Eating Disorders:

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Eating Disorders

• By Aaron OBrien
• Randall Isomura

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Definition and Criteria

• Eating Disorders should never be misunderstood to
  be purely nutritional problems.
• Problems can be normalizing weight or food
  intake.
• Eating Disorder is a psychological disorders, but
  its the malnutrition which could cause a disease

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Survey from Magazines
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Criteria Cont

• Anorexia Nervosa is self-imposed starvation.
• It is characterized by a severe fear of obesity,
  even when emaciated, and distorted body image.
• Individual with Anorexia Nervosa appears
• Very thin
• Often wears layers of baggy clothing to hide body
  and to keep warm
• May have a covering of fine white hair on the
  skin

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Diagnostic Criteria

• Refusing to maintain normal body weight for age
  and height.
• Intense fear of becoming fat or gaining weight,
  even though underweight
• Inability to accurately see ones body weight,
  size or shape. (being skinny and still see your
  self as a FAT person)
• Absence of at least three consecutive menstrual
  cycles.

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Warning Signs

• Commenting repeatedly about being or feeling fat,
  asking question such as do you think Im fat
  when weight is below average.
• Dramatic weight loss for no medical reason.
• Reaching a weight that is below the ideal
  competitive weight for that athlete and
  continuing to lose weight even during off-season.
• Preoccupation with food, calories, and weight.

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Warning Signs Cont

• Complaining frequently of constipation or
  stomachaches.
• Mood swings
• Social withdrawal
• Relentless, excessive exercise
• Excessive concern about weight
• Strict dieting followed by binges
• Increasing criticism of ones body
• Strong denial that a problem exists even when
  there is hard evidence

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Bulimia is

• Bulimia - also called Bulimia Nervosa, is a
  psychological eating disorder.
• Bulimia was only diagnosed as its own eating
  disorder in the 1980s.
• Bulimia is characterized by episodes of
  binge-eating followed by inappropriate methods of
  weight control (purging).

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Binge-eating

• A binge - is an episode where an individual eats
  a much larger amount of food than most people
  would in a similar situation.
• Binge eating is not a response to intense hunger.
  
• Usually a response to depression, stress, or self
  esteem issues.
• During the binge episode, the individual
  experiences a loss of control.

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Binge-Eating Continued

• During a Binge individuals using eat what is
  called comfort foods, these include
• Sweet Foods, high in calories
• Smooth or soft foods, like ice cream, cake and
  pastries.
• Bingers consume large quantities of food.
• Sometimes as much as 20,000 calories at a time.

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Binge eating 20,000 calories

• Cola 80
• Snickers Bar - 270
• Chocolate Chip ice cream 280
• Large Fries (Burger King) 600
• Jack in the Box Big Cheese Burger 700
• Pepperoni pizza - 1,080

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Binge could include

• 4 serving of ice cream
• 4 Snickers Bars
• 5 Sodas
• 10 slices of Pepperoni pizza
• 6 large Burger King Fries
• 4 J-Box Big Cheese Burgers
• 18,000 Calories

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Inappropriate Methods of Weight Control

• An inappropriate methods of weight control is
  also referred to as Purging.
• Some of these methods include
• Vomiting
• Fasting
• Enemas
• Excessive use of Laxatives and Diuretics
• Compulsive Exercising

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Bulimia Subtypes

• Purging - The person regularly engages in self
  induced vomiting or the misuse of laxatives or
  diuretics
• Non-Purging - The person uses other inappropriate
  compensatory behaviors, such as fasting or
  excessive exercise.

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The Bulimic Cycle

• First a binge-eating episode occurs
• During this time the individual losses control
• The loss of control is followed by a short-lived
  sense of calmness
• Calmness is followed by self-loathing and
  Depression
• This self-loathing gives way to Purging
• The cycle of overeating and purging usually
  becomes an obsession and is repeated often.

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Diagnostic criteria for Bulimia nervosa

• Eating Secretively
• Disappearing repeatedly immediately after meals,
  especially after large meals
• Appearing nervous if something prevents the
  person from being alone after eating
• Losing or gaining extreme amounts of wt
• Smell or remnants of vomit in the rest room or
  elsewhere (Vomit is sometimes stored in
  containers to be disposed of later).
• Disappearance of large amounts of food
• The binge eating occurs at least 2 days week for
  a 6 month peroid.

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Bulimia Diagnostic Cont

• Eating much more rapidly than usual
• Eating until feeling uncomfortably full
• Feeling disgusted w/ oneself, depressed or
  feeling very guilty after overeating
• The binge can causes marked distress

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Warning Signs in Athletes

• Fatigue
• Performance issues
• Sleep disturbances
• Weight related issues
• Supplements or special diets

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Steps in the Management of Athletes with eating
disorder

• Finding Facts
• Talk to there roommates or teammates because
  those are the individuals that often share
  information.
• If there is a team doctor, sport nutritionist, or
  a therapist have them make the first assessment.
  They usually have to see all three.
• The goal of this initial assessment is not
  diagnosis of an eating disorder but to gather
  information from which to make the decision
  whether formal referral for such is necessary.

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Steps in the Management Cont

• Confront and refer the individual
• If the initial assessment warrants, the
  individual needs to be confronted.
• The policy and plans need to be in place so that
  their wont be any confusion.
• If the person is a minor, a designated athletic
  staff member should contact the parents to alert
  and discuss what should be done.

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Steps in the Management Cont

• Follow-up
• Some athletes go home to get treatment if they
  live locally.
• Many continue attending school, which brings up
  the question of whether continued sport
  participation should be allowed.
• If the client looks fragile, an injured status is
  appropriate.
• Sometimes taking away participation in team
  activity can cause even more problems (emotional,
  stress, etc.)
• Strength and conditioning activities should be
  considered separate from competitive activities.

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What NOT to do

• Dont monitor their food intake
• Dont have them weigh in frequently
• Dont give them nutrition information
• Dont have them weigh during practices
• And be careful on the comments about weight in
  general.

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Prevention

• Prevention
• A prevention is not well defined and are not
  completely successful
• If the coach, boy/girlfriend, or parents suspects
  anything of that individual they can make it
  worst by triggering that individual behavior that
  leads to anorexia nervosa
• A strength and conditioning coach can only reduce
  the frequency of events known to be triggered.

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Coaches Role

• Coaches comments are very important
• Weighing athletes or suggesting that an athlete
  lose weight must be well planned
• Handle weight issues and comments in private

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Questions?