Athletes: Disordered Eating and Body Image Issues on the Rise

Written by: Dr. Lyndsay Elliott

According to the Clinical Journal of Sports Medicine, an estimated 13 to 42% of athletes are affected by an eating disorder, depending on the sport and the gender of the participant. These numbers appear to be on the rise due to increased awareness and treatment sought for such an elite group.

Athletes face an even greater physical risk to themselves compared to non-athletes due to the stress that they place on their bodies on a daily basis. Those most vulnerable are involved in appearance sports (i.e. gymnastics, swim, figure skating and dance), but eating disorders are also common in endurance sports (i.e. running or cycling) and sports that have weight classifications (i.e. wrestling). Many cases of eating disorders are not reported or handled in secret, due to the pressures on athletes to perform and encouragement of coaches for achievement.

Eating disorders in athletes can take a variety of different forms, including:

• Restriction of calories or purging behaviors to drop weight or improve performance.
• Hunger due to level of physical activity, which may result in binge eating episodes.
• Excessive exercise or vomiting to compensate for any extra calories consumed.
• Disordered or idiosyncratic eating patterns due to the physical demands athletics place on their bodies.

Less is known about eating disorders among male athletes, since most of the studies have been conducted on female athletes. One issue males contend with is body dysmorphia, which leads to a preoccupation with becoming muscular, and a desire to promote size and strength. They may limit the types of foods eaten to decrease body fat or stimulate weight loss, or increase protein intake or complex carbs to gain muscle mass. Many males affected with the disorder go unnoticed or untreated, as they avoid discussing their concerns, and instead attribute it to a desire for success at their sport.

Warning signs

Coaches, teammates and parents should be aware of the traditional physical warning signs of eating disorders, which if left untreated can have serious health risks, including cardiac failure. These consist of:

• Menstrual irregularities or amenorrhea
• Fine hair on the body
• Low blood pressure or dizziness
• Swollen or puffy cheeks
• Decreased stamina in performance
• Frequent complaints of feeling cold
• Weight loss
• Fatigue
• Bradycardia or heart arrythmias
• Hair loss

Parents whose children participate in athletics should make an effort to closely monitor their child for any warning signs of disordered eating. Consistent communication with the coach can help to ensure that the child is being appropriately monitored, and creating an open dialogue about any concerns will also allow the child to be accountable for their actions as they build their talents and strengths. If you notice that your child is becoming extremely competitive, exhibiting an severe preoccupation with their ability level or feeling pressure to perform, intervention may be necessary. Further, consult with your child’s physician to ensure that they are medically stable to perform.

For those parents with children entering college, the NCAA has made a specific effort to target eating disorders in college athletes, conducting research and screenings. The NCAA has posted a 53-page brochure online dedicated to the female athlete triad (which comprises disordered eating, amenorrhea and osteoporosis), unfortunately, there is nothing to specifically address males at this time. More info on NCAA resources can be found at: ncaa.org/health-safety.

While sports participation itself is not necessarily the cause of the disorder, it may, coupled with any genetic or temperament predisposition to eating disorders, create a convergence of risk factors that is problematic for athletes. While the research of these factors are still under investigation, it is agreed in the field that the “perfect storm” of influences contribute and leads to the perpetuation of disordered eating issues among athletes.

Dr. Lyndsay Elliott is one of Southern California’s most prominent Psychologists in her field of expertise. Dr. Lyndsay (as her patients call her) maintains her clinical practice in Newport Beach, California. As a food and body image expert for the last 15 years, Dr. Lyndsay is known for her break-through work with children, teens and young adults. She particularly enjoys consulting with parents to help develop a healthy self-image for their children. Dr. Lyndsay empowers individuals with her ease, strength, and experience, ultimately propelling her patients into a new arena of growth, control and balanced living. Check out Dr. Lyndsay’s daily tips and blog at www.DrLyndsayElliott.com, on twitter @DrLyndsay and Facebook at Dr. Lyndsay Elliott, Inc.

Sources:

Sundgot-Borgen, J., Torstveit, M.K.. Prevalence of Eating Disorders in Elite Athletes Is Higher Than in the General Population. Cl. J. Sports Med. January 2004 14(1) 25-32 (accessed November 11, 2011 at http://journals.lww.com/cjsportsmed/Abstract/2004/01000/Prevalence_of_Eating_Disorders_in_Elite_Athletes.5.aspx)

Beals, K.. Disordered Eating Among Athletes: A Comprehensive Guide for Health Professionals (Beals 2004).

