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The Role of Exercise

Eating Disorders in Sports

Many young people are diagnosed with an eating disorder while participating in a sport. Competitive sports are a common activity for modern youth, and it has become normal for families to center the schedule and other activities around sports.

 

Athletics are attractive to people with a predisposition for eating disorders: the opportunity to burn calories and the environment of intense activity and social status are a potent draw. For anxious and goal-oriented teens, the anxiety-relieving effect of exercise can at first seem to improve coping skills.

In some cases, young people who participate in a sport may unintentionally trigger malnutrition by failing to compensate nutritionally for increased activity. 

For these reasons, rates of eating disordered behaviors and eating disorders are higher in athletics than the general population - especially the "aesthetic" sports like gymnastics and dance and in sports like wrestling where there is pressure to keep weights low. Unfortunately, few coaches and trainers are trained in the diagnosis or treatment of an eating problem - and may even unintentionally encourage risky behaviors.

Parents should watch out for an athlete who "has to" participate rather than "wants to" participate. A driven need to move and be overly active may be an exercise addiction driven by malnutrition. Exercise is a common method of "purging" calories, and is dangerous.

Parents must also be alert to the dangers of bargaining: where the patient says sports are what motivates them to recover. Unfortunately, bargaining with eating disordered thinking rarely works - recovery must proceed for its own sake.

During recovery, many physicians stop all exercise to preserve both mental and medical health. Some physicians are unaware of the damage to bones and internal organs that can come from exercise without full nutrition, so it is important to seek expert clinical advice from eating disorder professionals and make decisions based on the individual patient.

Many recovered eating disorder patients return to their sports, and to enjoying athletics. Some do not.

     

    Resource & Research Links

    Eating Disorders Often 'Overlooked' in Elite Athletes, sportspsychiatry.org, July 2011

    When Being Varsity-Fit Masks an Eating Disorder, New York Times

    Olympic Committee Position Statement on girls and women in sport

    Female Athletic Triad Coalition
    WebMD on Female Athletic Triad

    Tips for coaches from the NEDA Educator's Toolkit

    Sport and Eating Disorders - Understanding and Managing the Risks, A. Currie, MD, Asian J Sports Med. June 2010

    Prevalence of eating disorders in elite athletes is higher than in the general population, Clin J Sport Med. January 2004

    The Female Athlete Triad: An Emerging Role for Physical Therapy, P. Papanek, J Orthop Sports Phys Ther. 2003, "Briefly, when coupled with inadequate nutrition, the high caloric expenditure of exercise training results in a sustained negative caloric balance or low energy availability, which is exquisitely sensed by the hypothalamus, initiating a complex neuroendocrine adaptive cascade. This cascade is associated with changes in the hypothalamic-pituitary-ovarian axis, such that estrogen levels are decreased, resulting in reproductive dysfunction that may include amenorrhea, oligomenorrhea, or anovulation. Low estrogen in otherwise young healthy women, like menopause, is associated with decreased bone mineral density and increased risk of fractures. The triad is not an inevitable consequence of participation in sports or physical activity at any level, however, exercise may contribute to the disruption of caloric balance."

     

     


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