Eating and Exercise Disorders in Sports
Sports and athletics are a great way to build self-esteem, promote physical conditioning, and demonstrate the value of teamwork, and sets a foundation for lifelong physical activity. However, not all athletic stressors are positive. The pressure to win and an emphasis on body weight and shape can create a toxic combination. Athletic competition can also be a factor contributing to severe psychological and physical stress. When the pressures of athletic competition are added to an existing cultural emphasis on thinness, the risks increase for athletes to develop disordered eating.
In a study of Division 1 NCAA athletes, over one-third of female athletes reported attitudes and symptoms placing them at risk for anorexia nervosa. Though most athletes with eating disorders are female, male athletes are also at risk—especially those competing in sports that tend to place an emphasis on the athlete’s diet, appearance, size, and weight requirements, such as wrestling, bodybuilding, crew, and running.
15 - 70% of athletes will experience some form of disordered eating or exercise disorder in their athletic career.
Myths:
“Routine Body Composition Testing is required in Sports” - Body Composition Testing has a role to play in that body weight can influence an athlete's speed, endurance, and power, whereas body composition can affect an athlete's strength, agility, and appearance. An optimal competitive body weight and relative body fatness should be determined when an athlete is healthy and performing at his or her best rather than a constant evaluation and micromanaging of body composition which has shown to be detrimental to athletes.
“Only Female Athletes experience Eating and Body Image Disorders” - the fact is that we are seeing more male athletes come forward with body and exercise disorders such as anorexia, bulimia, binge eating disorders and orthorexia.
“Athletes will speak to their parents or coaches about their eating and
exercise disorders” - Often Athletes feel a deep sense of shame and feel
alone and are more than likely to not speak to anyone about what they are
feeling or doing.
Types of Eating and Exercise Disorders
Anorexia Nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image.
Bulimia Nervosa is characterized by a cycle of binge eating and compensatory behaviours such as self-induced vomiting designed to undo or compensate for the effects of binge eating.
Binge Eating Disorder, the most common eating disorder in the United States, is characterized by recurrent episodes of eating large quantities of food; a feeling of a loss of control during the binge; experiencing shame, distress, or guilt afterward; and not regularly using unhealthy compensatory measures to counter the binge eating.
Orthorexia an obsession with proper or ‘healthful’ eating. Although being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself, people with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.
Laxative Abuse is serious and dangerous, and involves the repeated, frequent use of laxatives to eliminate unwanted calories, lose weight, “feel thin,” or “feel empty.”
Compulsive Exercise is extreme, excessive exercise that significantly interferes with areas of one’s life. Many people struggle with symptoms associated with this term.
Common Symptoms of an Eating Disorder
Emotional and behavioral:
In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns
Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
Appears uncomfortable eating around others
Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
Skipping meals or taking small portions of food at regular meals
Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
Withdrawal from usual friends and activities
Frequent dieting
Extreme concern with body size and shape
Frequent checking in the mirror for perceived flaws in appearance
Extreme mood swings
Physical:
Noticeable fluctuations in weight, both up and down
Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
Difficulties concentrating
Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)
Dizziness, especially upon standing
Fainting/syncope
Feeling cold all the time
Sleep problems
Cuts and calluses across the top of finger joints (a result of inducing vomiting)
Dental problems, such as enamel erosion, cavities, and tooth sensitivity
Dry skin and hair, and brittle nails
Swelling around the area of salivary glands
Fine hair on the body (lanugo)
Cavities, or discoloration of teeth, from vomiting
Muscle weakness
Yellow skin (in the context of eating large amounts of carrots)
Cold, mottled hands and feet or swelling of feet
Poor wound healing
Impaired immune functioning
Risk Factors for Athletes:
Sports that emphasize appearance, weight, and/or muscularity
Individual Sports rather than Team Sports
Endurance Sports such as Long Distance Running
An Overvalued believe that lower body weight = improved performance
Low Self-Esteem, a family history of Eating Disorders, History of Trauma, Family or Cultural Pressures
Coaches who overly emphasize winning and performance rather than the well being of the athlete
Social Influences - such as peer groups, social media
Performance Anxiety
Negative Self-Appraisal and Negative Self Talk
Positive Factors for Athletes:
A positive, athlete-orientated Coach who emphasizes factors that contribute to personal success, such as motivation and enthusiasm.
