Eating Disorders In Athletes - Anorexia Nervosa Athletica And Bulimia Nervosa In Sport
Cycling- A high risk sport for eating disorders
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
"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
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
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 due to the close link between body weight and running performance.
Athletes at risk of eating disorder. Weight category sports risk
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
Muay Thai Boxing
High risk sports for eating disorders include lean sports Such as cycling, running, horse racing
Checklist- Are you at risk of developing an eating disorder
While not intended as a full diagnostic method of eating disorder Bean 2004 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
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
Low self image/ self esteem
Lying about eating habits
Regularly feel cold
Obsession with weighing scales
Restlessness, disturbed sleep pattern
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
Eating for comfort/ numbness
Normal weight or extreme weight fluctuations
Guilt and shame after bingeing
Damaged knuckles from self induced vomiting
Menstrual pattern irregularities
Regular muscle cramps
Body image dissatisfaction
Disappearing after meals to vomit up food
Preoccupation with food, body image, appearance and body weight
Secretive eating patterns
Boxing Weight Categories from BBC Sport
It's uphill all the way and extra weight slows a cyclist down
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.
1. Sundgot-Borgen J. Eating disorders in female athletes. Sports Med. 1994 Mar;17(3):176-88.
3. Bean A, The complete guide to sports nutrition (4th Ed). London. A & C Black 2004.