How Eating Disorders Develop in Athletes

Athletes tend to be highly competitive and disciplined individuals who go to great lengths to excel in their sports. This personality type combined with the expectations of teammates and coaches as well as spectators may make them at a higher risk of developing an eating disorder than the average person.

Athletes who compete in sports that emphasize appearance or require speed, lightness, agility, and quickness are at higher risk for developing an eating disorder than are non-athletes or athletes in sports that require muscle mass and bulk.

Which Athletes Are Most at Risk for Eating Disorders?

Eating disorders are most common in athletes that participate in the following sports:

• Ballet and other dance
• Figure skating
• Gymnastics
• Running
• Swimming
• Rowing
• Horse racing
• Wrestling

Which Eating Disorders are Most Common in Athletes?

Both men and women are susceptible to eating disorders, although a greater percent of eating disorders are found in women. The two most common eating disorders found in athletes are:

• Anorexia Nervosa
• Bulimia

Compulsive exercise is also problematic. It is not a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) but can be a symptom of an eating disorder.

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. The process of bingeing and purging results in loss of fluid and low potassium levels, which can cause extreme weakness, as well as dangerous and sometimes lethal heart rhythms.

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, such as amenorrhea
• 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 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.

Many athletes mistakenly think they're not at risk for osteoporosis because they exercise and exercise is known to strengthen bones. However, research shows that exercise alone does not prevent bone loss. Irreversible bone loss starts within six months to two years of the loss of menses. Another negative consequence of eating disorders is the close association with depression.

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.

Warning Signs of an Eating Disorder

• Preoccupation with food, weight, and appearance
• Repeatedly expressed concerns about gaining weight
• Increasing criticism of one's body
• Frequent eating alone
• Use of laxatives
• Trips to the bathroom during or following meals
• Continuous drinking of diet soda or water
• Compulsive, excessive exercise
• Complaining of always being cold
• Denies being hungry
• Cooks meals for others while not eating
• Eating too little, training too hard
• Underweight or notable weight loss
• Stress fractures or overuse injuries