A former Olympic figure skater and UNC Ph.D. student is working to fight eating disorders

A hallway in the BC Place Stadium is awash with navy puffer jackets and knit beanies. A choir of voices inside the stadium chant “USA! USA!” In the hallway, athletes jump around, ready to make their entrance to the opening ceremony at the 2010 Winter Olympics. 

Rachael Flatt stands among the other Team USA athletes. She is a senior in high school and a competitive figure skater about to be swept into a moment she’ll remember forever.

“It was definitely one of the highlights of my life,” Flatt said.

Flatt left skating in 2014 while attending Stanford University. While she said the transition out of skating was challenging, her biology and psychology classes began leading her toward a new passion.

“I’ve always been interested in medicine, and sports medicine and sports psychology, having spent so much time in those respective areas as an athlete,” Flatt said. “When I started doing research my senior year of college, I started seeing a lot of parallels in the lab I was in, and I guess I should say the ‘lack of’ resources available to athletes.”

Flatt understood the prevalence of eating disorders among athletes, especially within the skating community. She said several of her peers suffered from eating disorders and poor body image, due to the “aesthetic nature” of the sport.

Now she is a Ph.D. student under Dr. Cynthia Bulik, the founding director at the UNC Center of Excellence for Eating Disorders. Alongside Apple, uBiome, Recovery Record and the National Institutes of Health, the Binge Eating Genetics INitiative (BEGIN) study aims to predict when participants are most likely to binge or purge based on readings from Recovery Record for Apple Watch.

Flatt and Bulik share a love of skating. Bulik, who skated as a child and picked it back up in adulthood, won bronze in a partner skate at the 2012 Adult National Figure Skating Championships. They met while planning a continuing education course for the Professional Skaters Association on body image. When Bulik announced she would be taking a graduate student in the upcoming year, Flatt applied and was accepted.

“Our goal is to develop treatments that, based on people’s data from the app and Apple Watch, can predict AHEAD OF TIME, when they are at risk for binge eating or purging and helping them to stop the behavior before it occurs,” said Bulik in an email. “We call it a “just-in-time” treatment and is made possible by integrating technology into our standard treatments for eating disorders.”

Flatt said she saw many of her peers suffer from eating disorders and poor body image. While she said her support system helped her keep her head up, it was difficult to hear constant remarks on her weight.

“I, for one, definitely dealt with poor body image from the time I was a teenager,” Flatt said. “Unfortunately, being in the spotlight, and when you’re getting judged based on how you look in an arena full of 18,000 people and nine judges, it’s really challenging to not come away with any of those perceptions about yourself.”

Judges and coaches would walk up to Flatt and tell her she needed to “lose a couple of pounds,” under the guise of coaching.

“From their perspective, it’s sometimes not necessarily about looking thinner, it’s about looking more muscular or more toned or more built,” Flatt said, highlighting how these traits are associated with higher jumps in the skating world.

At least 30 million people in the United States suffer from an eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders. Out of all American women, 1.5 percent suffer from bulimia nervosa in their lifetime, while 2.8 percent of adults suffer from binge eating disorder. 

Bulik’s study is still in the first stage of study, and only 1,000 people have participated so far. In the future, Bulik wants to transform the way that eating disorders are treated, since half of those who are treated for bulimia nervosa or binge eating disorder never fully recover or are prone to relapse. Bulik and Flatt hope to bring this treatment to the athletic world and adapt the approach for athletes with body image issues. 

Flatt also hopes to do research regarding transitioning athletes out of competition and into everyday civilian life, a process she found particularly challenging.

“Having some people to talk to about it — friends, family, athletic peers — in addition to taking those small steps forward and trying some new things that are outside of your comfort zone were the two things that helped me move forward and find something new in my life that I was really excited about and really motivated to be successful at again,” Flatt said. “I found another passion.”

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