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GROWING PAINS

Published Oct. 11, 2005

Within six weeks of turning pro at age 13, tennis player Jennifer Capriati landed on the covers of Sports Illustrated and Newsweek.

So anticipated was her debut that reporters took to calling her first pro tournament "The Virginia Slims of Capriati."

She was a gifted, joyous, remarkably normal eighth-grader who happened to have $5-million worth of endorsement contracts.

Veteran reporters started a pool that first tournament: Would this lively young savior of American tennis burn out at 18 years old or 19?

It turns out the cynics might have been too conservative. Capriati, 16, already appears worn from the travel, the exhibitions, the commercial obligations, the media scrutiny and the uneasy pressure of being the sole financial supporter of her family.

"Nobody is capable of doing what she's doing," said former pro tennis player Mary Carillo, now a television commentator. "No adult could do it, much less someone her age."

Gymnast Kristie Phillips was supposed to be the next Mary Lou Retton. Phillips moved away from home to train when she was 8 years old, winding up in Houston with the famed Bela Karolyi, coach of Retton and Nadia Comaneci.

Kristie was 14 when she appeared on The Tonight Show and on the cover of Sports Illustrated. She was hailed as the country's great hope for a gold medal in the 1988 Olympics, which were still two years away.

By the time she was 17, Phillips hated the sight of the gym. She claims Karolyi pushed her to take laxatives, thyroid pills and diuretics to lose the weight brought on by puberty. She said she took 12 Advils and six anti-inflammatory Naprosyns a day for the pain in her fractured left wrist, which she trained on for three years because she felt she couldn't afford the time off to let it heal.

She failed to make the '88 Olympic team. A few months later she took scissors to her wrists in a botched attempt to kill herself.

Even now she suffers from bulimia, which sends victims into a potentially fatal cycle of binge eating and vomiting. She says it was brought on by the sport's obsession with weight.

"I weighed 98 pounds and I was being called an overstuffed Christmas turkey," Phillips said. "I was told I was never going to make it in life because I was going to be fat. I mean, in life. Things I'll never forget."

Playing sports is a healthy pastime that for most children is no more damaging than playing the piano. But for the elite child athlete, sports can be devastating.

Child labor laws prevent a 13-year-old from punching a cash register for 40 hours a week. But that same 13-year-old can toil for 40 hours a week inside a gym or on a tennis court.

College athletes are restricted by the NCAA to 20 hours of training per week. But no laws, no agencies, put limits on how much a child can train.

Young athletes, especially girls, trade more than their childhoods for a shot at glory. They risk serious physical and psychological problems that linger long after the public has turned its attention to the next phenom in pigtails.

The intensive training and the pressure heaped on by coaches, parents and agents _ the very adults who should be the child's protectors _ often result in eating disorders, weakened bones, hormonal imbalances, stunted skeletal development and damaged self-images.

Training effects

Young female athletes face problems not encountered by male athletes. One reason is that, at least in tennis, gymnastics and figure skating, girls reach the highest levels of their sports years before their male counterparts. Another reason is the female body is affected by intense training in drastically different ways than the male body.

Consider these statistics:

Of 182 female college athletes interviewed for a study, 32 percent practiced at least one form of disordered eating (vomiting or use of laxatives, diuretics or diet pills).

Among college gymnasts, 62 percent had eating disorders.

As many as 66 percent of all female college athletes have amenorrhea, irregular or nonexistent menstrual periods. By comparison, 5 percent of the general female population are amenorrheic.

Amenorrhea (pronounced a-MEN-a-ray-a) is so prevalent among elite athletes that when researcher Bob Marcus began a study six years ago comparing the bone densities of amenorrheic and normally menstruating athletes on the Stanford women's track team, he had to go outside the team to find a control group. Every athlete on the team was amenorrheic.

The consequences can be serious. Four studies during the past seven years concluded girls and women who lost menstrual function lost bone density. They thus became more susceptible to stress fractures, premature osteoporosis and curvature of the spine.

Because studies of young female athletes began only in recent years, researchers can only guess at the long-term impact of intensive training. But based on his Stanford study, Marcus predicted a two- to three-fold increase in osteoporosis for amenorrheic athletes.

The problem can be especially dangerous for the very young. Strenuous exercise coupled with poor eating habits can delay the onset of puberty for years. Many elite athletes don't have their first periods until they retire from sports. Olympic gymnast Kathy Johnson began menstruating only when she quit the sport at age 25.

