HUDSON — What started out as a way to speed up her running times wound up sending Olivia Robinson’s health into a tailspin — and put her on a long road to recovery.

Olivia, 16, a junior at Western Reserve Academy, was a freshman runner on her cross country team a couple years ago “when everything started for me.”

“I didn’t know about proper nutrition,” Olivia said. “I just stopped eating and exercised more, and at first that worked for a while — I’d been out of shape — but it caught up with me.”

Olivia said she first noticed a serious problem when her hair started falling out and menstruation stopped.

“At first, we thought it was a medicine I was taking,” she said. “It was that I wasn’t eating. My eyebrows fell out entirely, I had to paint them in.”

Olivia was taken to the ER at Akron Children’s Hospital five times, with no diagnosis. Things came to a head when she had a hypoglycemic episode at her grandparents’ house and passed out.

“I was out for 15 minutes,” she said. “They called an ambulance. A few days later, I got the diagnosis from Dr. [Jessica] Castonguay. I missed the last month of school. I couldn’t even function.”

The diagnosis? A condition called Female Athlete Triad.

Castonguay, who works in Akron Children’s Hospital’s Adolescent Medicine and has been working with Olivia, said Female Athlete Triad is “issues that come together in female athletes,” and the severity can range widlely.

“There’s quite a wide variety of patients that we see,” Castonguay said.

There are three parts to the triad: an eating disorder, lack of menstruation and decreased bone density.

The eating disorder usually comes from not understanding the proper nutrients required for athletics, Castonguay said. When an athlete doesn’t eat enough, “they don’t have enough fuel in the engine,” and that leads to low energy and other, more serious, medical issues.

This disorder is often seen in female athletes in cross country, gymnastics, ice skating and other sports “where a slender physique is considered the ideal.” The number of female athletes impacted could be as high as 50 percent.

While a female athlete with F.A.T. may also have anorexia, the two conditions are distinct from each other, Castonguay said. The key difference is that females with F.A.T. tries to lose weight to improve speed or athletic performance, while a female with anorexia tries to lose weight due to concerns about her appearance.

“I was trying to lose weight to run faster,” Olivia said. “Not because of how I looked. I was trying to go faster, not reach a certain weight. That’s how I explain the difference.”

Castonguay said she is proud of Olivia’s progress.

“It went great,” Castonguay said of Olivia’s most recent track season. “We weren’t sure she’d be able to run two seasons ago. Olivia and her family were really dedicated to keeping her healthy. The treatment takes time and effort. It’s not something everyone can do, but she did it. I’m glad she is talking about it publicly, to raise awareness. Many would not.”

The long-term prognosis for a patient depends on how early F.A.T. is detected, Castonguay said. If it is caught in the early stages, a patient can be cured. However, those with more advanced cases may find themselves struggling in high-stress situations, and some patients may struggle with F.A.T. for the rest of their lives.

Olivia said the recovery process has been challenging.

“It was interesting how hard it was to recover,” she said. “I thought ‘oh, I just have to eat,’ but it wasn’t that simple. I had a lot of relapses. I didn’t want to acknowledge I was sick. In my sophomore year I had relapses, but by the end of the year I was getting better as I realized what I was doing to myself.”

Castonguay said one hurdle is making coaches realize the seriousness of the issue.

“Not having periods is not good for female health,” she said, adding that menstrual dysfunction can impact bone density, and could even lead to osteoporosis.

One way to help prevent F.A.T. is to not do group weigh-ins, Castonguay said.

“They also shouldn’t say ‘lose five pounds,and you will go faster,’” she said. “With young people, they think if five is good, 10 is better.”

The athlete can always get advice from their family doctor and get a referral from a dietician, Castonguay said.

While male athletes may experience similar problems from not eating enough to sustain intense physical activity — particularly men in sports such as weight lifting, wrestling, body building or boxing, where athletes must “make weight” — there is not a lot of information on this ailment regarding male athletes.

Castonguay believes it’s not as prevalent in males.

Olivia said she is grateful to Castonguay and Akron Children’s Hospital.

“Not everyone has that resource,” she said. “Akron Children’s really helped me.”

Olivia will be the captain of next year’s cross country team, and runs track. She also participates in Spanish Club, Garden Club, Sexuality Alliance and the Service Leaders Program. She also has been working on a couple other projects through independent study. One is creating a presentation to educate others about F.A.T. She already has done one presentation at the school.

“It happens to a lot of athletes,” she said.

She is also working on is developing a protein bar designed for athletes, one with enough calories to sustain an athlete’s needs and with natural ingredients. Most energy bars, Olivia said, are aimed at those interested in losing weight.

“There’s not enough energy for someone who could use up 400 to 800 calories in a cross country practice,” she said. “The ones that do focus on body building have a lot of unknown ingredients. When you have an eating disorder, you memorize the nutrition labels, believe me. I was scared to eat them.”

Reporter April Helms can be reached at 330-541-9423,, or @AprilKHelms_RPC