Eating Disorders In Athletes Or do we mean Disordered Eating?

A WOMAN IS OFTEN MEASURED by the things she cannot control. She is measured by the way her body curves or doesn’t curve, by where she is flat or straight or round. She is measured by and inches and ages and numbers. By all the outside things that don’t 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.

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

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

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

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

Anorexia Athletica Intense fear of gaining weight or becoming fat even if individual is usually underweight Restriction of food (<1,200 kcal/day) Compulsive exercise Amenorrhea Occasional bingeing or purging

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

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

Disordered Eating

What Can Cause Disordered 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 athlete’s weight/appearance

How Many Athletes Battle Eating 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

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

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

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

Educating Students & Athletes

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

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

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

Eating Disorder Prevention Emphasize Individuality Don’t 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

Nutrition Counseling for Eating Disorders Patients When Prevention is Not Provided Or When Prevention Fails

Treating Athletes with Eating 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

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

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.