Molly Seidel Still Struggles

Content warning: This story covers disordered eating. If you are struggling with an eating disorder and are in need of support, please call the National Eating Disorders Association Helpline at 1–800–931–2237. For a 24-hour crisis line, text “NEDA” to 741741.

On its face, Molly Seidel’s explanation for pulling out of the World Championships marathon last summer—she had a stress reaction in her sacrum—seemed clear enough. On July 1, Seidel’s agency, Total Sports, issued a statement on Twitter citing the injury. “Continuing to train and race would mostly likely lead to a full fracture, so we made the hard decision to pull from worlds,” it read in part. Keira D’Amato got the call to replace Seidel.

The lower back injury, it turns out, really was a full fracture. And that fracture was only one problem in Seidel’s overall health outlook.

The Olympic bronze medalist, 28, had also been struggling with her mental health—and it’s a struggle that is ongoing. In February, she received a diagnosis of attention-deficit hyperactivity disorder (ADHD) and was trying different strategies to cope with the symptoms, which include depression, anxiety, and the return of the eating disorder that Seidel has suffered with at different times for the past 12 years.

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Seidel battles bulimia, and in interviews with Runner’s World, she described it as coming in waves. “It’s been a persistent problem on and off, and it just got so, so bad after the Olympics,” she said.

Seidel has been working all summer to get it back under control, but she feels deep embarrassment that it remains an issue for her.

“I’m working as hard as I can to come out the other side,” she said. “But it’s a huge sense of shame and a sense that I’ve just let a ton of people down. People expect me to be fully cured, fully healed, be an advocate for this stuff.

“And it’s not a completely linear thing. I think that’s been the hardest thing. I just want it to be this one linear, upward trajectory. It never is.”

A born marathoner

For the better part of two years, Seidel’s progress in the marathon was a straight line up.

In February 2020, in her debut at the distance, she finished second at the Olympic Marathon Trials, making Team USA for Japan. At the time, her eating disorder was in the rearview mirror. Seidel was instantly a fan favorite, both for her remarkable performances and her honesty about how obsessive compulsive disorder and bulimia marred her college running career, and how she had sought treatment after she graduated from Notre Dame.

Given her athletic success, she became a powerful symbol of triumph over disordered eating.

The Olympics were postponed for a year due to the coronavirus pandemic, and in October 2020, Seidel ran the London Marathon, an elite-only race held on a closed loop course. She finished sixth, improving her PR to 2:25:13.

Then came 2021. In the oppressive heat and humidity of Sapporo, Japan, Seidel won the bronze medal, running 2:27:43 while television cameras showed her friends and family cheering wildly at home in Wisconsin. At the medal ceremony, Seidel stood on the podium and beamed.

But in the days and weeks after that performance, the requests from media, sponsors, and fans became overwhelming.

“I don’t think I ever fully processed just how difficult the Tokyo experience was even though it was enormously positive,” she said. “By the end of it, it was incredibly stressful. I was bulimic in Tokyo. I never took the time to fully process and reset afterward. It was kind of like go, go, go, go, go. Always got another race. We’ve got New York, we’ve got Boston. And it kind of just compounds to the point where I was incredibly depressed. Anxious all the time. And just everything was coming back.”

She managed to get through the 2021 New York City Marathon. She finished fourth, was the top American, and ran another PR: 2:24:42.

Behind the scenes, things were far from perfect. Seidel was chronically undereating, and she was overwhelmed with the demands of her job that had nothing to do with running. On Instagram, she’d get direct messages. Half of them she characterizes as vile—attacks on her running performances or worse.

The other half were from people who suffered from eating disorders and wanted her advice.

A typical message might say, “I have an eating disorder and my doctor told me to do this but what do you think I should do?”

Seidel wasn’t prepared for the influx of messages. She thought to herself: “I don’t know, I’m not licensed, and I’m going to be honest, it’s pretty triggering,” she said. “I hate using that word, but it’s true. I’m feeling like a fraud already. I’m literally going through treatment. I deal with this on a daily basis. And I’m, like, being expected to be this perfect icon to be held up.”

