Eating Disorders In Athletes - Anorexia Nervosa Athletica And Bulimia Nervosa In Sport
Liam Hallam is a sports science graduate. He is also a keen cyclist and a lover of the Derbyshire Dales and Peak District.
Cycling- A high risk sport for eating disorders
In sports such as cycling, running and triathlon eating disorder incidence can be high due to a need to be lean for performance
Many athletes pay attention to their diet and nutritional needs
Many athletes are very careful about what they eat and often look at alternative dietary programmes in order to gain advantages in their endurance, strength, power and recovery from sporting performance however there is a very close relationship between attention to detail and obsession over diet, weight and body image.
Eating disorders such as anorexia nervosa (anorexia nervosa athletica it's sporting version) and bulimia nervosa represent extremes in eating behaviours.
Definition of an eating disorder
An eating disorder is defined as[1]
"A distorted pattern of thinking and behaviour about food"
Clinical eating disorders such as anorexia nervosa and bulimia nervosa have clearly defined official specific behaviour criteria for definition which involve cycles of food restriction.
It has to be noted that many people can still have disordered eating despite not falling into these categories. Many people have a fear of becoming fat and obese despite a normal healthy body weight. Many people look in the mirror and see a person that appears larger than they actually are and subsequently put restrictive calorie measures in place.
High risk sports for eating disorders include aesthetic sports such as gymnastics, figure skating, bodybuilding
The aesthetic nature of figure skating puts skaters at risk of developing eating disorders
Why are athletes likely to develop eating disorders?
Athletes have been shown to be vulnerable to eating disorders. In certain sports up to 60% of female athletes may suffer from disordered eating[1]
Eating disorders are more prominent within sports where a low body weight, slim physique or low body fat level is deemed to be an advantage to performance. Distance runners are at risk of developing eating disorders such as anorexia nervosa and bulimia[2] due to the close link between body weight and running performance.
Athletes at risk of eating disorder. Weight category sports risk
Muay Thai Boxing- fighters at risk due to eating disorders.
Weight category sports and eating disorders
Any sport which involves its athletes having the priority of specific weight categories will always be at risk of developing disordered eating. Examples include boxers needing to make specific weights for each fight.
Weight Category Sports include
Boxing
Muay Thai Boxing
Weightlifting
Lightweight Rowing
Judo
High risk sports for eating disorders include lean sports Such as cycling, running, horse racing
Jockey's needing to regularly 'make weight' are at risk of potential eating disorders.
Checklist- Are you at risk of developing an eating disorder
While not intended as a full diagnostic method of eating disorder Bean 2004[3] considers that if you answer yes to six or more the below statements you could be at risk of developing an eating disorder and therefore may benefit from further help.
Factors that might indicate risk of eating disorder
- Do you count the calories in everything you eat?
- Do you think about food and eating a lot?
- Do you worry about weight gain?
- Do you consider that you diet excessively?
- Do you feel guilty while eating?
- Do you feel guilty after eating?
- Do you dislike or worry about your body shape?
- Do you exercise to compensate eating extra?
- Do you consider yourself fat while family, friends and colleagues consider you to be slim?
- Does your body weight fluctuate dramatically?
- Do you every force yourself to vomit after eating?
- Do you avoid certain foods despite liking eating them?
- Do you feel guilty or stressed if you have interruptions to your regular diet or eating regime?
- Do you incline invitations to meals out with friends and family in the event you may have to eat fattening foods?
And a factor to be considered in addition by the author
- Do you feel inclined to weight yourself daily?
Can athletes exercise and train with an eating disorder?
Athletes are often creatures of habit and a combination of psychological drive and physiological factors mean that despite extremely low calorie intake many can often continue to train and compete despite disordered eating.
Athletes often have a strong psychological drive to exercise and be able to motivate them to push to exhaustion. Sufferers of anorexia are often strong willed too and have a high desire to achieve their goals.
It is also noted that the body adjusts to a reduced calorific intake by slowing the resting metabolism to compensate. In a way the body becomes more energy efficient to maintain an energy balance despite fasting.
