A view on eating disorders

July 29, 2013

After attending the recent Disordered Eating in Sport and Fitness conference at Loughborough University, I came away thinking far more education is required to help look after the health of our athletes. My experience of elite sport, as an athlete and a performance nutritionist, has really exposed me to the prevalence of disordered eating and the lack of prevention, screening, access to treatment and a clear rehabilitation and recovery programme for our athletes.

As a practitioner, volunteer or coach within sport, everyone should have a basic level of training in the prevention and identification of eating disorders. This certainly doesn’t mean they should be expected to treat the athlete involved. However, within every sports organization, a clear pathway of communication should be established, for quick and easy access to professional treatment.

This Blog isn’t written with the hope of providing you with all the answers for something that is a multi-faceted and extremely complicated problem, but I do hope it encourages you to invest in a little more time into understanding the risk factors for disordered eating in sport. Here are some thoughts and ideas that came out of the conference which just might spark some ideas that relate specifically to your sporting or social environment.

Eating as an athlete changes your relationship with food

If you’re serious about your sport and serious about using nutrition to optimize training gains, performance and recovery, it’s likely that a number of different factors influence food selection. These factors include meticulous attention to diet and weight, the addition of supplements, goal directed eating, complete restriction of certain food groups and external pressures from coaches and peers to achieve a specific body composition. All these factors change your relationship with food and can be enough to trigger a pre-disposition to disordered eating.

Characteristics for athletic success can also be interpreted as signs for identifying those ‘at risk’ of disordered eating

  • Mentally tough vs. Aesthetic
  • Committed vs. Excessive exerciser
  • Ambiguous vs. Perfectionist
  • Easy to coach vs. Over compliant

Does the sport environment increase the risk of developing disordered eating?

It should be stressed that sport does not cause an eating disorder. The risk factors are the same for everyone. There are simply sport-related risk factors to be aware of.

There is a misconception that all elite athletes are mentally strong and psychologically healthy. Athletes also tend to be over self-critical, which is toxic to mental health. The very characteristics that help make an athlete successful can become a liability. It is a fine line between dedication and obsession. For example, when an athlete starts to change their thought process from “if I’m thinner, I’ll be better” to “if I’m thinner than him/her, I’ll be better than him/her”, there is already a simple mind shift that can lead to a lack of perception and control over body composition goals.

  • Leanness is performance enhancing in many sports
  • Making weight requires a degree of disordered eating
  • High physiological demands due to volume and intensity of training
  • Competitive thinness
  • Revealing clothing can contribute to decreased body self-esteem
  • Critical weight comments from coaches and teammates
  • Lack of disclosure for fear of de-selection
  • Access to treatment can be difficult

How can we help support athletes?

Sports clubs and organizations usually have a very clear pathway for screening, preventing and treating physical injuries. In very few sports is there any support or treatment protocol for mental health or disordered eating issues. Why shouldn’t there be screening and prevention strategies for mental health?

Access to a multi-disciplinary support system involving physiotherapists, doctors, strength and conditioning coaches and psychologists is a luxury for some elite athletes but unless these practitioners work as a collective and are athlete centered, identifying early and treating disordered eating can be very difficult.

Disordered eating encompasses a broad range of problems with food, beyond just anorexia and bulimia. Disordered eating can also be used as a coping strategy for stress or depression. Therefore, removing this strategy can cause more problems unless the athlete is armed with coping strategies for stress. As a practitioner, I’m aware of the risk factors for disordered eating and strategies for prevention and identification but most importantly, I’m aware that this is an extremely complicated issue best treated by experienced practitioners with the help of a GP. If you’re interested in learning more about disordered eating in sport, click on these links below.