This can have a profound effect on skeletal development: 48 percent of bone mass and 15 percent of height are achieved during adolescent years. If a girl isn't menstruating, she isn't producing estrogen. If she isn't producing estrogen, her bones cannot develop properly.

"We find women in their 20s with the bone density of postmenopausal 50-year-old women," said Dr. Aurelia Nattiv, team physician for Pepperdine University.

In one study by Seattle research physiologist Barbara Drinkwater, a 21-year-old ballet dancer who had been amenorrheic for six years had the spinal bone density of a 90-year-old woman.

What causes amenorrhea? Starvation is one cause. Young elite athletes _ who tend to be hard-driving, competitive perfectionists _ often starve themselves in pursuit of perfect athletic form.

Amenorrhea develops, one medical theory goes, because the body senses inadequate energy to support a fetus and thus shuts down the reproductive machinery.

Amenorrhea goes hand in hand with eating disorders, which bear their own brand of disaster.

Eating disorders

Eating disorders have become such a serious and widespread problem that two years ago both the U.S. Olympic Committee and the NCAA began distributing posters, literature and videos to their athletes and coaches to combat it.

"It's something that's still under the rug," said Drinkwater. "No one really wants to acknowledge that this is taking place. And it's not a benign condition."

Tennis players Carling Bassett-Seguso and Zina Garrison both went public last year with their struggles with bulimia. Gymnast Cathy Rigby was bulimic for 12 years. Kathy Johnson, bronze medalist in balance beam at the 1984 Olympics, kept her battle with bulimia a secret until now.

She became bulimic because she was older than most of her competitors and felt starving could keep her body like a child's. She was bulimic for 10 years without anyone knowing.

"I thought I could look like I was 12 or 14 if I watched what I ate," Johnson said. "I became a vegetarian, which is wonderful, but the problem is every athlete is somewhat compulsive. You have to be to do all the work we do. I kept thinking, "If only I was lighter, I could be better.'

"It will probably shock most of my coaches to learn I ever dealt with this at all. But people are kidding themselves if they think we can ignore the weight issue in our sport."

Johnson, 32, overcame bulimia a year after she retired.

"I'm the healthiest I've ever been," she said. "But I know a lot of athletes who never made it all the way back."

In her job as a network television commentator, Johnson sees young gymnasts she knows are bulimic.

"I tell them that it's not this big, horrible, awful thing you need to keep secret. But some of them feel, "If I let it out, then it will all fall apart.' They're afraid they'll really lose control."

Kristie Phillips wasn't bulimic until she left the sport. She said she regularly took laxatives, diuretics and thyroid pills to keep her body pencil-thin while training. She said Karolyi thought her optimum weight was 92 (she's 5 feet tall). When her weight crept to 98 pounds at age 16, he harangued her with insults, she said.

When she ballooned to 112 after a brief stint training with another coach, Karolyi put Phillips on such a spare diet she lost 20 pounds in three weeks, she said.

Phillips also claimed the woman who oversaw her diet under Karolyi's direction told her Karolyi would make Phillips vomit if she didn't drop the weight quickly.

Karolyi emphatically denied he threatened Phillips or even advised her on her diet.

Phillips, now a 20-year-old sophomore at LSU, recalls having no energy.

"I don't know how I didn't hurt myself. I was so weak, and he was still making me do everything."

Puberty the enemy

For elite female athletes, especially in gymnastics and figure skating, puberty is the enemy. Whereas physical maturation brings boys closer to the masculine ideal, it takes girls further away.

Before puberty, girls have 10 to 15 percent more fat than boys. After puberty, girls have 50 percent more fat.

The battle to keep bodies light, thin and childlike can drive young athletes to extreme behavior. Ballet dancers have been known to eat Kleenex, which fills their stomachs without adding any calories.

"The question becomes, "What is sport worth in terms of long-term health consequences?'

" Drinkwater said.

Bulimia also takes its psychological toll. It sends athletes into a cycle of binging and purging that makes them feel out of control and ashamed.

"Part of you is mortified, embarrassed," said Johnson. "I was so in control (on the outside). I won an Olympic medal, for God's sake. I kept thinking, "Show some respect for yourself. Show some dignity.' "

Said Phillips: "Everyone goes through it, but nobody talks about it because they're embarrassed. But I don't put the fault on us. It's the pressures that are put on us to be so skinny. It's mental cruelty.

"It's not fair that all these pressures are put on us at such a young age, and we don't realize it until we get older and we suffer from it."