Many anorexics and bulimics have been known to abuse caffeine drinks such a coffee and diet cola to increase energy levels. However long term glycogen stores become exhausted and ultimately affect performance through decreasing VO2 Max and chronic fatigue may also set in as well as increased infection susceptibility.
Below are characteristics of anorexia nervosa and bulimia nervosa to look for.
Anorexia nervosa characteristics to be aware of
| Visible (physical) signs of anorexia nervosa | Psychological signs of anorexia nervosa | Behavioural signs of anorexia nervosa |
|---|---|---|
Extreme severe weight loss | Obsession regarding food and dieting | Eating very little/ nothing |
Emancipated appearance | Obsession regarding thinness | Obsession with food calories |
Significantly below normal body weight | Claiming to be fat when normal/ underweight | anxiety and arguments about food |
Irregular Menstrual Cycle | Fear of weight gain | Refusal to eat in public |
Amenorrhoea | Low self image/ self esteem | Lying about eating habits |
Regularly feel cold | Depression | Obsession with weighing scales |
Bluish extremities | Anxiety | Eating rituals |
Restlessness, disturbed sleep pattern | Perfectionist attitude |
|
Dry/ yellowish skin | High need for social approval |
|
Characteristics of bulimia nervosa
| Visible (physical signs of bulimia nervosa | Psychological signs of bulimia nervosa | Behavioural signs of bulimia nervosa |
|---|---|---|
Salivary glands swollen leading to puffy face | Low self esteem | Uncontrolled binge eating |
Excessive tooth decay | Impulsive personality | Eating for comfort/ numbness |
Normal weight or extreme weight fluctuations | Depression | Guilt and shame after bingeing |
Damaged knuckles from self induced vomiting | Anxiety | Purging |
Menstrual pattern irregularities | Anger issues | Laxative abuse |
Regular muscle cramps | Body image dissatisfaction | Disappearing after meals to vomit up food |
Frequent dehydration | Preoccupation with food, body image, appearance and body weight | Secretive eating patterns |
Useful Links
Boxing Weight Categories from BBC Sport
It's uphill all the way and extra weight slows a cyclist down
Lean sports like cycling can lead to potential eating disorders in athletes
Support for Eating Disorders
- Eating Disorder Support Groups for Bulimia and Anorexia
Eating Disorder Support Groups - Bulimia and Anorexia Support Groups - Beat - eating disorder help UK
Information and help on all aspects of eating disorders, including Anorexia Nervosa, Bulimia Nervosa, binge eating disorder and related eating disorders. We believe eating disorders will be beaten.
References
1. Sundgot-Borgen J. Eating disorders in female athletes. Sports Med. 1994 Mar;17(3):176-88.
2. Katz J L., Long-distance running, anorexia nervosa, and bulimia: A report of two cases. Comprehensive Psychiatry Volume 27, Issue 1, January-February 1986,74-78
3. Bean A, The complete guide to sports nutrition (4th Ed). London. A & C Black 2004.
Comments
Liam Hallam (author) from Nottingham UK on December 16, 2011:
Thanks for taking the time to coment Woman. However eating disorders such as anorexia nervosa athletica and bulimia nervosa are not simply women's problems. They do seem to be covered more in terms of the female population however coverage of the problem in men is much less documented.
Woman on December 15, 2011:
Men it is a woman disese
Liam Hallam (author) from Nottingham UK on October 19, 2011:
Thanks NotSoPerfect- sometimes it takes a shock toi get someone's attention. Thank you so much for your feedback. CF
NotSoPerfect from United States on October 18, 2011:
Yikes, a little scary, something to think about. I know a few of my female friends who should read this. Good hub. Voting up, useful and interesting.
Liam Hallam (author) from Nottingham UK on September 01, 2011:
Thanks INFJay for your feedback. Cool Tshirt- I want one!! CF
Jay Manriquez from Santa Rosa, California on September 01, 2011:
thought provoking article! Thanks.
