Boston Marathon Prep and the Pressure to Perform: A New Jersey Eating Disorder Therapist Weighs In
For many runners, the Boston Marathon is the definition of success. Qualifying and being able to stand on the iconic finish line means the world. Maybe even more so than how you perform in the marathon! As a New Jersey eating disorder therapist, I have seen the impact these big goals can have on a runner. From the high stakes pressure to qualify to the early morning long runs, marathon prep is not an easy task. It is easy to fall into unhealthy behaviors and spiraling thoughts.
My own experience with the Boston Marathon is untraditional. I have never been the one running down Boylston Street (sprinting down the sidewalk to see the finish doesn’t count). For me, the Boston Marathon represents community. I was introduced to the Boston Marathon through my dad and his experience running it. Coming from New Jersey where the streets are extremely flat, I remember him prepping for the race by running the same two hills, Moorestown - Mount Laurel Road and what was known as triple hill in Haddonfield, in order to prepare for the famous Heartbreak Hill. Knowing that Heartbreak Hill would be the toughest part, I was determined to be there to cheer him on.
The thing that stands out to me the most from these memories, however, is the running community that filtered through the city the entire weekend. Despite being in the throes of my eating disorder during his first Boston Marathon, my memories remain priceless, filled with pasta dinners, talks of fueling, and the kindness spread from runners of all abilities. These experiences now shape the way I support athletes in my practice, offering eating disorder therapy that honors both their goals and their well-being.
The Pressures of Marathon Training
Now that we know why training and running a marathon can be so incredible, let’s dive into the hard stuff. If you are an elite-level runner, racing the Boston Marathon, there is a lot of pressure. In recent years, there have been some amazing performances by Americans, such as Meb Keflezighi in 2014 and Des Linden in 2018. The high expectations to perform well can make it difficult to enjoy the process. How an athlete internalizes these pressures can impact their confidence, self-image, and performance.
These pressures are not only present in elite athletes. For many Boston Marathon qualifiers, the pressure is in the qualifying part. With runners getting faster, the qualifying times are faster. For the 2025 Boston Marathon, the “cut-off” time was actually 6 minutes and 51 seconds faster than the qualifying standard per age group. Yes, that means you had to run 6 minutes and 51 seconds faster than the actual qualifying time. So now, for 2026, the qualifying times have been dropped by 5 minutes per age group, making it even more difficult to hit that standard.
Connections Between Performance Pressure and Eating Disorders
Endurance sports have a higher risk of eating disorders. Athletes training for marathons face obstacles such as proper fueling and body image. Fueling has changed over the years. Recent studies show that a higher carbohydrate intake per hour, results in better performance and recovery. There are no more recommendations for 1 gel per 45 minutes!
Registered Dietitian, Rebecca Jaspan states, “The recommendation is to eat 30-50 grams of carbohydrates per hour. This is going to increase or decrease based on mileage and higher efforts you’re going to need more. For a 4+ hour marathon, aim for 2-3 gels per hour, which translates to about 8-12 gels for the whole marathon.” Rebecca is the owner and dietitian at Rebecca Jaspan Nutrition where she works with athletes that are struggling with disordered eating or eating disorders.
Many runners begin restricting food through a desire to eat “perfectly” in order to optimize performance and maintain a specific weight. This stems from many myths around there being a perfect way to fuel and about body size and performance. It is all out of good intentions. However, pushing your body while under-fueling can lead to dangerous consequences. At Serendipity Counseling, we help runners navigate these challenges with compassion and evidence-based support.
Warning Signs and Consequences of Underfueling during Race Prep
Relative Energy Deficiency in Sport (RED-s) is a term used to describe what happens when we are not fueling our body enough for the amount of running being done. RED-s impacts every system in our body from the endocrine system, cardiovascular, nervous, reproductive, muscle, and skeletal. This can look like bone injuries, difficulty recovering from workouts, loss of period, difficulty managing emotions, decreased performance, mood swings or irritability, and getting sick often. Nobody wants to get to the end of a marathon training cycle and get sick or injured.
Closing Thoughts from an Eating Disorder Therapist in Cherry Hill, NJ
Understanding when dedication turns into harmful behavior can be difficult. It is usually a slow decline and not so black and white. The Boston Marathon is an amazing accomplishment and something to be celebrated. However, remembering the basics of taking care of your body should always be number one. Without proper training, fueling, and rest, you may never get to see just how much fun crossing that finish line can really be.
Remembering why you are setting this goal is an important and impactful factor to come down to. If you are not enjoying the journey, the pressure will feel high on Marathon Monday. Having others to run with can help increase the enjoyment and fun throughout your training process. Community has always been a big part of my running journey and what led me to love the sport. From my middle school days on the Mount Laurel Striders to the days cheering my dad on at his last Boston Marathon, running has connected me to so many wonderful people. It has made me feel connected, loved, and a part of something greater. If you are looking for a community, check out your local running store and ask about training runs!
Begin Working with an Eating Disorder Therapist in Cherry Hill, New Jersey
Preparing for high-level competitions like the Boston Marathon can amplify the pressure to perform, both mentally and physically. For many athletes, that pressure can quietly impact their relationship with food, movement, and self-worth.
At Serendipity Counseling, I offer eating disorder therapy that supports athletes in finding balance between performance goals and overall well-being. Therapy can help you redefine success in a way that prioritizes your health, not just your finish time. If you’re feeling overwhelmed by the demands of training or struggling with body image and eating patterns, here’s how to take the next step:
Schedule a free 15-minute consultation to discuss your experience and goals.
Begin eating disorder therapy tailored to the unique mental and physical demands athletes face.
Get the support you need to move forward with confidence, clarity, and care.
Additional Therapy Services for Athletes in New Jersey
In addition to individual therapy, I provide focused support for runners and lead groups designed specifically for athletes seeking a safe space to share and heal. I also engage in community education and advocacy to break the silence around eating disorders in sports. When you're ready to reach out, support is here.
About the Author: A Compassionate Eating Disorder Therapist in NJ
Kate Ringwood is a licensed professional counselor and lifelong runner. Kate ran competitively in high school and college, leading her passion for helping others with their own relationship with running. Her passion to help guide folks through having a healthy relationship with food, body, running, and performance is what led her to open up Serendipity Counseling.
