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Alexa Knutson: Get Me Back

TW: eating disorder


Alexa waving to the crowd at a water polo game

As a high school athlete, I committed to the fourth-best collegiate water polo program in the country. I started in many games throughout my freshman season and felt that I would thrive as the starting goalie during my next three years. Going into my freshman season, I was the strongest and most confident I had ever felt. 


One November morning in my dorm room, I had just gotten back from a post-practice brunch with some teammates. While changing into my outfit for class, I remember looking in the mirror and picking out parts of my body that felt too muscular or bulky. I attributed this to how much I had improved in the weight room and the amount of protein I was consuming. I immediately realized that I was in complete control of how much I was eating and lifting. After practice the next morning, I decided to bypass my usual overnight oats from our team fridge as well as my post-practice Dave’s Killer Bread bagel. These small changes gave me a sense of control and eased the body-image-related anxieties that were beginning to creep into my mind. As the next post-practice meal approached, I did the same, except this time removing the omelet as well. This left me with fruit, cheerios with almond milk, and a few pieces of deli turkey. After about a week or two of these gradual restrictions, I became hyper-aware that this was the only part of my life that I felt complete control over. 


While this sense of control eased my anxieties, practice each day felt like a marathon I had not prepared for. I found myself unable to concentrate, struggling through sets, and crying through workouts that used to be fun. My hands and feet would go numb during practice, I would feel dizzy, my legs and hips would cramp, and my body would shake uncontrollably. While I did my best to hide these symptoms and be positive for those around me, all I could think about was how much time was left in practice and how sick I felt. Despite all this, I felt zero motivation to return to eating more. The desire for control and safety that I felt through restriction was more comforting than feeling energized. As athletes, the idea of pushing through pain and discomfort is burned into our minds, and this mentality transferred seamlessly into struggling with Relative Energy Deficiency (RED-S) symptoms. What I didn’t realize about the “no pain no gain” mantra is that it doesn’t consider the harmful symptoms that should not be pushed through. We might see a select group of women at the top of their sport in the media, but we don’t see the hundreds more behind the scenes who had to step away from their sports because of unhealthy practices they adopted in trying to reach the top. 


Alexa holding a water polo ball

These symptoms continued to worsen throughout the season, with one of my worst presenting during our conference game at Indiana University. Before we left for away games, we had access to a sheet where we filled out our orders from each restaurant for the trip. It generally didn’t matter what the restaurant was, I didn’t want it. By April I had very few safe foods, which did not happen to be at most restaurants, if any. The night before the game, we were in the hotel conference room for a team dinner. We had ordered from an Italian restaurant—which meant pasta—however, by dinner time, I had still not been told if I would be playing the following afternoon. I was torn between wanting to have energy if I was going to play, but if I wasn’t, I saw no reason to eat. Halfway through dinner, one of my teammates had finished her meal and mentioned wanting more food. Without thinking, I offered up the rest of my pasta, which she took excitedly. I was relieved and happy to have it out of my sight and that we would soon be heading up to bed. However, about an hour after dinner, while still in the conference room, I got a text saying that I would be starting in our game at 1 pm the next day. My stomach dropped, and all of a sudden, a rush of guilt flooded my mind.


When I woke up the next morning, my legs ached and my body felt like a ton of bricks. I thought that I would feel better if I had some toast and eggs, but every bite felt like eating cardboard and I didn’t feel any better after. When we got to the pool, I changed into my game suit in the locker room with my legs shaking and my mind racing. I was mad at myself and scared to do anything. I forced down half of a Belvita bar and went out onto the pool deck to start warming up. As I treaded out of the water for the first shot of warmups, the reality of my energy-depleted body sunk in. The whistle blew, I touched my head to the crossbar and floated out of the goal. I went through every technique that usually calmed my mind and body but none of them worked. I felt like I was playing outside my body. 


The rest of the game was a blur. I remember shaking for most of the game and was unable to perform in the way my team needed me to. I couldn’t focus and was eventually pulled from the game in the second half. We ended up losing to Indiana, and I felt like I had let everyone down. I didn’t eat our post-game meal, which led to stabbing stomach pain and me lying on the airport floor replaying the game over and over again in my mind. I knew that I was so much better than my performance that day and felt an overwhelming paralysis between my desire to play well and the safety of my eating disorder.


As the season and semester came to an end, I was finally able to avoid all unnecessary obligations that expended energy, that is, except for exercise. Returning home for summer felt like a breath of fresh air. I felt zero expectations to perform, which meant being able to exercise as much as I wanted and eat as little as I wanted. As my body shrunk, I felt safe. Somehow, feeling so small felt so powerful. My mind had been completely taken over by my eating disorder. I felt like no outside factors could phase me because of the perceived sense of safety my eating disorder gave me. However, everything phased me. I had zero patience, I refrained from talking at all costs, and I couldn’t focus long enough to write a simple workout set on a whiteboard. I spent that summer coaching for my old water polo club, and though I did the best I could, I felt extremely guilty that I was not my best self for the athletes I was coaching. 


Looking back, I still don’t remember much from my freshman season or the following summer. What I do remember are the constant stressors I felt throughout the season regarding my performance, my impact on the team, my body changing, and the discomfort of being away from home. These four things seemed so uncontrollable at the time, that once restriction started to feel like the only thing I could control or alter, it became my safety net.


Alexa playing water polo

As athletes, we are expected to have one body type; as women, we are expected to have another. I struggled to accept my muscular body outside of my sport. In the pool, I felt strong and powerful, but outside of the pool, I felt too muscular and not woman enough. As women, we were taught at a young age that we needed to blend in, we couldn’t be too loud, too different, or take up too much space. And while these ideas of what a woman should be are changing, the weight of these previous expectations are still on our shoulders. 


