they’re never going to have success, that they are not working hard enough, and it makes you think: I am nothing,” he says. “So we always try to prove ourselves.”

Brajkovič also wants to see a cultural shift within cycling. In 2019, he tested positive for the stimulant methylhexanamine, which he says came from a contaminated meal replacement shake he took to help with his bulimia. The UCI accepted his use was unintentional and reduced his ban to 10 months. But he remains angry at the lack of support.

Illustration depicting eating disorders in cyclists
Some ex-pro cyclists are speaking out about their eating disorders to try to change the culture and make sure riders fuel themselves sufficiently. - Jo Burt / Immediate Media

He says team nutritionists are often badly informed, team doctors do not always respect a rider’s medical privacy, and coaches routinely fail in their duty of care: “For them, it is easy to fix the problem: if you have a rider with an eating disorder and he is performing, that is fine. But when he stops performing, he is out.”

By speaking about their problems, riders like Brajkovič and Cimolai are trying to help the next generation find a healthier equilibrium. “I now know that with one plate of pasta, I go stronger,” says Cimolai. “It is important to find balance. Cycling is my passion. Cycling is my work. But cycling is not my life.”

Sam Woodfield now runs the UpShift Nutrition Racing Team, which proudly prioritises the wellbeing of its riders, and supports the #TRAINBRAVE campaign, backed by McGregor, which aims to educate athletes about eating disorders. “If it helps one person, it’s worth it,” he says.

“There’s more to cycling than being super-light. I’m heavier now, but I’ve gone from a 330-watt FTP (functional threshold power) to 425 watts for 20 minutes, 470 watts for 10 and just short of 500 watts for five minutes. If I lose 3 kilos, I’ll lose power and struggle to get through a day of work. So why do it?”

Weaver says cyclists should work with their natural body shape. “If you ride your bike and enjoy it, you’ll fall where is right for you,” she insists.

“Just celebrate being the body type you are. A lot of classics-style riders, who are bigger and eat healthily, perform better than the ones who are fixated on every gram. It’s about saying: ‘I love cycling, but I’m also getting fit as a by-product’. Not everything needs a goal other than pure enjoyment.”