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Organ Failure and Diet Pills: How a “Shrink-to-Send” Mentality Upended Her Life

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Originally published in Gym Climber, in 2020.

“Gabbs, you look kind of yellow.”

I’d rolled my eyes, “No I don’t.”

My dad chimed in from the other room, agreeing with my then boyfriend, Mike, “No, he’s right, you are yellow.”

But where? I’d asked myself. Later that evening I checked in the mirror and there it was, in my eyes and skin. I was surprised I’d missed it. Soon after though, I received a call from my doctor. As per my last round of blood work, I was in liver failure, which explained the yellowing of my skin and eyes. I hung up and didn’t think much of it. A few weeks later, I competed in my last Youth Sport and Speed Divisionals with a broken right ring finger and a partial tear to the A4 pulley tendon. Three days after that, I was hospitalized for anorexia.

I was 117 pounds at five-foot-nine and popping diet drugs as though they were candy. It was my freshman year of college, and I lived on campus. I’d go and buy jars of weight-loss pills, diuretics and caffeine pills at the local grocery store and hoard them in my dorm like a squirrel. This excessive drug use is eventually what brought me to the point of not only liver but kidney failure as well. Pissing your own blood is a scary experience, but it didn’t snap me out of it. I kept indulging in severely restricted eating, drug use and overexercising, because the number on the scale determined what grade I could climb, and how well I would perform at a competition. If I fell short of my expectations for either, it was because the number on the scale was too high, and it was my fault for not being disciplined enough to drive it lower.

After checking into the hospital, I suddenly had zero control over anything—all the way down to when I was allowed to go to the bathroom. Other than “I’m allergic to dairy, don’t give me yogurt,” I didn’t have a choice in what I ate, how much or at what times.. So much of eating disorders revolve around the need for control. Having that freedom to do what I wanted exactly how I wanted pulled out from underneath me was jarring, and I quickly found that trying to bargain with, convince or even fight the nurses was futile. I was stuck in a box, with zero say in how my days unfolded and nurses checking up on us every fifteen minutes. Commence panic.

We weren’t allowed to stand up for more than a minute at a time. Save for a couple designated breaks per day, the bathrooms were locked to prevent purging, and nurses followed us in when we did go. They checked on us every fifteen minutes, even at night. Medications were administered in the mornings. Sometimes blood was drawn, depending on the day of the week. We were weighed daily without clothes on and allowed no more than eight ounces of water to prevent water purging—a practice I myself was extremely guilty of. The windows were bolted shut, suicide proof, which turned the recreation room into a stale terrarium.

Shrink To Send

Photo by Alvaro Saavedra

You may be wondering what could have possibly brought a person to this point. Part of it was having been badly bullied for being a “huskier” child. Another part was having grown up in the performing arts. I took up the violin at age 9, started taking it seriously by 12 and spent my first two years of undergrad as a music performance major. I also danced classical ballet for many years. But competition climbing made any pre-existing insecurities I’d had about my body even worse. I’d watch my fellow competitors crush boulder and sport grades and stand on the podium, win national titles and even go to World Championship events. And because I started climbing and competing so late, I felt very out of place and desperately wanted to send harder so that I, too, could fit in.

I was 14 when I first heard it. Not even from another competitor, but the mouth of an older climber I frequently socialized with in the gym. The “shrink your strength-to-weight ratio to climb stronger” argument. It seemed to work for all the strong climbers I looked up to in the gym. They were shredded, some even sent double digit boulder problems outdoors. Then there were my heroes: Jill Church, Alex Puccio and Sasha DiGiulian. They were—and still are—monsters. I wanted to be like them. And if I wanted to be like them, surely restricting my food intake was the way to do it, right?

Wrong. But it led me down a multi-year rabbit hole of unhealthy dieting. Things really came to a head during my freshman year of college. It was my last chance to make the Youth National Team. I trained harder than ever, but I would barely eat anything after my training sessions. The less unnecessary weight I had to carry up the wall, the better. I declared myself a vegetarian, then came the diuretics and the diet pills. And the caffeine, my gosh, the amount of caffeine pills and energy shots I took on a regular basis just to keep myself going throughout the day was obscene. I was doing my best to train my chops off, and balance my first year of college in a degree program I hated. I was depressed out of my mind, and the lack of caloric intake—under the guise of a necessary sacrifice in order to achieve what I wanted as a competitor—did not help my cause. One of the gym directors caught on to what I was doing to myself, and he threatened to kick me out of the gym and terminate my membership if I didn’t get my act together. All that managed to do was make me better at hiding my habits. A friend started driving out to me on his days off during the week. He’d take me out climbing—to the gym or the crag, didn’t matter which—and make me eat something afterwards. Towards the end, those were the only days of the week where I was eating a full-sized meal.

