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Kayleigh Durm was a junior in high school and a coxswain on the school's lightweight 8 rowing team in 2005, when her coaches started jokingly asking her a question during team dinners.

"Oh, Kayleigh, do you really need to eat that extra breadstick?" they would say.

She was 4-foot-11 and weighed 95 pounds.

While she says her coaches made the comments in a teasing and good-natured way, the words stuck with her, and she started to question her own weight and eating habits and how they would affect her team during races.

"I became hyperaware of what I was eating and would always say, 'I'm full, I don't need any more food,' even when I was starving," she says. "I just didn't want to get to that point when I was adding more stress to my boat, where I was the coxswain who weighed 100 pounds and not 90."

After coxing for a year at Syracuse University, Durm left the team after feeling "burnt out." She ultimately transferred to Ohio State, where she didn't row, and graduated in 2011. She's now the director of rowing operations at Columbia University, after spending three years as a volunteer coach at MIT. She had rediscovered her passion for the rowing in 2012, posting about the sport on her social media accounts and quickly becoming an accessible resource for high school coxswains. That same year, she founded the blog Ready All Row blog.

However, it didn't take long before Durm discovered a dangerous trend. Over and over, she received one simple question from high school-aged coxswains, both male and female: "What laxatives do you recommend to lose weight?"

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In a survey of 201 Division I college athletes by espnW, 32 percent of rowers answered "yes" when asked if they've ever had an eating disorder. (That compares to 14 percent of all athletes surveyed.) Fifty-four percent of the rowers said they have a teammate with an eating disorder.

And the rate of eating disorders among rowers outpaces that among women in general. According to a 2006 study from the Multi-Service Eating Disorders Association, 15 percent of women ages 17 to 24 have an eating disorder, and a study published in the National Center for Biotechnology Information found that 13.5 percent of women undergraduates an eating disorder.

So what is it about rowing that seems to foster disordered eating? Much of it seems built into the nature of the sport itself.

"Imagine how stressful that must be? You've been training for years and you might miss out because you're not at the ideal weight."

Ruth Whyman

Rowers fall into two categories: lightweight and openweight (also known as heavyweight). Lightweight, traditionally for shorter, smaller athletes, commands a maximum weight of 130 pounds for female rowers, and the average weight for everyone in a boat can't exceed 125 pounds. Openweight has no official weight restrictions. In both divisions, the coxswain, who leads the team and steers the boat but does not actually row, must weigh at least 110 pounds, or otherwise must bring weight, such as sandbags or water, with them in the boat to make up the difference.

While openweight rowing is an official NCAA sport with championships in Varsity 8, Second Varsity 8 and Varsity 4, lightweight rowing is not, and only a handful of colleges have teams for women. Both divisions, however, are featured in the Olympic Games and in many high schools across the country.

Lightweight rowers are weighed on race day and can potentially lose their seat in the boat if they don't make the requirement, so some live in constant fear of not making weight. And it can become an all-encompassing obsession.

"I've been in environments with [lightweights] where weight and food is the sole thing they talk about in the run-up to racing," says Ruth Whyman, a former rower at the University of Washington and a member of Great Britain's national team. "They segregate themselves from heavyweights because it's easier not to eat around them, but all they talk about is food.

"Imagine how stressful that must be? You've been training for years and you might miss out because you're not at the ideal weight." Openweight rowers experience a different -- but equally demanding -- kind of pressure. From feeling the need to look a specific way to being measured using a ergometer (which determines how much energy one is using in comparison to their weight), openweight rowers are constantly thinking about their weight in terms of maximum efficiency in the boat. The best rowers are typically tall and lean because they have the best power-to-weight ratio -- a formula that divides a rower's energy output in watts by their weight to determine a specific score. As heavier rowers add more weight and drag to the boat, those individuals are expected to contribute more power to compensate.

"There is such a specific body type that people aim for in rowing," Whyman says. "But I do think that a lot of that pressure comes from within the squad itself. I have never felt pressure from a single one of my coaches. Whether it's my national team or for Washington, I've never felt pressure from them to lose weight."

While every team relies on power-to-weight metrics differently, with some putting more emphasis on it than others, many rowers put great stock in their own numbers -- as many college-level and professional athletes do -- and work to improve in this regard. The lighter the overall boat is, the faster it will go, and this concept is not ignored.