Good Social Support and Influence from teammates, teachers, coaches parents who have a positive healthy attitude towards size and shape.
Coaches and Parents who are knowledgeable and can educate and support the changing female body and have an understanding of the pressures and stressors that Sports can generate.
Understanding Athletes and Eating and Exercise
Though most athletes with eating disorders are female, male athletes are also at risk, especially those competing in sports that tend to emphasize diet, appearance, size and weight. In weight-class sports (wrestling, rowing, horse-racing) and aesthetic sports (bodybuilding, gymnastics, swimming, diving) about 33% of male athletes are affected. In female athletes in weight class and aesthetic sports, disordered eating occurs at estimates of up to 62%.
Source: Sport Nutrition for Coaches by Leslie Bonci, MPH, RD, CSSD, 2009, Human Kinetics. Byrne et al. 2001; Sundot - Borgen & Torstviet 2004
Among female high school athletes in aesthetic sports, 41.5% reported disordered eating. They were eight times more likely to incur an injury than athletes in aesthetic sports who did not report disordered eating.
Source: Jankowski, C. (2012). Associations Between Disordered Eating, Menstrual Dysfunction, and Musculoskeletal Injury Among High School Athletes. Yearbook of Sports Medicine, 2012, 394-395.
One study found that 35% of female and 10% of male college athletes were at risk for anorexia nervosa and 58% of female and 38% of male college athletes were at risk for bulimia nervosa.
Source: The National Center on Addiction and Substance Abuse (CASA) at Columbia University. Food for Thought: Substance Abuse and Eating Disorders. The National Center on Addiction and Substance Abuse (CASA) Columbia University; New York: 2003.
The prevalence of eating disorders in college athletes is higher among dancers and the most elite college athletes, particularly those involved with sports that emphasize a lean physique or weight restriction (e.g., figure skating, wrestling, rowing).
Source: The National Center on Addiction and Substance Abuse (CASA) at Columbia University. Food for Thought: Substance Abuse and Eating Disorders. The National Center on Addiction and Substance Abuse (CASA) Columbia University; New York: 2003.
Among female college athletes surveyed, 25.5% had subclinical eating disorder symptoms.
Source: Greenleaf, C., Petrie, T. A., Carter, J., & Reel, J. J. (2009). Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviours. Journal of American College Health, 57(5), 489-496.
In a survey of athletic trainers working with female collegiate athletes, only 27% felt confident identifying an athlete with an eating disorder. Despite this, 91% of athletic trainers reported dealing with an athlete with an eating disorder. 93% of trainers felt that increased attention needs to be paid to preventing eating disorders among collegiate female athletes. 25% worked at an institution without a policy on managing eating disorders.
Source: Greenleaf, C., Petrie, T. A., Carter, J., & Reel, J. J. (2009). Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviours. Journal of American College Health, 57(5), 489-496.
A study of female Division II college athletes found that 25% had disordered eating, 26% reported menstrual dysfunction, 10% had low bone mineral density, and 2.6% had all three symptoms.
Source: Beals KA, Hill AK. The prevalence of disordered eating, menstrual dysfunction, and low bone mineral density among US collegiate
Female high school athletes reporting disordered eating were twice as likely to incur a musculoskeletal injury as athletes who did not report disordered eating.
Source: Jankowski, C. (2012). Associations Between Disordered Eating, Menstrual Dysfunction, and Musculoskeletal Injury Among High School Athletes. Yearbook of Sports Medicine, 2012, 394-395.
Getting Help:
National Eating Disorder Information Centre (NEDIC) https://nedic.ca
Talk to your Family Doctor, Friends, Coach, Family
Seek Assistance from a Certified Nutritionist - one who specializes in Eating and Exercise Disorders
Kids Help Line 1-800-668-6868
Seek Counselling - LifeCare Centres 905-231-2273
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