For a very short window of time I saw results from this kind of behavior. I started putting down 5.13’s in the gym. Getting out to the crag didn’t matter much to me at the time because I was training to crush on plastic at competitions. However, this ultra brief uptick in my performance quickly plummeted, and I became so malnourished I could barely make it up a 5.9. Then I broke my right ring finger and partially tore my A4 pulley tendon at the New River Gorge two weeks before my last Youth Sport and Speed Divisionals. Any chance I’d had at making the Youth National Team was dashed for good. I attribute a large part of that injury to the fact that I was so poorly nourished when my partner and I went out to climb that weekend. Food and water keep your body together so it doesn’t fall apart. But at that point, I had such an uncontrollable problem that I couldn’t see it. I’d tunnel visioned into climbing’s “shrink to send” culture and couldn’t find my way out. And I loved climbing so much that I’d do anything to succeed at it. Even starve myself straight into liver failure.


Navigating the Difficult Road to Recovery

Gabrielle climbing at the newly opened Sportrock Performance Institute, a training center that hopes to develop an athlete support system of professionals including nutritionists, sports psychologists and physiotherapists. Photo by Alvaro Saavedra

A slice of toast would have me full for hours—not that I ate toast all too often to begin with. I used to live by the phrase “nothing tastes better than skinny feels.” And because the stomach is a muscle—it shrinks and expands according to how much you eat—it hurt to eat much more than toast in one sitting anyway.

After checking into the hospital, all of a sudden I was required to eat three meals a day, plus two snacks. Regardless of what kind of eating disorder you were in for—anorexia, binge eating, bulimia—everyone was on the same meal plan. And if you couldn’t finish everything on your plate at mealtime, you had to sit at the nurse’s station and drink the caloric equivalent of what you hadn’t finished in the form of Ensure. In the short time I was checked in, I was a repeat offender at the nurse’s station, along with a couple of the other girls. To this day, I hate Ensure and shudder at the thought of drinking it.

In short, it was hell and I hated every second of it. Our therapists and psychiatrists were not easily accessible, and they sometimes cancelled randomly on patients. I spent a whole day in tears because I just wanted to leave. I journaled, called friends from the rec room phone and cried some more. I cried a lot. A part of me was also cripplingly scared of what I’d do to myself if I were let back out into the wild again, but I was more anxious inside the hospital than out. I concluded that I’d rather take my chances on my own. I was supposed to have been there for a month: I lasted four days. My saving grace was that I was 18, almost 19, and I could sign my own paperwork. I left AMA (Against Medical Advice) on June 22, 2015, and swore to myself that I’d never end up back there again—I’d have sooner shot myself in the foot.

Navigating recovery was difficult and that, even, is a gross understatement. About a month and a half before ending up in the hospital, I met up with a psychologist who specialized in eating disorders. At that point, I was so far gone that she initially refused to treat me. If I died in her care—which was very likely—it made her legally liable. And when I reached out to her again following my early check-out, she refused to treat me again because I’d left AMA. But after some heavy-duty persuading from my mom, she eventually agreed to take me on as a patient.

For the first few months of our sessions, I was absolutely resistant to anything she had to say to me. I refused to believe a thing she said, because, surely she was lying, right? And there was climbing to think about. How would I send hard things or make the national team if I gained any weight at all? But I was trapped in a psychological torment. Pulled back and forth by needing and even wanting to get better, but also terrified of the bodily changes that’d come along with recovery. I’d be hideous. It’d affect climbing in the worst way possible. And if I didn’t have climbing, I had nothing.