Thompson, S. and Sherman, R.T.. Athletes, Athletic Performance, and Eating Disorders: Healthier Alternatives. J. of Social Iss., Summer 1999, 55(2), 317-337. (accessed November 11, 2011 at http://onlinelibrary.wiley.com/doi/10.1111/0022-4537.00118/pdf)

Thompson, S. and Sherman, R.T.. Managing the Female Athlete Triad. (accessed November 11, 2011 at http://www.ncaa.org/wps/wcm/connect/2db7d8004e0db26bac18fc1ad6fc8b25/female_athlete_triad.pdf?MOD=AJPERES&CACHEID=2db7d8004e0db26bac18fc1ad6fc8b25)

Pearson, C.. Male Athletes Struggle with Eating Disorders. (September 2011). (accessed November 11, 2011 at http://www.huffingtonpost.com/2011/08/16/eating-disorders-men_n_928206.html)

Coming Home from College for the Holidays: How to Handle the “Freshman 15″

Written by: Dr. Lyndsay Elliott

We’re happy to have a new guest blogger, Dr. Lyndsay Elliott. Dr. Lyndsay, PsyD, is a clinical psychologist who specializes in food and body image issues out of her Newport Beach office. We believe these topics are incredibly important as eating disorders are rampant in Orange County.

We’re excited to have Dr. Lyndsay’s expertise!

Starting college is an exciting but overwhelming time for most young adults. Learning how to balance academics, a new social scene, and any work obligations can leave self-care in a place of neglect. Even with the welcomed change of “leaving the nest,” transitions are a difficult time for most people, and learning how to nourish oneself without the conveniences of home can be a challenge.

You may notice that when your child comes from college for holiday break, that they have gained weight. Anxiety sets in because you’re concerned about how your child is taking care of themselves, what or if to say anything about the change, and yet not wanting to avoid dealing with possible issues that are associated with their changing body. Below you will find some strategies in dealing with such issues to help alleviate the stress as well as to provide support for your loved one:

• Don’t assume that the weight gain is an issue. Perhaps their changing body is reflective of self-exploration, new freedom and fun that they are experiencing at college. Creating independence and learning how to feed themselves appropriately takes time, and there is a learning curve associated with this new phase in self-care.

 

• Watch out for warning signs that your child is concerned about the changes in their body. How do they talk to themselves about the weight gain? Are they criticizing their bodies or complaining that they do not fit into their clothes? You may have to purchase a few new items of clothing during this time of transition so that they feel confident and comfortable, but you do not have to buy a new wardrobe. Once their weight settles out, you can decide what else, if anything, needs to be purchased.

 

• Have a body composition test done by a professional. Is the new weight reflective (and appropriate) of any growth that has occurred or an increase in age? Physical maturity usually completes during the college years, and weight gain/loss can occur during times of growth.

 

• Spend consistent time with your child, and be a good observer during meals. Are they eating intuitively, or are there new behaviors that cause concern?

 

• Continue to monitor your child’s actions following meals. Are they drinking a lot of water, then disappearing or spending long periods of time in the bathroom? If you suspect that your child is purging, you should confront them with any worries.

 

• State any concerns in a loving and clear, but firm manner. If possible, use the same descriptors that they are using themselves (i.e. “I’ve gained so much weight”) to prevent them from accusing you of believing they are “fat.” Any concerns that you have should be addressed directly in the context of what concerns your child is stating, or behaviors you have noticed.

 

• Ask questions. How is your child making the transition in college? What are their stressors in school? Have they developed friendships or when are they feeling lonely? Are they too involved with the social scene? Develop ways that you can best support them while also holding them accountable to take care of themselves (i.e. nourish themselves appropriately), and not be pushed away because your child is too embarrassed to admit any difficulties.

 

• Hold your child accountable for their actions, and any commitments they make to increase their self-care. If they are gaining weight because they are going out and drinking most nights, chances are they are neglecting other areas of their life (i.e. academics or sleep) and need to re-prioritize their commitments.

 

• Praise any positive behaviors during this time of transition. Remember that they are still learning, and continue to encourage in areas that are appropriate. The holidays are for spending quality time with loved ones, and celebrating new milestones (i.e. college). Do not allow the weight gain to take away from such special and infrequent experiences, but rather enhance and build upon this new phase of their life. Afterall, you are still their parent, able to offer guidance and support in times of need, while also holding your child accountable for self-care and without avoiding potentially destructive behaviors. Finally, if your child still needs more support, encourage them to seek out help from their college counseling center where they can receive (often free) support to cope with stressors, or specialized counseling in food and body image issues.

Lyndsay Elliott, PsyD, is a clinical psychologist and maintains a boutique practice in Newport Beach, California. Dr. Lyndsay specializes in food and body image issues, and has been an expert in the field since 1996. Dr. Lyndsay posts relevant information on her blog at www.DrLyndsayElliott.com, on twitter @DrLyndsay and Facebook at Dr. Lyndsay Elliott, Inc.