Eating Disorders in Athletes

Eating disorders are a serious issue in the conduct of the training and the performance of many different types of athletes. While the pixie-sized female gymnast is a common subject of scrutiny in these analyses, eating disorders are a significant problem in a wide range of sports, affecting both male and female participants.

The expression "eating disorder" is a generic one. It includes the defined psychological disorders, bulimia and anorexia nervosa, as well as any efforts made by an athlete to alter his or her physical shape, without proper regard for overall physical health. Eating disorders may arise through the self-perceptions of the athlete as to the appearance of his or her body, or through the direction of a coach, the stresses of competition, or similar pressures. Eating disorders tend to affect athletes under the age of 30.

Athletes are more vulnerable to the onset of eating disorders than are people in society at large, due to the very nature of what makes for athletic success. The required commitments to intense sport training, with its physical demands combined with the prospect of achievement, invariably attracts persons who are competitive, and often perfectionist by nature. In almost every sport, especially as the athlete progresses to elite levels of competition, the athlete will experience an increasing emphasis from coaches, trainers, and other support staff on the recording of personal data. Physical factors such as weight, the dimensions of the body, physique, and percentage of body fat become increasingly important as the elusive "competitive edge" is sought. This monitoring will cause some athletes to become overly attentive to the finer details of their physical appearance, when the minute changes from week to week or month to month become a concern, even when such changes will have no objective impact on performance. Christy Heinrich (1972–1994), an international-level American gymnast who was told that she was too fat to compete at the Olympic Games, and who subsequently died of an eating disorder, is a profound example of this obsession with appearance.

While any sport may create an environment in which an eating disorder may arise, certain disciplines are prominent. Sports where the appearance of the athlete is either a stated performance factor or is present by implication through the culture of the activity are the most likely to breed eating disorders. For female athletes, gymnastics, diving, swimming, and figure skating are the most common sports where eating disorders arise. Various studies have estimated that as many as 60% of female gymnasts in the United States have felt pressure at some point in their competitive career to engage in eating disorder practices, due to the profound pressure existing in the sport to fit a small, slender prescribed body type.

Other sports with a specific weight orientation are also activities in which an eating disorder may arise. Wrestling, boxing, and various rowing categories have specific weight limits that the athlete must meet, or be disqualified from competition. In rarer circumstances, distance running, with its premium on leanness and strength-to-weight ratios, can create pressures an athlete that may trigger an eating disorder.

Anorexia nervosa, known commonly as anorexia, is a condition in which the person simply restricts food intake to the point of virtual starvation. Anorexia is a mental disorder with profound physical consequences; it carries with it a very bitter irony, that the desire of an athlete to improve their physical appearance, to create a slim, healthy look for competition, will cause significant damage to the physical systems required to sustain performance. The anorexic person will demonstrate a fixation with food types and calorie counting, as well as a pronounced weight loss. Anorexia can lead to malnutrition, an interruption in a female's menstrual cycle, and the risk of future osteoporosis (loss of bone density and strength), and even death.

Bulimia is a condition caused by the same underlying motivations as anorexia, but manifests in a different way. Bulimia will stimulate the athlete to eat to excess and then to purge through vomiting. Bulimic persons often have injuries to the mouth and esophagus (passage from the mouth to the stomach) caused by the induced vomiting, as well as damage to their teeth through exposure to excess amounts of stomach acid. Dehydration is also common. Bulimics also are fixated on their weight, and they are commonly depressed.

As both anorexia and bulimia are mental health conditions that manifest in physical ways, the treatment of these conditions will require mental health therapies, such as counseling, that are supported by the efforts of the sports coach.

There are other eating disorders that are of lesser risk to the athlete, but which are both unhealthy and unlikely to aid in competitive success. "Crash diets," so called because they involve a sudden interruption of regular eating habits in an effort to lose weight, tend to deny the body its essential fuels, vitamins, and minerals. Another eating disorder is the use of laxatives to increase the production of wastes, in an effort to generate a sudden loss of weight. Excess laxative use will cause dehydration.