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Disordered Eating and Body Image Issues Among Athletes Rising

Eating disorders affect an estimated 13 to 42% of athletes, depending on sport and gender. The number of reported cases appear to be on the rise as a result of increased public awareness and a greater willingness of athletes to seek treatment.

The effect of eating disorders on athletes is greater than on non-athletes because of the increased stress they place on their bodies on a daily basis. Those most vulnerable participate in so-called "appearance" sports (i.e. gymnastics, swim, figure skating and dance), but eating disorders are also common in endurance sports (e.g. long-distance running, triathlons, cycling) and sports with weight classifications (e.g. wrestling). Eating disorders are subject to chronic under-reporting or are handled in secret, due to the pressures on athletes to perform from coaches and parents (as well as pressures the athletes place on themselves to achieve high levels of performance).

Many different forms

Eating disorders in athletes can take a variety of different forms, including:

  • Restriction of calories or purging behaviors to drop weight or improve performance;
  • Binge eating in response to hunger resulting from a high level of physical activity;
  • Excessive exercise or vomiting to compensate for any extra calories consumed; and
  • Disordered or idiosyncratic eating patterns due to the physical demands athletics place on their bodies or training schedules.

Less is known about eating disorders among male athletes, since most studies involve female athletes. One issue males contend with is body dysmorphia, which leads to a preoccupation with becoming muscular, and a desire to promote size and strength. They may limit the types of foods eaten to decrease body fat or stimulate weight loss, or increase protein intake or complex carbs to gain muscle mass. Many males affected with the disorder go unnoticed or untreated, as they avoid discussing their concerns, and instead attribute it to a desire for success in their sport.

Warning signs

Coaches, teammates and parents should be aware of the traditional physical warning signs of eating disorders, which if left untreated can have serious health risks, including cardiac failure. These consist of:

  • Menstrual irregularities or amenorrhea
  • Fine hair on the body
  • Low blood pressure or dizziness
  • Swollen or puffy cheeks
  • Decreased stamina in performance
  • Frequent complaints of feeling cold
  • Weight loss
  • Fatigue
  • Bradycardia or heart arrythmias
  • Hair loss

Parents whose children participate in athletics should closely monitor their child for any warning signs of disordered eating. Consistent communication with the coach can help to ensure that the child is being appropriately monitored, and creating an open dialogue about any concerns will also allow the child to be accountable for their actions as they build their talents and strengths. If you notice that your child is becoming extremely competitive, exhibiting an unhealthy preoccupation with their ability level or feeling pressure to perform, intervention may be necessary. Further, consult with your child's physician to ensure that they are medically stable to perform.

Targeting eating disorders

For parents of children entering college, the NCAA has made a specific effort to target eating disorders in college athletes, conducting research and screenings. The NCAA has posted a 53-page brochure online dedicated to the female athlete triad (which comprises disordered eating, amenorrhea and osteoporosis), but unfortunately, there is nothing to specifically address males at this time. More information on NCAA resources can be found at: http://www.ncaa.org/health-safety.

Perfect storm

While sports participation itself is not necessarily the cause of an eating disorder, it may, coupled with any genetic/temperament predisposition to eating disorders, create a convergence of risk factors for athletes. While the research of these factors are still under investigation, experts agree that the "perfect storm" of influences often contributes and leads to the perpetuation of disordered eating  among athletes.

Lyndsay Elliott, Psy.D. is a Clinical Psychologist in private practice in Newport Beach, California, and has extensive experience treating eating disorder and body image issues. To visit Dr. Elliott's website, click here, follow her on Twitter @DrLyndsay, or visit her Facebook page at Dr. Lyndsay Elliott, Inc. 


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Posted November 16, 2011