"The pressure for having the perfect rower body came from me, because I knew what I wanted," Whyman says. "I was comparing myself to a lot of other women constantly, and it's extremely different to be in the changing room and be self-conscious if someone else has what you're striving for, and you don't have it, and thinking that affects you as an athlete. Thinking, 'Maybe if I was just five pounds lighter, I could go a second quicker.' There's a lot of pressure put on me by me."

While other sports, such as gymnastics, seem to favor particular body types and focus on appearance and physique, rowing is unique in its emphasis on weight and numbers on the scale, regardless of division.

"The tough part about rowing in particular is that you are literally pulling your own weight," says two-time Olympic gold medal-winning rower Susan Francia. "If a rower is overweight they are literally weighing down the boat. In rowing, your power-to-weight ratio is pretty important, so it's a fine balance between encouraging athletes to be at their ideal weight and pushing them into body image issues, which control their eating habits."

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Coaches must walk a thin line, says Meghan O'Leary, right, a member of the 2016 U.S. Olympic rowing team, as they might need to instruct rowers to lose weight without shaming or encouraging bad habits. Damien Meyer/AFP/Getty Images

Durm says that she did skip meals during her junior year in high school, which greatly affected her energy level at practice. (Her decision to cut back on eating was short-lived when she saw the effect it was having on her performance.) However, she remembers watching teammates and opposing crews go to drastic lengths before weigh-ins on race day to make the necessary weight.

"Everyone kind of experimented with losing weight," she says. "Especially when we were at a race, and we were an hour from weigh-in, you would see girls putting sweatpants and trash bags on when it was 84 degrees out -- that was some of the more obvious stuff. But there were other girls who would disappear into the bathroom for a while and come out, and you knew they had been in there making themselves throw up. But you couldn't directly say that to them without it causing a problem."

Coaches, on the other hand, must walk a thin line, says Meghan O'Leary, a member of the 2016 U.S. Olympic rowing team, as they might need to instruct rowers to lose weight without shaming or encouraging bad habits. According to espnW's survey, rowers said they've been called fat by a coach at the same rate as respondents overall -- about one in five.

"With some athletes, I might say, 'That's not a safe weight for you to be, so let's just forget that goal and be happy where you are.'"

Elizabeth Avery

According to the Seattle Times, the University of Washington fired Bob Ernst, its longtime women's rowing coach, in 2015 after he reportedly made disparaging remarks about women on the team about their weight and performance. Rowers voiced concerns about pressure to skip class in order to meet a weekly quota of time-trial workouts, undergoing forced weigh-ins (which violated a school policy) and living with a general sense of fear, according to the Seattle Times. The school does not have a lightweight women's program.

Whyman, who graduated from Washington in 2014, said she never experienced anything like the complaints she read about, and she said she was surprised by the news. A spokesman for Washington declined to comment.

Coaches should be required to take classes focused on eating disorders so they know how to deal with athletes struggling, how to ensure they aren't doing anything to foster such behaviors and how to recognize warning signs, says Elizabeth Avery, a Boston-based nutritionist who works with student-athletes at Emerson College as well as in her own private practice.

"With some athletes, I might say, 'That's not a safe weight for you to be, so let's just forget that goal and be happy where you are and just try to get you to perform the best you can,'" Avery says. "What I always do with athletes, instead of focusing on their weight or their appearance, I talk about nutrition expressly around performance optimization."

Athletes can stop viewing eating as a negative, but rather as a necessity and an essential part of training, if they focus exclusively on how they can use food as the proper fuel for their sport, says Avery, who also helps athletes determine appropriate eating times for the ultimate benefit.

Avery, who rowed for Colgate University, says the risks caused by lightweight weigh-ins at the high school and college levels outweigh the benefits of having a class for smaller athletes who might be attracted to rowing.

"A lot of teams have an A and B boat, like varsity and junior varsity, and the bigger programs have a C and a D boat, and they should all be openweight," Avery says. "If you don't have the power to make the A boat, it's OK to be in the C or D boat, but you shouldn't have to worry about your weight. Because I think what may start out as simply trying to make weight can often lead to something much deeper, like a body image problem."

The NCAA, for its part, has recently made mental health, including eating disorders, a priority. In 2016, the organization worked with mental health professionals and organizations to develop a set of guidelines and best practices that have since been distributed to all member institutions in how to recognize, treat and prevent disordered eating habits, as well as other conditions.

