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 disorder.

What are the signs of an eating disorder?
Anorexia:
•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 months

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.

Bulimia:
•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 binge.

40% of persons with binge eating disorder are male.

Disordered eating:
This is discussed in the November 2004 issue of the Sports Nutrition Newsletter.

What are the medical and physical consequences of eating disorders?
Anorexia:
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.

Bulimia:
•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 frequent vomiting.
•Chronic irregular bowel movements and constipation due to laxative abuse.
•Bloodshot eyes.

Binge Eating Disorder:
•Obesity
•High blood pressure
•High cholesterol levels
•Heart disease
•Diabetes
•Gallbladder disease

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.