Since runner Mary Cains story about body-shaming became public, other athletes have come forward with similar stories, using the hashtag #FixGirlsSports. JOHANNES EISELE / AFP via Getty Images

When 23-year-old Mary Cain talked to the New York Times about her experiences as part of the Nikes Oregon Project, an elite professional U.S. running club, she said her weight was continually a topic of discussion.

A rising star in the running word, Cain was 17 years old in 2013, when she was recruited to join the Oregon Project, which was coached up until a few months ago by Alberto Salazar. But she never lived up to her potential. Her performance deteriorated despite training with some of the best distance runners in the nation, which Cain claims is due to continued pressure by Salazar to lose weight. Not only was her weight a constant theme during one-on-one discussions, he publicly body-shamed her in front of her teammates. Her weight dropped to 114 pounds, she went three years without having her period and suffered five broken bones due to poor bone health.

Since Cains story became public earlier this month, several other athletes have come forward with similar stories, and not just from endurance running communities. The hashtag #FixGirlsSports has been championed with girls sports advocates welcoming the chance to discuss a culture that too often equates body weight to athletic performance despite a shortage of science supporting the idea that certain sports or positions require a specific body type.

One of those advocates is Catherine Sabiston, a professor in the Faculty of Kinesiology and Physical Education at the University of Toronto and a Canada Research Chair in Physical Activity and Mental Health. Shes conducted research surrounding the prevalence of body talk in sport and listened to Cains story with interest.

The research we do in our lab came to life in that video, said Sabiston.

Cain attributes her struggles with body image to comments made by her coach, but Sabiston says remarks about body shape and weight can also come from parents, teammates and spectators.

For girls in particular, the sport environment is prone to high levels of teasing as well as negative weight and body shape commentary, she said.

Theres no doubt that female athletes receive mixed messages when it comes to their bodies. Not only are they expected to be strong and fit enough to excel athletically, they also feel pressure to conform to societys notion of what a female form is supposed to look like. This dichotomy alone can cause female athletes to be self-conscious about their bodies. But when the coach, who arguably has the greatest influence on an athletes confidence and performance, initiates that body talk, those negative emotions surrounding body image continue to escalate.

Sabiston says theres surprisingly little education designed for coaches when it comes to discussing weight and body image with their athletes. Nor is there much understanding regarding how coaches perceive issues related to weight, body shape and its effect on performance. To find out more about the culture of body talk within sport, Sabiston and her research team collected three years of survey data from athletes and conducted nearly 100 interviews with female athletes, coaches, parents, spectators and referees.

Our data are showing that the sport environment may foster negative body image emotions such as shame, guilt, envy and embarrassment, and these emotions relate to a poor quality sport experience and girls drop out, said Sabiston.

The prevalence of weight commentary and body talk is a large reason why teenage girls are up to six-times more likely to drop out of sport than boys. Coaches who, according to the interviews conducted by Sabiston, demonstrated explicit and implicit biases that higher weight bodies are less suitable for sport, initiate much of that talk.

Keep in mind that the athletes and coaches interviewed by Sabiston and her team were adolescent females participating in community-based sport, which means its not just elite athletes like Cain who are subjected to negative body talk. And given that the bodies of adolescent girls are changing, which in itself increases self-consciousness, any additional comments regarding body shape or size can add to an already precarious sense of self.

Cains body image issues worsened to such a degree that she resorted to self-harm and had suicidal thoughts. And while not every female athlete with anxiety related to their body shape or size has that level of distress, they often feel discriminated due to their physical appearance.

A key message in Cains dialogue is that constantly thinking about weight and appearance in itself is detrimental to performance, says Sabiston. It takes away an ability to focus on the sport.

Sabiston says theres a lack of support for athletes struggling to overcome a negative body image. Most of the available resources focus on eating disorders, not on the larger issue of learning to accept and love your bodys shape, size and athleticism. Its also her recommendation that coaches receive training onbody commentary and weight concerns, and ultimately how to talk about body image with all athletes.

Equipping coaches with information delivered through sport organizations and policies that discourage body talk in girls sport more generally may reduce the prevalence of body image concerns in athletes, said Sabiston. This education would also enhance the coachs capacity to be a positive role model, which has been identified as a key strategy to keep more girls in sport and liking it.

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