"We know that there are a lot of benefits to sports, whether it's building self-esteem or promoting an active lifestyle throughout one's lifespan, or teaching skills and teamwork and character traits that are wonderfully positive," says Dr. Jessica Mohler, the coordinator of sport psychology services at the United States Naval Academy and a member of the NCAA's Committee on Competitive Safeguards and Medical Aspects of Sports. "Sports have the ability to provide that experience for our student-athletes, but we know that athletic competition also has some risks and it can also be stressful -- both psychologically and physically.

"And certainly the pressures of sport competition, the pressure to perform at a high level added to sports' body types and size -- sports that potentially emphasize thinness or certain body types related to performance -- those athletes have an increased risk to develop really disordered eating behaviors."

The NCAA also sent out modules to all coaches on recognizing the signs and symptoms for a number of mental health disorders in hopes of providing education for those who work with student-athletes on a daily basis, Mohler adds.

But for Durm, the first line of defense is teammates looking out for each other.

"Your No. 1 athlete could be doing some of this stuff that an athlete with a known eating disorder is doing, and you're not paying attention to her because she's pulling good ERG scores and looks healthy," Durm says. "You need to say, 'We can't have this -- it's not good for you, first of all, but also it's not good for others in the sport. We don't need to be perpetuating these behaviors."

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According to espnW's survey, about two out of every three female college student-athletes say they worry about long-term damage to their bodies. Kristen Maloney, a two-time U.S. national all-around champion in gymnastics in 1998 and 1999, a member of the 2000 Olympic team and one of the most successful collegiate gymnasts in UCLA history, was equally known for her toughness and ability to work through pain as she was for her legendary career. She had eight surgeries while competing and returned to the sport each time. Now 36, she looks back at her gymnastics career with new perspective on her injuries and the treatment of them.

Less than a year before the 2000 Olympics, I had a titanium rod surgically inserted into my leg. I was 18 years old, and I'd been in pain for a couple of years at that point. I had a stress fracture that just wouldn't heal -- and I was out of time to rest it. I wanted to be an Olympian, and I would do anything to get there. This rod was supposed to stabilize my leg and help it heal.

It all sounds pretty intense, but the surgery itself wasn't that crazy. I've had many surgeries after, and honestly, this was a relatively easy one. I went in, they put the rod in and I left. I would have watched the procedure if they had let me.

Unfortunately, though, the surgery didn't help.

The fracture didn't heal like it was supposed to, and my leg started to hurt again pretty quickly. In the lead up to the Olympic trials, I tried to reduce my training -- to do landings onto softer mats, or to scale back on how many of each skill I did -- but the truth was that I had a fracture in my bone. Even if I changed my training, I was still going to have a lot of pain.

So that year I was just focused on getting through it all. The main goal in training was to make sure I was putting an equal amount of weight on both legs when I landed dismounts, jumps and tumbling passes. You go high in the air in gymnastics, and it's essential that the force of your landing is spread evenly throughout your body, or you'll get hurt. I would try to put all of my attention on the right way to do each skill, to try to distract my mind from the pain as I pounded both legs, equally, into the ground.

Less than a year before the 2000 Olympics, when she was 18 years old, Kristen Maloney had a titanium rod surgically inserted into her leg. Mike Powell/Getty Images

Looking back, this sounds like so much pain, and it was. But I can't even really put into words just how badly I wanted to be on that Olympic team. Without question, it was what I was going to do. I was going to be on it, no matter what. There was no other option for me. Anything that stood in the way of that was just something to be dealt with.

And this injury was that -- just something to be dealt with so I could be on that team.

During that time I knew my coaches wanted the best for me, and it wasn't easy for them to know what the best thing was. I'm not sure any of us thought long term. I wanted to compete at the Olympics, and I was going to find a way to do it. I don't harbor any sort of resentment. If they had tried to stop me I would have found new coaches.

In the months leading up to the Olympics I was also rehabbing a shoulder injury. My shoulder had been bothering me for awhile -- I think I had overcompensated by training on bars too much while trying to rest my leg injury. In a weird way, dealing with the injuries was actually a welcome distraction. It was something else to focus on besides making the Olympic team. I had won nationals in each of the two years before and I felt enormous pressure to prove myself again. It was the kind of pressure that if you thought too much about, it could crush you -- it was just too hard to wrap my brain around it all.