After months and months of this kind of resistance, I gave up. I threw in the towel, because being stuck in that headspace was exhausting. I literally could not do it anymore. So, I started taking what my psychologist said at face value, even if I didn’t believe her. But eventually, I did and this led to far more constructive conversations between her and I, and I finally started to make real progress for the first time ever. Five years later, I am still with this psychologist. We meet once a week and without her help, I likely wouldn’t be here telling this story. She is the reason I am sitting here writing this article instead of being buried six feet in the ground somewhere. I owe so much of my recovery to the effort she put into me as a patient.


The Five Year Mark

I left the hospital on June 22, 2015. I told myself that if I could make it five years without relapsing, or engaging in any kind of eating disorder-like behavior, I’d consider myself fully recovered. In the past, mostly through high school, I’d get help, be okay for a little while, relapse and then end up back in another therapist’s office. Rinse and repeat. But not this time. This year is that five year mark and I could not be more stoked. It was a long, tough process that came with a massive amount of conscious effort on my part, but it’s been so worth it to come out the other side alive and healthy. If anyone reading this article is struggling or on the fence about getting help, do it. Recovery is not a pretty process, but the end result is beautiful. I never could have expected the kind of happiness that’d come along with recovery, but now that I’m there, I couldn’t dream of backpedaling into that pattern of self-destruction.

As cliche as it sounds, the proof is in the pudding. As soon as I started really eating right, my climbing and competition performance improved tenfold. In 2016, I attended my first collegiate nationals and was picked for the first inaugural University National Team. I attended the University World Championships in Shanghai, China later that year. I’ve since quit sport climbing though—I could never get over my lead head despite trying every trick in the book. Instead, I’ve taken up speed climbing and have chosen to specialize in it on the competition circuit. I’m also an avid boulderer and participate in competitions such as Dark Horse and the Tristate Bouldering Series. Specializing in these two disciplines, where strength and power are paramount, gave me a new appreciation for putting on muscle mass. And as the seconds came off my speed times, the number on the scale meant less and less. If anything, losing weight started to psyche me out because I knew that if I dropped too low, my speed times would suffer and I’d get injured. I am finally at a point in my life where I could not possibly care less about how I look, as long as I can pull the speed times and boulder grades that I want, and perform well at competitions.

To all the youth climbers who may read this: do not repeat my mistakes. There are no pros to eating disorders, only cons. It will harm your climbing and run the potential to cause permanent or long-term damage. My stomach never managed to stretch back out. As a result, eating slightly large or even “normal” sized meals makes me physically sick. I eat slow and have to pace myself. Up until recently, I existed with dangerously low blood pressure all the time because my eating disorder affected my heart. I strive to be a better example for the youth team kids that I coach so that the coming generation of climbers doesn’t have this problem. The thought process of disordered eating doesn’t exist in a vacuum, nor does it come out of nowhere. It’s on all of us as a climbing community to change the conversation surrounding food.

This may come as a surprise to some readers but anorexia is the deadliest psychiatric disorder, trumping even schizophrenia and bipolar disorder, the latter of which I also struggle with. And speaking from experience, it was tenfold easier to tame my problems with bipolar disorder than it was to recover from anorexia. A 2012 article by Thomas Insel, the former director of the National Institute of Mental Health, estimates the mortality rate of anorexia at ten percent. The obvious causes of death associated with anorexia are starvation and metabolic collapse, but others commit suicide (Insel, 2012). Insel also explores in his article the changing demographic of eating disorders. While an illness that stereotypically and disproportionately affects white women; men and other ethnic groups are not exempt from experiencing anorexia. And unfortunately, men and minorities are often dismissed and even mocked for voicing their struggles with eating disorders. Moreover, most insurance companies will not cover inpatient care for eating disorders, which disproportionately prohibits low income folks from accessing the necessary treatment to fully recover from anorexia. The inpatient program I ended up in, which shall not be named, was terrible. It has a reputation for being one of the worst eating disorder recovery programs in the Northern Virginia/D.C. area, but it is the only one that would take my family’s health insurance.

Five years ago I almost died of an eating disorder. Now, I’m a college graduate, aspiring sign language interpreter, trail steward and 2024 Olympic hopeful—all milestones I never thought I’d reach, given my general practitioner said I’d be lucky to make it past October 2015. Everything tastes better than skinny feels and no competition is worth risking your health over. If you are struggling, please seek help. Trust me, your future self will thank you for it. It is a fabulous thing to come out the other side, be able to stare your eating disorder in the face and say “I won.”