Gracie Gold (Credit: nabechiko29 (Flickr: U.S. Championships Ladies FS/VC) [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

The Elephant on the Track: Eating Disorders in Athletes

In Columnists, Opinion, Sports by Sofia WeissLeave a Comment

Picture the gossamer-thing dresses, bright lights, judges, and dozens of cameras capturing every square inch of skin. In this context, it is no wonder that figure skating can deliver a severe blow to body image. Olympic star Gracie Gold’s recent step-back from the sport to enter treatment for an eating disorder heartbreakingly demonstrates the destructive power of the figure skating environment. Skating is not, however, the only sport where women and men are at risk of developing unhealthy relationships with food and their physiques. Whilst the issue is most associated with sports that emphasise a “lighter is better” approach, – gymnastics, distance running, and diving, for instance – eating disorders can be seen across the athletic spectrum.

Eating disorders are mental illnesses with physical consequences. They encompass everything from seemingly trivial (hint: they almost never are) food limitations to life-threatening conditions such as anorexia and bulimia nervosa. Increasingly being recognised is binge eating disorder (BED). No matter the diagnosis, the central tenet of eating disorders in athletes tends to be the initiation of restricting energy intake, such that consumption cannot match energy expenditure. This concept of low energy availability may be due to insufficient education regarding health eating requirements and physical activity, but often there are more pernicious origins. After all, incorrect weight perceptions are common in young people: persistent overestimation of weight and attempts to lose weight even when unnecessary are both well documented (Haase et al., 2011). Furthermore, athletes are known to be a group particularly at risk of developing eating disorders or engaging in unhealthy behaviours for controlling their weight (Greenleaf et al., 2009 & 2010). After all, they not only face the typical social pressure to be thin, but they are also immersed in a world that focuses on their bodies.

Any deviance from the norm when it comes to nutrition can have significant consequences for an athlete’s health, especially because what we demand of our bodies. The female athlete triad is a syndrome that has been established to coalesce the three separate, but related, conditions of disorder eating, decreased bone mineral density leading to early-onset osteoporosis, and hormonal issues related to menstrual dysfunction. I would argue that the very fact that there exists such a ‘triad’ to be diagnosed suggests that there is a bigger issue at hand.

Andrew Flintoff has recently shared his own struggle with an eating disorder (Credit: Gareth Williams via Flickr)

Andrew Flintoff has recently shared his own struggle with an eating disorder (Credit: Gareth Williams via Flickr)

The problem is not an exclusively female one either: the prevalence of eating disorders in male athletes both collegiate and elite is far higher than in the general population (Sundgot-Borgen et al., 2005). Indeed as early as 2004, Michael East, the former Commonwealth 1500m champion, warned that many of his contemporaries were developing a dangerous obsession with undereating. East voiced his concerns in the run-up to the 2004 Olympic Games, and related it to some of the finest middle distance runners in the world. More recently, England cricketing legend, Andrew Flintoff, revealed his own battle with bulimia.

So what should we do? Firstly, we need to talk about these issues with greater openness and understanding. The more we can create an environment where athletes can voice their own struggles with reconciling training and nutrition, the more likely we are to be able to identify issues at their inception, rather than when they have become tragic pathologies requiring intensive intervention. Secondly, if we can add to this by improving the resources available at the university and athletic institution level to educate athletes about their dietary requirements, we could move some way towards effective prophylaxis. Crucially too, the stigma associated with seeking mental health treatment must be eliminated. Here, those with influence in the sporting world can play a key role by recommending and encouraging timely and appropriate mental health treatment for their athletes.

Above all, however, we need to avoid perpetuating this veritable misnomer that being thinner makes you better at your chosen sport. Without adequate nourishment, one simply cannot perform optimally. Given this reality, athletes ought to be encouraged to think firstly of their health, and then of their performance.

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