Even without as much training time as I would have liked, I placed third at the Olympic trials and was named to the team. I was so very proud of that achievement, but when I think about the Olympics, my overarching memory is of how difficult it was. My leg always hurt. There wasn't much I could do. No amount of Advil was going to heal a stress fracture.

When Kristen Maloney looks back on the 2000 Summer Olympics, she says her overarching memory is of how difficult it was because of the pain in her leg. Doug Pensinger/Allsport/Getty Images

After the Games were over I went to college at UCLA and competed my freshman year, but the pain was still just as bad. That summer after, I had another surgery where they took the rod out. And then I rested. I did almost nothing my entire sophomore year of college. I didn't do anything that would be high-impact on that leg. I mostly just walked around, and I did very little gymnastics.

So you can imagine how devastated I felt when it still didn't heal, even after a year. The doctors wouldn't clear me to do gymnastics unless I had a rod put back in, so I went through it all over again.

This time, though, I ended up with a bone infection. I knew something was very wrong. My leg hurt to the touch. I couldn't sleep at night. It hurt even more than it had at the Olympics. I felt like I'd hit rock bottom.

The doctors told me that I wouldn't do gymnastics again. They told me I should just be thankful that I had my leg, that they had caught the infection in time and that I would eventually walk normally again. Walking normally again was the goal.

But I remember, very clearly, thinking to myself, "No, no. I'm going to do gymnastics again. You're just being dramatic."

I was determined, and probably a little naïve about the situation, but maybe that worked to my advantage. I'm not sure if I should have taken those statements more seriously, and as an adult, it makes me cringe a little to think that I pretty much dismissed them. At the time, though, I didn't get what the big deal was -- people come back from injuries all the time, and I would, too. I honestly don't know how I managed to get back to gymnastics. It was part luck and part stubbornness.

I had to sit out another full year. When I came back, I had to go very slowly, and I was like a little kid in the gym. I loved every minute of it. I remember the first time I competed vault again in a college meet. It felt amazing. I was so happy to be back.

Best of all was that I wasn't in pain anymore. Sure, I had aches and pains, but the throbbing, all-encompassing pain I had felt for more than five years was gone. I competed my last two years at UCLA, and when we won the 2004 NCAA team championships my senior year, it felt every bit as good as it had felt when I made that Olympic team. I count those two achievements as absolutely equal. When my NCAA career was over a year later (I stayed one additional year as a redshirt), I was sad, but I was finally ready to be done with the sport.

Kristen Maloney, who has coached both college and club gymnastics, says young gymnasts need to know how much work goes in to pursuing the sport at the college or Olympic level. Iowa State Athletics

During my career I never thought, I could be hurting my body permanently. I probably should have. If I could, I would probably change almost everything about the way I addressed my injuries at the time. I wish I had given them the time to heal early on, so I wouldn't have been in so much pain, for so many years.

But then again, I also wanted to make an Olympic team. I still don't even know: How much could I have rested and healed, and still been a viable candidate to make the team? Every year it is very political. Taking time off to heal hurts your chances, let's be honest. I probably could have been on the Olympic team still, but there was never any reassurance. So even with hindsight, I don't have too many regrets.

All in all, I think I got lucky. My shoulders are a mess, and I have some knee pain that's related to the leg injury, but I am pretty much fine. My shoulders hurt if I try to do anything overhead -- swinging, throwing or hanging. I performed in Cirque du Soleil for a couple of years after college but stopped when shoulder pain started to bother me too much. I don't think I'd ever be able to do CrossFit, and a marathon is probably out of the question for my leg. (Though maybe, if I really put my mind to it?) In my everyday life, though, I'm doing all right. I'm in a lot less pain today than I was as a gymnast.

I have a newborn son, and I think about whether I would want him to train for the Olympics. If it was what he really wanted -- and not just because it was just something he thinks he should do, or something he's good at -- I'd say yes. It's all worth it.

I've coached at both the college and club level, and am currently doing gymnastics choreography for private clubs while studying to take my judging exam. I love gymnastics, and I think I'll always want to be involved in the sport.

I think young gymnasts need to know that pursuing the Olympics or a college career requires a lot of hard work and takes a ton of commitment, and not to lose sight of what they want, but at the end of the day it's also OK if they can't get there. I'd tell them, "It's OK if you have an injury and you need to take time off to let it heal. It's OK. Really."

Courtesy Chloie Jonsson