My family became increasingly worried as my body continued to fade and as I refused to eat what would be considered “normal food.” After coaching one day, my sister called me into her room, sat me down on her bed, and told me that she had already talked to our mom and that I was going to eating disorder treatment. The rational part of me saw their side and understood where they were coming from, while the rest of me wanted to get in the car and run away. Two things kept me from expressing this: seeing the worry on my sister’s and mom’s faces, and the realization that my sick body was incapable of returning to water polo. 


Over the course of the next few months, I realized that eating disorders don’t just affect the person struggling, they affect everyone around them as well. Stagnating into an unhealthy routine was what I felt “safe” doing, however, this “safety” never led to fulfillment. It’s easy to be harsh on our own bodies, but I couldn’t stand the idea of letting down the people I loved. I encourage anyone with an eating disorder to allow a few people close to you into your experience. Some of the people who have helped me the most throughout my recovery are those who know how to challenge me when I need it. Going through recovery alone is so much harder than with an army behind you, but people can’t help if they don’t know how. 


After my intake exam, I was told that I was being recommended for the Partial Hospitalization Program for Anorexia Nervosa. This meant being in treatment every day from 8 am to 4 pm. After hearing this, I wanted nothing to do with the program, but I saw how much stress my health had been putting on my mom, and knew that doing this program would help to ease her mind. However, the thing that I struggled to accept the most, other than the meal plan, was exercise restriction. Exercise had been something that I used as a way to numb out emotions and feel powerful in my body. Because of this, I exercised anyway. I would sneak out for nightly runs, or find ways to be home when no one else was so I could lift in secret. I felt like the only way I could increase my meal plan compliance was to have control through exercise. This continued until my dietician and nurse sat me down and informed me that if I continued to exercise, my heart could stop. In my mind, this was only something that happened to other people. Regardless, I knew that even if I didn’t care for myself, I at least had to try to make a change for my family. 


Alexa running on a treadmill

After pushing back my discharge date from the program halfway through, I finally completed it and was able to return to school in late August. I was excited to see my teammates and coaches, but being on exercise restriction meant being unable to practice. I watched every practice from the pool deck until late November of that year when I was finally able to get in for a 30-minute “light swim”. Throughout this period of watching practice, I felt like I had let my team and coaches down. I didn't think I deserved to be on the team because I didn’t feel like an athlete. I didn’t see my body as one of an athlete, but I feared gaining the weight and muscle I needed to play again. Watching practice continued throughout the whole year as my labs, weight, and meal plan compliance fluctuated. I was constantly trying to achieve the perfect balance between eating enough to get through my return to play protocol and not eating too much to where I would gain weight or have “too much energy.” At the time, having “too much energy” meant that I needed to eat less or exercise more. This was my new way of controlling what I was putting into my body. What I thought was me striving towards recovery was actually me falling into complacency. I was constantly mad at myself for not having recovered and been cleared already. By the end of the season, I was exercising in secret, completing only 50-60% of my meal plan, and eventually bumped down to the second phase of my return to play plan. 


My instruction for the following summer, in order to have a chance of returning to the team, was to return to an Intensive Outpatient Program (IOP). While being back in treatment, I realized how much damage I was doing to my mind and body by striving to eat just enough, but not “too much”. I also realized that pushing my body to get back to the player I was, or better, was not a realistic goal for me to have. I didn’t see a version of myself who could commit to 20 hours of training a week without resorting to this half-in, half-out state of recovery. I’d realized that I was unable to be the player and leader my teammates needed, or the sister, cousin, or friend everyone knew me as. With all my energy being consumed by an eating disorder, I was a shell of myself and unable to fulfill these roles that were once such a natural and joyful part of my life. In my mind, water polo equaled restriction, and continuously trying to fight that mindset while actively being around my team and constantly thinking about water polo didn't seem possible. I needed to separate myself from the environment that I associated so strictly with my eating disorder. 


Halfway through the summer, I made my decision to step away from water polo and I could not feel more at peace with this decision. Even though stepping into the unknown is scary and uncomfortable, the prospect of living a life with no energy, dreading every day, and being alienated from friends and family is worse. Inaction, ultimately, is an action, and sometimes the scariest one we can make. Through this change, I have rediscovered my goals and passions outside of water polo such as swimming, cycling, art, helping kids, writing, and so many little things in my everyday life that bring me joy.  When you wake up every morning dreading everything that expends energy, there is no room for passion or connection, and any dwindling energy goes toward surviving. Without change, there is no growth. For me, the change was stepping away from water polo, for others I know, it has been anything from re-organizing their workspace to taking time off school. No matter what this change looks like, it is necessary to see everyday life in a different light and search for personal reasons for recovery. 


With all this being said, I still have a long way to go in my recovery. I am still introducing new foods, learning how to balance nutrition and exercise, and reminding myself of my goals. These goals, though similar to last year’s, differ greatly in that I now want to achieve them for myself. I want to have a family of my own one day, I want to feel strong in a healthy body, and I want to be present in my friends and family’s lives. I now know that the life and relationships I want are unattainable while being consumed by an eating disorder. 


If you are reading this and are struggling with any of the above or something similar, accepting the idea of change can be overwhelming and though the first step may be the scariest, it is worth taking. I remember my dietitian telling me, “Your eating disorder will always be there if you decide that recovery isn’t for you,” and this is what pushed me to take the first step. 


I say all of this in hopes of helping anyone who feels alone in struggling with an eating disorder. Change is hard, and stagnation is hard, but we get to choose which hard we want to go through. There is so much more to life than food, exercise, or your body. If you allow yourself the opportunity to experience all aspects of being a human, you might be more open to what it has to offer. One of my favorite quotes: “Create a life that you are excited to wake up to every morning.” 


Difference is beauty.

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