Eating Disorders in Athletes

Eating disorders such as anorexia and bulimia occur at an increased rate in athletes compared to their non-athlete peers.  Traditionally, the athletic culture has placed greater emphasis on an optimal body type for each sport, and even more specifically- each position played.  Athletes are at greater risk due to the heavy demands of exercise required to participate in the sport, both to practice and to compete.  Many spend a large portion of their day in the gym, or participating in their sport, quickly depleting their energy stores.  The physical and psychological effects of excessive training and undernutrition lead to the development of full blown eating disorders and long term medical complications.  Discerning what appears to be typical behavior for a sport from a potential problem can be challenging.  A study of Division I athletes revealed that 33 percent of female athletes had symptoms, attitudes, and behaviors placing them at risk for anorexia nervosa.  Meanwhile, these athletes are often weighed, measured, and have their body fat measured in order to make a cut.  The training required for sports is more than what is “necessary” for health, but an eating disorder will have adverse effects on an athlete’s health and performance. Professional treatment is required in order to safely navigate the road to recovery.

Three conditions that are not classified as eating disorders, but rather “subclinical”, are anorexia athletica, muscle dysmorphia, and the female athlete triad. Individuals with these conditions do not always meet eating disorder diagnostic criteria, but left untreated, these individuals could experience extreme health consequences and even progress into a clinical eating disorder.

The term “anorexia athletica” is used to describe unhealthy weight loss processes found in some individuals. They achieve this weight loss through compulsive, excessive exercise beyond the level of healthy physical activity. Many symptoms of anorexia nervosa are present as well, such as restricted caloric intake and fear of weight gain.

Muscle dysmorphia involves a preoccupation with not being muscular enough. Seen more often in males, individuals perceive their body to be much smaller than it actually is. As a result, they spend hours each day at the gym and may even resort to steroids in an attempt to gain muscle mass.

The female athlete triad is relatively common among young women that play sports. It involves three conditions: menstrual dysfunction, low energy availability, and decreased bone mineral density. When energy availability is persistently low, normal bodily processes cannot function properly. The body can stop producing adequate levels of estrogen, which is necessary for menstruation and bone health. Menstruation must be restored through increased caloric intake, decreased physical activity, or both.

Athletes that participate in weight-class sports or those that emphasize a small, thin body are at even higher risk of developing an eating disorder. Endurance sports with a heavy training load can be dangerous, and the process of “cutting weight” often involves dehydration techniques that can lead to serious complications. An athlete with anorexia nervosa will often struggle with a combination of restrictive dieting, overtraining, and allowing themselves to rest on recovery days, and they often miss out on social activities to fit in training sessions. They may have rigid rules around food and exercise, use exercise to compensate for foods they eat, and they’re often very critical of body weight and composition.  For sports that require making a certain weight in order to compete, the athlete becomes consumed with this goal.  As athletes grow, reach puberty and adulthood, the weight goals may be unrealistic.  This time period can be very challenging for an athlete that has set his/her sights on competing.

 

To read more about the treatment of eating disorders in athletes, stay tuned to part 2 of this blog post.

References

McCallum Place Eating Disorder Centers. McCallumPlace.com. https://www.mccallumplace.com. Accessed August 21, 2018.

 

Tierney AS. Elite Athletes and Anorexia Nervosa: What Coaches, Trainers, Administrators & Parents Need to Know – Part I. Eating Disorder Hope. https://www.eatingdisorderhope.com/blog/symptoms-eating-disorders-athletes-anorexia-part-1. Published August 13, 2018. Accessed August 21, 2018.