Taking a step back

In the early part of this year, Seidel ran two races: The 10-kilometer U.S. Cross-Country Championships (she finished eighth) and a half marathon in Arizona, which she won in 1:10:06. Then she began her buildup for the Boston Marathon.

She was the hometown favorite, because she had lived and trained in Boston for more than four years after college and was still living there when she made her marathon debut. (Seidel moved to Flagstaff, Arizona, in the spring of 2021.)

If the post-Olympics time period had been a whirlwind, the days before Boston were a full-on frenzy of appearances and media requests. Would an American woman with ties to the city break the tape on Boylston Street?

On race day, Seidel had television cameras tracking her every step. She went with the leaders, Peres Jepchirchir of Kenya and Ababel Yeshaneh of Ethiopia, as they broke the race open early with a hot pace. Seidel paid for it later. By mile 15, her right hip was hurting, and she dropped out of the race. It was her first setback in a marathon in five starts.

After the race she was in a really dark place, she said. She was having what she called a “full-on relapse of bulimia” and weekly panic attacks.

“I should have taken that as an indicator of, ‘Okay, we need to reset and step back,’” she said. “But it was this mentality of, ‘I just need to get through worlds, I just need to get through worlds.’”

In June, she pulled out of the New York Mini Marathon 10K, explaining on Instagram that she had begun taking Adderall for ADHD and was seeking a therapeutic-use exemption (TUE) to be able to use it in competition. Adderall is allowed by the World Anti-Doping Agency during training, but athletes can’t have it in their system during races.

Dr. Tom Hildebrandt, professor of psychiatry and director of the Center of Excellence in Eating and Weight Disorders at Mount Sinai Health System in New York, said roughly 20–30 percent of people with bulimia also have ADHD. He has not treated Seidel.

ADHD diagnoses are often missed, primarily in women, he said, because it will manifest as inattention. “It’s particularly true in people who are, let’s say, good at things. You can have a high IQ and still be inattentive,” Hildebrandt said. “You can be appropriate at school or good at school and still be inattentive. It’s not picked up. Whereas if you act out a lot, particularly in boys, it’s more likely to be picked up.”

Observers wondered if Seidel would be able to navigate the bureaucratic TUE process for Adderall before the World Championships in July in Eugene, Oregon.

Her Olympic performance had earned her the chance to represent Team USA at worlds. The other two American women on the team, Emma Bates and Sara Hall, were selected from their performances at the Chicago Marathon in 2021.

Seidel went to Eugene in late June, during the U.S. Outdoor Track and Field Championships, for what is known as team processing, an administrative session to prepare athletes for international competition. They fill out paperwork and get sized for uniforms. And, new in 2021, athletes undergo a mental health screening.

Seidel answered the questions on the screener honestly—and her responses raised red flags. The U.S. Olympic and Paralympic Committee (USOPC) doctors, who administer the screening, referred her for treatment.

A USOPC spokesperson wrote in an email to Runner’s World that the test screens for anxiety, depression, eating disorders, drug and alcohol abuse, and sleep disorders, among other things. The results athletes provide are then flagged for follow up by a USOPC licensed mental health provider. From there, the athletes are connected to mental health resources.

“The screenings are not intended to screen athletes out of competition or off Team USA, but are a part of a broad approach to intervene and provide support to athletes who struggle with mental health, so they are able to achieve their goals,” the spokesperson wrote.

Seidel said she was connected with a new team of specialists, many in Salt Lake City. “USOPC set up everything for me and they’re continuing treatment for me,” she said. “Honestly it was so much easier being able to have them take the reins on it. And feel very much like, ‘Okay, they’re going to help me out on this.’”

The week after Seidel had gone through team processing, she had an MRI on her back, which at the time, was misread as the stress reaction in her sacrum.

