Eating Disorders In Athletes - Anorexia Nervosa Athletica And Bulimia Nervosa In Sport

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
In sports such as cycling, running and triathlon eating disorder incidence can be high due to a need to be lean for performance | Source

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
The aesthetic nature of figure skating puts skaters at risk of developing eating disorders | Source

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.
Muay Thai Boxing- fighters at risk due to eating disorders. | Source

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.
Jockey's needing to regularly 'make weight' are at risk of potential eating disorders. | Source

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

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
Lean sports like cycling can lead to potential eating disorders in athletes | Source

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.

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Comments 6 comments

CyclingFitness profile image

CyclingFitness 4 years ago from Nottingham UK Author

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 4 years ago

Men it is a woman disese


CyclingFitness profile image

CyclingFitness 5 years ago from Nottingham UK Author

Thanks NotSoPerfect- sometimes it takes a shock toi get someone's attention. Thank you so much for your feedback. CF


NotSoPerfect profile image

NotSoPerfect 5 years ago from United States

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.


CyclingFitness profile image

CyclingFitness 5 years ago from Nottingham UK Author

Thanks INFJay for your feedback. Cool Tshirt- I want one!! CF


INFJay profile image

INFJay 5 years ago from Santa Rosa, California

thought provoking article! Thanks.

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