Eating Disorders and Athletes

Participation in athletics may put some individuals at an increased risk for the development of eating disorders such as anorexia nervosa or bulimia nervosa. These disorders are characterized by an overvaluation of weight and shape. The hallmark feature of anorexia nervosa is a refusal to maintain a normal weight, while individuals with bulimia nervosa maintain a normal weight but engage in binge eating and purging. Athletes are faced with unique concerns regarding body shape, weight, and nutrition in relation to athletic performance. However, research investigating whether athletes are at an increased risk for developing eating disorders has yielded mixed results.

While some studies indicate that participation in athletics may serve as a protective factor against disturbed eating attitudes and behaviors, other research has found that athletes endorse more difficulties with eating, dieting, and body image than nonathletes. There is a general consensus that participation in weight-class sports (i.e., wrestling, weightlifting, light-weight football, and tae kwon do), aesthetic sports (i.e., gymnastics, figure skating, diving, and synchronized swimming), and endurance sports (i.e., long-distance running, swimming, and cycling) heightens risk for the development of eating disorders. Weight-class sports encourage unhealthy weight-loss methods for competition, aesthetic sports judge athletes on appearance, and endurance sports generally require a lean physique for optimal performance. However, it is [Page 207]difficult to determine whether participation in these sports is fostering disordered eating or if individuals predisposed to develop a disorder gravitate toward certain types of sports.

Because athletes must deal with constant pressures to stay fit and healthy, eating disorders can follow.

Beyond the risk associated with participation in specific sports, higher rates of disturbed eating attitudes and behaviors have been observed among other athletic subgroups including dancers, elite athletes, and college athletes. Individuals who are nonelite but high-intensity athletes are also at an increased risk for engaging in eating disorder behaviors. The risk to college athletes may vary as a function of other college-specific factors such as the availability of counseling and academic support, attitudes of coaches and trainers, and pressures to win. The initiation of sport-specific training at a young age also makes individuals vulnerable to the development of eating disorders. Prepubertal athletes may begin a sport that ultimately is not suitable for their adult body type, causing them to engage in pathological weight-loss methods in an effort to attain the necessary build for the sport.

There are a number of theories that seek to explain why these subgroups of athletes may be particularly vulnerable to the development of eating pathology. In general, athletes have additional pressures beyond societal expectations to attain a certain weight or body shape in order to optimize performance. Coaches frequently recommend weight loss to remedy subpar performances, but these recommendations are often made without guidance about proper nutrition and are not necessarily based on fact. Athletes are then left to their own devices, which may lead to experimentation with unhealthy weight-management techniques, such as extreme dieting or purging. The athletic environment can also lead to distorted perceptions of what is normal and healthy.

Coaches and athletes may begin to develop unhealthy expectations of body shape and weight, overlooking emaciated individuals who are performing well. They may be blinded by improved performances that accompany weight loss and view the shedding of pounds as a commitment to the sport. In this way, the athletic environment may “legitimize” both extreme weight loss and excessive exercise, thus masking a problem. A person who excessively exercises can appear disciplined and dedicated rather than “disordered.” In addition, because individuals with eating disorders are able to achieve a high level of performance for a long time in spite of energy deprivation, overexercising is a way to validate their behaviors and convince themselves and others their disorder is not a problem. Athletes may also be at high risk for disordered eating because of personality traits commonly shared by individuals with eating disorders, such as perfectionism, drive, conscientiousness, high personal expectations, obsessionality, and self-denial.

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