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IHSA Sports Medicine: Eating Disorders

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What is an eating disorder?
What are the potential consequences of having an eating disorder?
Which athletes are at greatest risk of developing an eating disorder?
What are some of the warning signs that an athlete has an eating disorder?
What should I do if I suspect one of my athletes has an eating disorder?
What are some good resources I can use or recommend to athletes and parents?

What is an eating disorder?

An eating disorder is when a person has persistent and frequent thoughts and behaviors relating to their body.

There are four distinct eating disorders: anorexia nervosa, bulimia nervosa, eating disorders not otherwise specified and the female athlete triad.

What is Anorexia Nervosa?
Having an intense fear of gaining weight, putting undue emphasis on body shape, having a body weight lower than a normal or predicted weight, and missing three consecutive periods.

What is Bulimia Nervosa?
An intense preoccupation with body weight and shape, with regular episodes of uncontrolled overeating of large amounts of food (binge eating) associated with purging to counteract the feared effects of overeating.

Purging can be done through self-induced vomiting, misuse of laxatives or diuretics, fasting, and excessive exercise.

What are Eating Disorders not otherwise specified?
Any eating disorder that does not meet the exact criteria for a known specific eating disorder.

What is the Female Athlete Triad?
It includes three interrelated pathologies: disordered eating (a wide spectrum of behaviors used in attempts to lose weight), amenorrhea (lack of three consecutive periods) and osteoporosis (loss of bone density).

What are the potential consequences of having an eating disorder?

Physical consequences
- Stress fractures
- Damaged joints and soft tissue
- Osteoporosis
- Loss of muscle mass
- Anemia
- Infertility
- Cardiac failure
- Electrolyte imbalances
- Death

Emotional consequences
- Feel tired, dizzy and irritable
- Depression
- Guilt
- Obsessive thoughts
- Self-worth measured only in terms of performance
- Mood swings
- Feelings of anxiety or fear

Performance consequences
- Decrease in strength
- Lower energy
- Decrease in endurance
- Decrease in anaerobic and aerobic capacity
- Decreased speed, agility and concentration

Which athletes are at greatest risk of developing an eating disorder?

Sports that report the highest incidences of eating disorders
- Figure skating
- Gymnastics
- Diving
- Swimming
- Cross-country
- Cheerleading
- Dancing
- Football
- Wrestling
- Athletes from all sports are at risk

Other risk factors
- Gender: more common in females
- Age: usually develops in adolescence or young adulthood
- Genetics: Type 1 diabetes
- Personality: perfectionist
- Rigid and risk-avoiding personality
- High achievement and goal setting
- Low self-esteem
- Depression
- Compulsion

What are some of the warning signs that an athlete has an eating disorder?

Changes in physical appearance
- Extreme loss or fluctuations in weight
- Loss of muscle mass

Behavior changes
- Excessive self-criticism
- Avoidance of food-related social activities
- Visiting bathrooms after meals

Mood and personality changes
- Fluctuations in mood, including signs of depression
- Irritability
- Lack of self-identity

Changes in athletic performance
- Decreased strength
- Decrease in speed and agility

Excessive exercise outside of practice
- Relentless physical activity above and beyond the requirements of the athlete's training program

What should I do if I suspect one of my athletes has an eating disorder?

Organize who is involved (parents, trainer, nutritionist, or psychologist) and the reasons why you are concerned.
Approach the athlete privately when there is enough time to talk to him/her seriously.
Tell athlete about your concerns and provide evidence to back up concerns.
Alleviate any concerns that athlete may have about losing their position on the team.
Do not back down in problem in initially denied.
Offer held and suggest that the athlete should receive professional help.
If athlete denies that he or she needs help, you can require them to see someone if you feel it is necessary.

What are some good resources I can use or recommend to athletes and parents?