Anorexia Symptoms and Complications in Athletes

Athletes benefit from self-motivation and discipline. But unfortunately, those traits—the same ones that can help someone become a great athlete—can also put them at greater risk for anorexia nervosa (often simply called anorexia) and other eating disorders.

Overview

People with anorexia tend to have a profoundly distorted body image and believe they are overweight, even when in reality they're extremely thin and/or undernourished. A person with anorexia may lose 15% to 70% of their normal body weight by severely restricting their food intake and/or exercising excessively.​

Athletes with anorexia are often dedicated to strict training and dietary guidelines. Heavily structured and controlled exercise and eating patterns make it relatively easy for them to hide—and not recognize they have—an eating disorder. Training schedules, competition, discipline, and/or travel become reasons for not eating. These explanations often mask unhealthy behavior from loved ones and coaches.

Research

Anorexia nervosa is an often undiagnosed, easily missed, and misunderstood mental health condition. According to the National Association of Anorexia Nervosa and Associated Disorders, approximately 9% of Americans will have an eating disorder in their lifetimes. Women are about three times more likely than men to develop anorexia. However, men with this condition are more likely to die from it.

Mortality Rates

Overall, opioid addiction is the only mental health condition with a higher mortality rate, and adolescents and young adults are at heightened risk of both suicide and death from physical complications of anorexia. In fact, studies show that young people from ages 15 to 24 who have anorexia are 10 times as likely to die as their peers who do not have anorexia.

Impact on People of Color

It's important to note that many people of color with eating disorders don't get diagnosed or have access to the treatment and support they need. In fact, research shows that people of color who have eating disorders are half as likely to get treatment, and their medical providers are less likely to screen them for these conditions.

Heightened Risk for Athletes

Two research studies found that adolescent athletes are at high risk for anorexia and other eating disorders, especially if they are female. However, adolescent boys and young men also are at risk. Initially, extreme weight reduction may seem to improve their athletic performance, but over time, continued starvation can lead to a variety of physical and mental health problems. as well as negatively impact athletic performance.

Additionally, those with anorexia often have comorbid mental health issues. Some of the most frequent conditions that occur alongside anorexia are obsessive-compulsive disorder, depression, anxiety disorders, attention deficit hyperactivity disorder, and autism spectrum disorder. People with anorexia have a heightened risk of suicidal ideation and suicide as well.

Health Complications 

Anorexia poses life-threatening complications for athletes, including:

• Abnormal heart rhythms (arrhythmias and bradycardia, which is a slow heart rate)
• Amenorrhea (interruption or absence of the menstrual cycle)
• Brain damage
• Dehydration
• Electrolyte imbalances
• Infertility
• Low blood pressure
• Heart damage
• Malnutrition
• Multiorgan failure
• Osteoporosis (brittle bones and decreased bone mass)
• Sleep disorders

Signs and Symptoms 

Common symptoms of anorexia may include the following:

• Avoiding activities that involve food
• Brittle hair and nails
• Constipation
• Dry skin and yellowish skin tone
• Excessive, persistent thinking about food, calories, and body weight
• Excessive weight loss
• Feeling cold (body temperature may be slightly low)
• Growth of lanugo (fine hair) all over the body
• Inappropriate use of laxatives, enemas, or diuretics in order to lose weight
• Lethargy
• Mood swings or depression
• Wearing layered clothing (to hide weight loss and for warmth)

Heightened Risk for Girls

The American College of Sports Medicine and the American College of Obstetricians and Gynecologists report that there are three related health problems, collectively referred to as the "Female Athlete Triad," that are often found in girls and young women who participate intensely in sports. This triad consists of the following:

• Irregular or missing periods
• Low energy (with or without an eating disorder)
• Weak bones, which leads to an increased risk of stress fractures and osteoporosis

Young women who attempt to reduce body fat by extreme measures are at high risk for eventual poor performance in exercise and sports, along with severe health complications caused by the development of eating disorders.

Nutrient deficiencies and fluid/electrolyte imbalance from low food intake can lead to increased risk of fractures, illness, loss of fertility, and serious medical conditions such as dehydration and starvation.

Treatment and Getting Help 

The good news is that there are effective treatments for anorexia. Common treatment options include individual, family, and/or group therapy, medications, nutritional counseling, and hospitalization. Any comorbid conditions should be treated as well.

Early interventions tend to result in better treatment efficacy and quicker recovery. Additionally, early diagnosis is key to prevent the potential physical damage that can develop as a result of anorexia's typical progression.

A Word From Verywell

Eating disorders in an athlete are serious and can become life-threatening if left untreated. Anorexia is a serious health concern that generally requires someone close to the athlete—a coach, teammate, or family member—to recognize the warning signs and encourage the person with anorexia to seek professional help. Identifying the eating disorder is essential to get the right help.