1. ADDICTIVE AND UNHEALTHY BEHAVIORS

2. Anorexia nervosa:
A psychobiological disease characterized by an intense fear of becoming obese, a disturbed body image, a significant weight loss, the refusal to maintain normal body weight, and amenorrhea.

3. Characteristics of Anorexia Nervosa
Weight loss to 15% below normal
Intense fear of gaining weight or being fat, despite being underweight
Disturbance in one’s experience of body weight, size, and shape
Females: absence of at least three consecutive expected menstrual cycles

4. Bulimia Defining Bulimia
An episodic eating pattern of uncontrollable food bingeing followed by purging; it is characterized by an awareness that the pattern is abnormal, fear of being unable to stop eating voluntarily, depressed mood, and self-deprecation.

5. Characteristics of Bulimia
Recurrent binge eating
A sense of lacking control over eating behavior during the binges
Engaging in regular self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain
Average minimum of two binge-eating episodes a week for three months
Consistent over- concern with body shape and weight

6. Prevalence of Eating Disorders
Accurate assessment is difficult to achieve because of the secretive nature of the disorder.

7. Research on the Prevalence of Eating Disorders
Athletes appear to have a greater occurrence of eating-related problems than does the general population.
A significant percentage of athletes engage in pathogenic eating or weight-loss behaviors (e.g., bingeing, fasting), although sub-clinical in intensity.
Eating disorders and pathogenic weight-loss techniques tend to have a sport-specific prevalence (e.g., among wrestlers vs. archers).

8. Predisposing Factors Weight restrictions and standards
Coach and peer pressure
Performance demands
Judging criteria

9. Recognition and Referral of an Athlete with an Eating Problem
Be able to recognize the physical and psychological signs and symptoms of these conditions.
If you suspect an eating disorder, make a referral to a specialist in the area.

10. Physical Signs of Eating Disorders
Weight too low
Considerable weight loss
Extreme weight fluctuations
Bloating
Swollen salivary glands
Amenorrhea

11. Physical Signs of Eating Disorders
Carotinemia—yellowish palms or soles of feet
Sores or callouses on knuckles or back of hand from inducing vomiting
Hypoglycemia—low blood sugar
Muscle cramps
Stomach complaints

12. Physical Signs of Eating Disorders
Headaches, dizziness, or weakness from electrolyte disturbances
Numbness and tingling in limbs due to electrolyte disturbances
Stress fractures
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13. Psychological–Behavioral Signs of Eating Disorders
Excessive dieting
Excessive eating without weight gain
Excessive exercise that is not part of normal training program
Guilt about eating
Claims of feeling fat at normal weight despite reassurance from others
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14. Preoccupation with food
Use of drugs such as diet pills, laxatives, and diuretics to control weight
Avoidance of eating in public and denial of hunger
Hoarding food
Disappearing after meals
Frequent weighing
Binge eating
Evidence of self-induced vomiting

15. Defining Substance & Alcohol Abuse
A maladaptive pattern of psychoactive substance use.

16. Defining Drug Addiction
A state where both discontinuing or continuous use of a drug creates an overwhelming desire, need, and craving for more of the substance.

17. Prevalence of Substance Abuse in Sports
Accurate assessment is difficult to achieve because of the sensitive and personal nature of the problem.

18. Studies have focused on alcohol and steroid use:
Alcohol use:
55% of high school athletes; 87%-88% of college athletes.
Performance-enhancing drugs:
5% of high school and college athletes report using them (40%-60% among elite athletes)

19. Athletes Take Drugs & Drink Alcohol To:
Escape from unpleasant emotions or stress, build confidence or enhance self-esteem
Enhance performance, peer pressure
Rehabilitate injury,
Look better
Control appetite and lose weight.

20. Major Categories of Performance–Enhancing Drugs
Stimulants
Narcotic analgesics
Anabolic steroids
Beta-blockers
Diuretics
Peptide hormones and analogues

21. Preventing and Detecting Substance Abuse
Key:
Only specially trained professionals work in drug treatment programs. However, fitness professionals play a major role in prevention and detection.

22. Substance Abuse Detection
Be aware of the warning signs of substance abuse:
Apathetic or listless behavior
Impaired judgement
Poor coordination
Poor hygiene and grooming
Profuse sweating
Muscular twitches or tremors

23. Making Referrals
The person who has the rapport with the individual should schedule a private meeting to discuss the matter.
Emphasize feelings rather than directly focusing on eating behaviors.
Be supportive and keep all information confidential.
Make a referral to a specific clinic or person on your referral list.

24. The End