Last week, elite runner, Mary Cain shocked the sports world with a stunning Op-Ed in the New York Times. This piece detailed the emotional and physical abuse that Mary endured under the coaching staff of Nike’s Oregon Project. Central to the abuse allegations was the troubling story of how Nike’s head coach, Alberto Salazar, mandated weight loss as a means to improve Mary’s running performance. What was positioned as a strategy for success, soon resulted in anxiety, depression, malnutrition and several injuries. In 2016, Mary ultimately summoned the courage to leave the project. Years later, she chose to bravely share her story with the world.

Mary’s story raises awareness about the danger of weight-focused training strategies and calls for a widespread culture change.

There are several truths we can learn from Mary’s experience that will help guide us forward towards change.

The “win at all cost” mindset is dangerous to athlete well-being

Coach Salazar and Nike cultivated a culture at the Oregon Project where “the end always justified the means.” This mentality had harmful effects on Mary’s physical and mental health and negatively impacted her professional career. Salazar’s obsession to make Mary thinner failed to help Mary run faster. It did however, succeed in worsening Mary’s running performance and caused her body to break down. This “win at all cost” attitude reflects an outdated paradigm in sports that persists today. When analyzed in greater detail, history has actually demonstrated that training athletes in this manner justifies neither the end nor the means. Instead,  ignoring physical and mental health problems typically lead athletes down an unsustainable path with negative consequences.

Mary Cain’s experience is unfortunately not unique  

For people unfamiliar with the culture of sport, Mary’s disclosure may seem shocking. Unfortunately, her experience is far too common in the world of athletics. Although Mary’s situation may represent an extreme case, punctuated by the high stakes of professional athletics coupled with her young age, this situation is not unique. It does not exclusively affect elite athletes, distance runners, or female athletes. It exists within all sports, at all levels and in athletes of all ages and all genders.

Access to a multidisciplinary team of professionals is key to athlete health and safety

Most sports teams do not provide their athletes with a team of multidisciplinary professionals that can support comprehensive well-being. All too often, coaches operate with a great deal of autonomy, full control and little oversight. Coaches often operate without the services of dietitians, sports psychologists or other health professionals involved in daily operations. With no annual or mandatory training in nutrition or psychology, coaches are not prepared to single-handedly manage the wellness needs of their athletes. This leaves athletes vulnerable to nutrition and health risks when coaches impose unsafe or uninformed training standards.

Here at Walden Behavioral Care, we see many clients who have similar experiences to Mary Cain.

Many of these athletes have suffered from ‘a win at all cost’ training approach at the expense of their emotional and physical health. To help athletes recover, Walden created the GOALS program, one of the few programs in the country that has specialized treatment designed for athletes.  Our mission is to equip athletes with the mental and nutritional skills that will help them achieve their full athletic potential and sustain a positive mindset. Walden’s expert team of multidisciplinary professionals understands what is needed to restore nutritional balance, train wisely, and achieve peak performance in sport while avoiding common pitfalls. We recognize the critical importance of emotional and physical health in collaborating with each athlete in our program. Utilizing research based methods, we help athletes and coaches understand how to navigate the difficult balance between performance and comprehensive well-being. With these pieces in place, we aim to ultimately build an athlete who can stand the test of time.

We applaud Mary Cain’s bravery in telling her story. The valuable lessons learned can help athletes and coaches lower risks for eating disorders and other mental health conditions. If you, or someone you know, is interested in healing your relationship with food, body image and/or exercise , check out the Walden GOALS eating disorder treatment program for athletes. Additionally, if you are a sports team/organization interested in educational programming, feel free to contact the GOALS program director, Emily Slager (, to inquire about a customized educational seminar.

Want to see what happens when you have a full team of experts supporting you?  Watch Ben’s story here.


Athletes and Eating Disorders

Matt Stranberg, MS, RDN, CSCS, LDN, is a licensed registered dietitian nutritionist and certified strength and conditioning specialist. He is a nutritionist and exercise science advisor for the Walden GOALS program. Matt devoted the early part of his career to refining the art of training elite collegiate and professional athletes. In graduate school, he developed expertise in nutrition, behavior change and eating disorders. Matt now devotes his practice to translating nutrition and exercise science into practical solutions. As a lead member of the GOALS team, Matt is known for his dedication to educating and empowering athletes of all backgrounds to facilitate a full and meaningful recovery from disordered eating. Matt holds a B.S. degree in Kinesiology from the Honors College at The University of Massachusetts Amherst, a master’s degree in Applied Exercise Physiology and Nutrition from Columbia University and was a dietetic intern at Boston’s Brigham and Women’s Hospital.

Dr. Paula Quatromoni, DSc, MS, RD, LDN, is a senior consultant for Walden Behavioral Care, and one of the nation’s top minds on the intersection of sports nutrition and eating disorders. As a registered dietitian, she has more than a decade of experience working with athletes with disordered eating and has published several papers on both clinical experiences and qualitative research on recovery experiences of athletes. Dr. Quatromoni is the Department Chair of Health Sciences and a tenured associate professor of Nutrition and Epidemiology at Boston University where she maintains an active, funded research program. In 2004, she pioneered the sports nutrition consult service for student athletes at Boston University. Dr. Quatromoni was recently named a 2016 Outstanding Dietetics Educator from the Nutrition and Dietetic Educators and Preceptors (NDEP) Council. She earned her B.S. and M.S. degrees in Nutrition from the University of Maine at Orono and her Doctorate in Epidemiology from the Boston University School of Public Health.