Eating Disorders In Athletes

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Eating Disorders In Athletes

• Or do we mean
• Disordered Eating?

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A WOMAN IS OFTEN MEASURED by the things she
cannot control. She is measured by the way her
body curves or doesnt curve, by where she is
flat or straight or round. She is measured by
36-24-36 and inches and ages and numbers. By all
the outside things that dont ever add up to who
she is on the inside. And so if a woman is to be
measured, let her be measured by the things she
can control, by who she is and who she is trying
to become. Because as every woman knows,
measurements are only statistics. And STATISTICS
LIE. Nike, Inc. in Helping Athletes with Eating
Disorders, 1993.
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Types of Eating Disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Other Disorders Otherwise Not Specified
• Binge Eating Disorder
• Anorexia Athletica
• But What About Disordered Eating?

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Binge Eating Disorder

• Recurrent episodes of binge eating
• Eating until uncomfortable
• Eating large amounts of food when not hungry
• Eating alone due to embarrassment
• Binge 2 days/week for 6 months minimum

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Binge Eating Disorder

• So what makes this differ from Bulimia Nervosa .
  . .
• Usually not associated with purging, fasting,
  excessive exercising, or laxative use

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Anorexia Athletica

• Frequently found in athletes
• Shows signs of disordered eating and distorted
  body image
• Fails to meet criteria for anorexia nervosa or
  bulimia

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Anorexia Athletica

• Intense fear of gaining weight or becoming fat
  even if individual is usually underweight
• Restriction of food (lt1,200 kcal/day)
• Compulsive exercise
• Amenorrhea
• Occasional bingeing or purging

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Common Causes of Eating Disorders

• Highly Successful in All Endeavors
• High Expectations for Self
• Parents Set High Expectations for Child
• Family Often Exerts Tight Control on Child
• Family has Low Tolerance for Conflict

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Disordered Eating

• Term is often used interchangeably with eating
  disorders
• Disordered eating has no specific diagnosis
• Continuum from normal eating patterns to eating
  disorders
• Disordered eating would fall somewhere on that
  continuum

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Disordered Eating
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What Can CauseDisordered Eating?

• Intense Dieting
• Desire for Athletic Success
• Fear of Failure
• Frustration or guilt when not able to control
  weight and/or apprearance
• Coach and/or parent comment about athletes
  weight/appearance

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How Many Athletes BattleEating Disorders?

• Depends upon research quoted
• Using DSM-IV criteria?
• Use only food restriction patterns?
• Depends upon the sport
• Rate increases in aesthetic and weight-dependent
  sports

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Again, Eating Disorders or Disordered Eating?

• Convincingly, more athletes do have disordered
  eating issues
• Distorted views on food, eating, weight, and
  performance
• Possible results
• Body Dysmorphia Disorder (BDD)
• Muscle Dysmorphia

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Body Dysmorphia Disorder (BDD)

• Obsession with a defect in visual appearance,
  specifically the face, hair, nose, and skin
• Treatment has varied results
• Some success with obsessive-compulsive disorder
  drugs
• Cognitive behavior therapy may be beneficial

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Muscle Dysmorphia

• Is a form of BDD
• Found in athletes who deliberately diet and
  overtrain
• Is an excessive preoccupation with being muscular
  and fit
• Have severely distorted body image
• See themselves as small and weak
• Possibly abuse steroids and other substances
• Depression, low self-esteem, social withdrawal

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Educating Students Athletes
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So When Do We Educate?

• It is NEVER to early
• Over 60 of 8-year old girls are either
  dissatisfied with their body or have tried to
  lose weight
• This number increased to over 80 by the time a
  girl becomes 11

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YOUR Role as a Sports Nutritionist

• Educate athletes about normal food intake
• Explain myths about diet, exercise, and health
• Evaluate food intake
• Work with team officials and medical personnel to
  document diet and behavior changes

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Prevention Education

• Educate to Prevent Eating Disorders
• So You Do Not
• Have to Treat Eating Disorders!

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Eating Disorder Prevention

• Emphasize Individuality
• Dont Focus on Weight/Appearance
• Reduce the Competition to be Thin
• Eliminate Group Weigh-ins
• Eliminate Team Weight Limits
• Focus on Overall Fitness
• Set Individual Goals
• Use Appropriate Guidance for Weight Management

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Nutrition Counseling for Eating Disorders
Patients

• When Prevention is Not Provided
• Or
• When Prevention Fails

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Treating Athletes withEating Disorders

• Develop a close relationship with athletes,
  coaching staff and other team officials
• Prepare that the athlete may not admit they have
  a problem
• Ensure confidentiality
• Never discuss issues with or in the presence of
  team members
• Develop a team approach to treatment
• Coach, Medical Staff, Counselor, and Parents

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Working with Parents

• Assume that parents may not be aware of their
  childs condition
• Understand that the parent(s) may not admit their
  child has a problem
• Realize that a parents and/or coachs comments
  may have served as a precursor for this condition

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In An Ideal World . . .

• All children would grow up to know that every
  person is born different and that individuality
  is a gift. Although the gift is placed in a box,
  wrapped with brightly-colored paper, and tied
  with a unique ribbon or bow,
• EVERY GIFT IS SPECIAL.