Athletes’ Eating Disorders

Athletes and dancers may face a greater risk for the development of an eating disorder, substance use, and alcohol disorders. The incidence of eating disorders among athletes continues to be on the rise, especially for those involved in sports that emphasize being thin. It is estimated that up to 62 percent of females who participate in “appearance sports” such as gymnastics, figure skating, dancing, and diving are suffering from an active eating disorder. High incidence of eating disorders also occur in endurance sports that emphasize low body weights such as running, cycling, and cross-country skiing; sports that have weight classifications such as wrestling, horse racing, and crew; and sports where the clothing is revealing such as swimming, volleyball, track, cheerleading, and bodybuilding.

Many of the attributes that are part of the formula for a successful athlete may predispose them to the development of an eating disorder, substance use, and Alcohol Use. Athletes’ personalities tend towards being perfectionist, overachieving, competitive, compulsive, and people-pleasing. These traits, when focused on the body can have devastating consequences. Athletes and often their coaches are preoccupied with controlling body weight and shape to enhance athletic performance. Weigh-ins and body fat analyses are often a weekly occurrence. The worst part is that these activities are usually done in a public setting with personal weights revealed to the entire team and staff. This can cause embarrassment and foster competition among team members to obtain the lowest weight through dangerous dieting methods. Teammates and coaches are significant people in athletes’ lives and can have an inordinate amount of influence. A recent study reported that 75 percent of gymnasts who were told by their coaches that they needed to lose weight resorted to dangerous weight control measures.

Judges in sports where athletes are evaluated on technical and artistic forms have admitted they consider thinness to be an important factor in deciding excellence and have even told athletes they should lose weight to achieve their athletic goals. This was the case with the elite gymnast Christy Henrich, who stated that a United States gymnastics judge told her she was too fat and needed to lose weight if she wanted to make the Olympic team. Christy felt this statement was the impetus for her to severely restrict her food intake in order to make weight. At the age of 22, Christy Henrich died as a result of her eating disorder. When their bodies are being constantly assessed personally and by coaches, judges, and spectators, it is understandable why so many athletes fall prey to disordered eating.

When athletes diet, they often go to extraordinary lengths to reduce their percentage of body fat. Severely restrictive dieting is the most common method, but many also engage in the purging methods of vomiting, laxative abuse and diuretic abuse. Restricting food intake can result in fatigue, dizziness, muscle wasting, stress fractures, depleted food stores, weakness, and fainting. Initially competitive performance may be unaffected but ultimately the athlete’s performance and health will significantly decline. Because of the addictive nature of eating disorders, even though their performance may be suffering, many eating disordered athletes find it difficult to stop their disordered eating.

Long-term and serious medical complications include cardiac problems and what is known as the “Female Athlete Triad”. The Triad refers to disordered eating, loss of menses, and osteoporosis. The resulting medical complications are often permanent and irreversible. Bone loss starts as soon as six months from loss of menstruation. A study found that anorexics were seven times as likely to develop stress fractures as a result of their bone density loss. This not only has immediate consequences on their performance but also long-term consequences such as chronic joint problems and increased risk of fractures for the rest of their lives.

Coaches, parents, teammates, and friends need to be alert to the early signs of eating disorders among athletes. Often, the eating disorder is well concealed, and the symptoms are misinterpreted as athletic burnout. Warning signs include:

  • Restrictive dieting

  • Purging through vomiting, diuretics, or laxatives

  • Withdrawal from teammates

  • Chronic fatigue

  • Excessive exercise outside of routine training periods

  • Inability to complete workouts

  • Weight loss

  • Loss of menses

  • Loss of concentration

  • Changes in mood

  • Fainting

  • Light-headedness

  • Decreased stamina

Because of the unique situation and influence of coaches, athletic trainers, and teammates, they can help prevent eating disorders among athletes. To accomplish prevention, the following should be kept in mind:

  • Recognize and educate athletes on the symptoms and warning signs of eating disorders.

  • Educate athletes on the physical risks of maintaining low body weight.

  • Do not overplay the impact of weight on athletic performance.

  • Promote total and healthy nutrition.

  • Eliminate public weigh-ins and body-fat analyses.

  • Provide a resource for emotional counseling.

  • Eliminate ridiculing or flippant remarks about body shape or weight.

  • Set realistic goals, taking into account the individual athlete’s body type and shape.

  • Recognize when healthy training regimens turn into obsessive regimens.

  • Encourage positive self-image and self-esteem.

Participation in sports can have an extremely positive effect on the development and maturing of an individual. It can promote the ability to work as a member of a team, teach perseverance, and enhance goal attainment. With the right emphasis coaches, athletic trainers, and teammates can promote emotional as well as physical health.