Eating Disorders and Athletes
By Nancy Brinch, MS, RD, LSW
Eating disorders among athletes are on the rise. And eating disorders
are NOT limited only to female athletes. While most athletes diagnosed
with anorexia and bulimia
are female, the incidence of these eating disorders in males who
participate in sports where low body weight is emphasized (wrestling,
crew, running) is higher than in males in the general population.
Research shows that male lightweight rowers and wrestlers often
develop distorted beliefs about food, weight and athletic performance
that are similar to the beliefs of female athletes with eating
disorders. In an attempt to make a specific weight classification
they may try to severely restrict food intake, limit fluid intake,
exercise excessively or increase body water loss (i.e. using a
sauna.) Such extreme emphasis on "making weight" often leads to
depression, low self-esteem and obsession with food and body weight
- signs seen in persons with eating disorders.
Some athletes who become preoccupied with overtraining and dieting
are at risk of developing "muscular dysmorphia." Muscular dysmorphia
is an obsession with being muscular and fit. Bodybuilders are
the athletes most likely to suffer from this disorder. Even though
they have well-developed muscles, persons with muscular dysmorphia
see themselves as weak and small. They think in order to overcome
their perceived deficiencies they must train excessively and make
nutritional choices such as extremely high intake of protein
and very low fat intake that do not benefit their health. Their
distorted body image contrasts with the distorted body image of
individuals with anorexia who see themselves as large even though
they are underweight. Both extremes of body image distortion result
in unhealthy eating and exercise behaviors as well as emotional
problems such as depression, low self-esteem and obsessive-compulsive
What are the signs of an eating disorder?
Refusal to maintain a body weight at or above a minimally
normal weight for height, body type and activity level
Intense fear of weight gain or being "fat"
Feeling "fat" even though underweight
Loss of menstrual periods for at least three consecutive
90% of individuals with anorexia are females. They are at increased
risk of developing osteoporosis due to loss of the menstrual cycle.
Without adequate estrogen menstrual cycle ceases and bones lose
calcium. This significantly increases the risk of being sidelined
with a stress fracture.
Repeated episodes of bingeing
Feeling out of control during a binge and eating beyond
the point of comfortable fullness
Compensating for a binge to prevent weight gain by purging
(self-induced vomiting, laxative abuse, diet pills and/or diuretics)
or by exercising excessively or by fasting.
Using body weight and shape as a measurement of self worth.
20% of persons with bulimia are male.
Binge Eating Disorder:
Periods of uncontrolled, impulsive or continuous eating
beyond the point of feeling comfortably full.
Bingeing is typically secretive.
Sporadic fasts or repetitive dieting but no purging behavior.
Feelings of intense guilt, shame or self-hatred after a
40% of persons with binge eating disorder are male.
This is discussed in the November
2004 issue of the Sports Nutrition Newsletter.
What are the medical and physical consequences of eating disorders?
Because the body does not receive essential nutrients, it slows
down all of its processes to conserve energy. This causes serious
medical consequences such as:
Abnormally slow heart rate and low blood pressure. The risk
for heart failure rises as the heart rate and the blood pressure
drop lower and lower.
Muscle loss and weakness.
Fainting, fatigue and overall weakness.
Hair loss. Dry hair and skin.
Severe dehydration that can result in kidney failure.
Osteoporosis (even in adolescents and very young women.)
Loss of menstruation.
Anorexia has the highest mortality rate of any psychiatric diagnosis.
Irregular heart beat and possible heart failure and death.
This is cause by dehydration and loss of potassium and sodium
resulting from purging behaviors.
Weakness, dizziness, fainting and headaches.
Damage to the throat resulting in difficulty swallowing.
Swollen glands that have a "chipmunk" appearance.
Tooth staining and decay due to stomach acids released during
Chronic irregular bowel movements and constipation due to
Binge Eating Disorder:
High blood pressure
High cholesterol levels
What to do if you or a friend has an eating disorder.
Athletes at RSC who think they or a friend may have an eating
disorder have several options. They can begin by talking to the
Athletic Training Staff. Students
and athletes at RSC also can schedule a free and confidential
appointment with the campus doctor or the nutritionist in Health
Services by calling (609) 654-4701. They can schedule a free and
confidential appointment with a campus counselor by calling Counseling
Services (609) 652-4722. See the November
2004 issue of the Sports Nutrition Newsletter for suggestions
on ways to help a friend with an eating disorder. This article
includes some reliable websites for persons with eating disorders
and for their family and friends.
Eating disorders can be successfully treated. The first step in
the recovery process is to acknowledge the eating disorder and
to seek treatment. Treatment includes recognizing and learning
how to deal with emotional triggers for eating disorder behaviors
as well as learning how to eat to support physical, mental and
emotional wellbeing. The members of the RSC medical and counseling
staff are experienced in treating eating disorders. They provide
compassionate and knowledgeable care for those students who are
willing to utilize their assistance.