Athletes and Eating Disorders

Athletes face tremendous pressure to excel and many feel pressure to achieve a certain body shape or weight that they see in the media or in fitness magazines. Athletes who compete in sports that emphasize appearance, agility, or speed (gymnastics, running, wrestling, figure skating, dance, or horse racing) are often more prone to developing an eating disorder than are non-athletes or athletes in sports that require muscle mass and bulk (football, powerlifting, skiing).

When an athlete goes to unhealthy extremes to achieve a particular and unnatural body shape and weight, they risk developing both physical and psychological health issues, including eating disorders. Bulimia is one such eating disorder that describes a cycle of binging and purging. Bulimia can begin when restrictive diets fail, or the feeling of hunger associated with reduced calorie intake leads to binge eating.

In response to the binge, an athlete may feel guilty and purge by vomiting or taking laxatives, diet pills, drugs, or excessive training to reduce fluids. Athletes may alternate between periods of binging and calorie restriction or compulsive exercise in order to lose weight.

Patients diagnosed with bulimia average about 14 episodes per week. In general, people with bulimia have a normal to high-normal body weight, but it may fluctuate by more than 10 pounds because of the binge-purge cycle.

The real threat to an athlete with an eating disorder is the extreme stress placed upon the body. The very practice of self-starvation, purging or obsessive exercise has a detrimental effect on performance.

Health Complications of Bulimia

• Laceration of the oral cavity (injury due to self-induced vomiting)
• Esophageal inflammation (acid from vomiting irritates the esophagus)
• Esophageal tears and ruptures (force from vomiting may cause the tears in the esophagus)
• Dental erosion (acid from vomiting erodes the dental enamel)
• Malnutrition.
• Abnormal heart rhythms (arrhythmias and bradycardia)
• Low Blood Pressure.
• Dehydration
• Electrolyte Imbalances
• Amenorrhea (interruption of the menstrual cycle)

Signs and Symptoms of Bulimia

Identifying athletes with an eating disorder is not easy. They are often secretive or blame their eating and exercise regimen on their training goals. More patients are identified by perceptive coaches, teammates, friends or family members who notice an athlete losing weight, exercising beyond their normal training regimen, or becoming overly preoccupied with food and weight. Some warning signs:

• Excessive weight loss or gain
• Being overly concerned with one's weight
• Visiting the bathroom after meals
• Depression
• Excessive dieting, followed by binge eating
• Always criticizing one's body
• Secretive eating
• Not wanting to socialize when there is food around
• Makes excuses to not eat when others are eating

The Female Athlete Triad

Women athletes with eating disorders often fit into a condition called the female athlete triad, a combination of:

• Low energy availability
• Menstrual irregularities
• Weak bones (increased risk of stress fractures and osteoporosis)

This attempt to reduce body fat by extreme measures not only leads to decreased exercise performance but also it can lead to severe health complications. Nutrient deficiencies and fluid/electrolyte imbalance from low food intake can lead to increased risk of fractures, illness, loss of reproductive function and serious medical conditions such as dehydration, and starvation. The medical complications of this triad involve almost every body function and include the cardiovascular, endocrine, reproductive, skeletal, gastrointestinal, renal, and central nervous systems.

Getting Treatment for an Eating Disorder

Eating disorders in an athlete are serious and can become life-threatening if left untreated. Bulimia is a serious health concern that often requires professional help to overcome. If you think you or a loved one is struggling with an eating disorder, speak to your healthcare professional. Your provider can help to identifying the type of eating disorder, but more importantly direct you towards the resources that can help you or your loved one find balance and wellness.