The physical pain and her mental health issues were enough for her to pull out of the World Championships. D’Amato was ready as the alternate, and with less than three weeks of training, she finished eighth in Seidel’s absence.

A hopeful future

Seidel has been making progress all summer, although her running has had stops and starts. A repeat MRI later in the summer showed the injury to her sacrum had been much worse than she originally knew—a full fracture—and explained her persistent pain. Now she’s back to daily running, although she has some tendon pain in her left ankle and Achilles as she builds back up.

She and her coach, Jon Green, are tentatively targeting three races in the fall—a 5K, a 10K, and a half marathon—to use as benchmarks as she returns to marathoning, ideally in 2023 if all goes well.

Green called them stepping-stone races, to get Seidel back into enjoying running and racing again. “That’s top of my priority list right now,” he said. “As races come around, if it will make things better, we will do them. If it won’t, we won’t.”

According to Hildebrandt, at his clinic, professionals frequently see elite athletes who have lost their pleasure in competing.

“The eating disorder provides yet another obstacle for them performing at their best,” he said. “It actually steals from their experience. They don’t enjoy the athletic process the same way. The eating disorder corrupts it.”

The summer has been an opportunity for Seidel to navigate the challenges of living with ADHD and its symptoms. “It’s kind of like learning to work with my brain,” she said. “When my brain is at its best, it actually works really well and is super conducive to really good marathon running.”

She is no longer taking Adderall. “It makes me feel like shit in training,” she said. “It makes me not eat. I think the Adderall through this spring was kind of like sticking gum in the cracking dam of my mental health.” She is, however, still pursuing a TUE for using it during competition, in case she needs it again at some point in the future. But the pressure to get it in time for upcoming races is lifted.

Instead, she is taking Naltrexone, which Seidel describes as an anti-addictive medication to help her manage the addictive qualities of bulimia. There are no restrictions on its use by anti-doping authorities.

With the help of her mental health team, she has learned that medication on its own is not going to be enough. Seidel needed to change her lifestyle as well.

That includes limiting her social media usage. She gets locked out of Instagram after 5 minutes a day, which is just enough to fulfill her sponsor obligations. Some people, she says, can handle more. Others can’t—and she’s one of them. Between the hurtful comments, the direct messages, and the inevitable comparisons she makes between herself and other elite runners, she ends up spiraling when she’s on too long. “Social media is really toxic for my brain,” she said.

The only person who has the password to change her social media time limits is her boyfriend, Matt Shapiro, a photographer whom she matched with on the dating app Hinge, in February, when she was really hurting. “It’s worked out despite us starting dating during a frankly horrible time for me,” she said. “He’s just been awesome with it.”

He knew running a little, before he met Seidel, but he wasn’t closely following the elite ranks. That remove has been helpful for her. It wasn’t until he watched her on TV in the Boston Marathon that he began to fully understand the sport and her place in it.

When she returns to major events, Seidel now knows she’ll have to schedule downtime before and after to decompress. “Boston was honestly hell on earth for me,” she said. “Because those days leading into it was constant media stuff, constant media appearances. And so it's like figuring out like, ‘Okay, I've got to be really good about lowering that temperature, and lowering the amount of stress that I’m experiencing and not just letting things pile up.’”

For that, she’ll rely more on her team, including Green and her agent, Chris Layne. Her job is to run.

She also is working with a dietitian to make sure she’s consuming enough calories, and she has substantially increased her carbohydrate intake. She’s coming back from long-term underfueling, and she wants to impress upon her followers that her eating disorder is not what made her successful at the Olympics. It’s the opposite.

“This spring I was not eating enough and I fully fractured my sacrum,” she said. “If I don’t eat enough, my bones will break.”

For now, Seidel is looking forward to seeing what she can do when she’s fully healthy. The next year will be about approaching 2024 at full strength. “I truly believe I can be stronger without bearing the weight of this eating disorder,” she said.

“If anything, I want the message to be that this has really hindered my career. And I want to see what I can do when I’m not bulimic. Because it is the one thing holding me back right now.”