Recognizing Disordered Eating

As mentioned in previous posts, it is important as a coach, athletic trainer, and teammate you are watching for signs of eating disorders. Most people will not admit they have a problem and will not seek help on their own. Because of the secretive nature of eating disorders such as anorexia and bulimia, it can be difficult to recognize when a student-athlete has a problem. However, if you are aware of some signals of disordered eating, you may be able to help an athlete before it develops into a full blown eating disorder. A short summary of some of the signs of disordered eating that you can watch for are listed below.

What they say: Someone may try to avoid eating a team meal or eating on the road by consistently saying “I already ate”, “I’m not hungry,” or “My stomach hurts.” If this avoidance becomes a pattern, consider talking with the athlete. The athlete may also be constantly talking about how they look or mentioning that they are fat or need to lose weight, even though they are at a normal or below normal weight.

How they act: Mood changes or social isolation can also be a sign of disordered eating. Watch for athletes who start to avoid hanging out with the group or who have gone from being generally happy to sad or seemingly depressed. Also be aware of whether or not student-athletes are skipping meal times or sneaking off right after a meal consistently.

How they look: Changes in weight can be another sign of disordered eating. If an athlete appears much thinner after a summer or winter break you may need to talk with them. Also, be on the lookout for hair loss, dry skin and hair, calluses on the palms of the hand, facial swelling, or brittle nails.

If you have an athlete you suspect has a problem, suggest they talk with health professionals on campus. Remember, disordered eating isn’t just a physical problem; it is a mental and behavioral issue as well. It is not as simple as increasing their caloric intake, they have to deal with their misperceptions about their body and food as well. Please encourage them to get help and use the resources below.

Academy for Eating Disorders
National Eating Disorders Foundation
NIMH Eating Disorders
Eating Disorders and Athletes
http://helpguide.org/mental/eating_disorder_treatment.htm

Bulimia Nervosa

Have ever had a friend who seemed to rush to the bathroom each time you finished having dinner with them? Or maybe you yourself have eaten a whole bag of cookies and then had the sudden urge to get rid of all the food you ingested. Bulimia nervosa is an eating disorder that involves a cycle of bingeing (eating a large amount of food) and purging (ridding the body of this food quickly). Unlike anorexia, individuals with bulimia appear to be close to their ideal body weight and do their best to keep their purging behavior secret.

Bulimia is characterized by:

• Recurring episodes of binge eating. Bing eating is characterized by eating, in a small amount of time, more than most people would eat and a sense of lack of control over the eating.
  
• Recurring inappropriate behavior to compensate for the binge eating to prevent weight gain. This includes self induced vomiting, use of diuretics or laxatives, fasting, or excessive exercise.
• These behaviors occur on average at least two times a week for three months.
  
• Distorted body image.

Physical Effects

• Brittle nails and dry skin and hair
• Facial swelling
• Jaundice
• Delayed wound healing
• Dehydration
• Fluid and electrolyte imbalances (This balance is very important to athletes and can impair performance)
• Abnormal heart rhythms
• Injury to the kidneys
• Urinary tract infections
• Irritation and infection of the esophagus, pharynx, and salivary glands
• Erosion of the teeth and cavities
• Rupture or tear in the stomach or esophagus
  

Psychological effects

• Anxiety
• Mood changes
• Personality changes
• Social isolation

How is it treated?

Treatment for bulimia requires a structured eating plan with nutrient dense foods to establish regular eating patterns. Steady maintenance of weight is the goal. There is also a need to work through the psychological and social issues the individual has towards food. They also have to work on the patient’s relationships with themselves and their body.

Most often, people with bulimia will not admit they have a problem. As a coach, trainer, teammate and friend, you need to watch out for some of the above changes and encourage someone who needs help to get it. Watch for behaviors such as eating in secret, disappearing after meals, excessive exercise beyond what is needed for their sport, or extreme focus on their body and weight. Below are some resources related to eating disorders.

Academy for Eating Disorders
National Eating Disorders Foundation
NIMH Eating Disorders
Eating Disorders and Athletes
http://helpguide.org/mental/eating_disorder_treatment.htm

Anorexia Nervosa

Anorexia Nervosa is often the first eating disorder that comes to mind. No doubt, you know or knew someone whom you suspected suffered from this disease or whom seem dangerously thin. Anorexia is a disorder of self-starvation, either by calorie restriction or excessive exercise, where the individual has a distorted body image. As mentioned before eating disorders are psychological disorders, where the individual believes that they are fat or is afraid of becoming fat, no matter how thin they appear or how low the number on the scale is.

A person with anorexia exhibits the criteria (taken from the DSM-IV):

• Refusal to maintain body weight at or above minimal normal weight for their age and height
• Intense fear of being fat or gaining weight
• A distorted body image
• In females, the loss of three consecutive menstrual cycles (amenorrhea)

What happens to you physically if you suffer from anorexia?

• Metabolic rate slows
• Loss of lean tissue hurts physical performance
• Increased risk of stress fractures (overuse injury)
• Dehydration
• The heart pumps inefficiently and becomes weak and thin
• Blood pressure falls
• The brain’s activity becomes abnormal
• Insomnia is common
• The digestive tract fails to digest food as needed
• Inadequate immune response
• Anemia
• Dry skin
• Low body temperature
• High level of fatigue

What happens psychologically?

• Anxiety
• Restlessness
• Irritability
• Tiredness
• Avoidance of eating and meals
• Claims of being fat
• Unusual weighing behavior
• Excessive training beyond what is need for the sport
• Obsession about body image
• Social withdrawal
• Depression

How is it treated?

The type and amount of treatment needed depends on the severity of the disease. Some clients have to be fed with feeding tubes, while others are responsive to feeding themselves. Obvious treatment addresses the diet and works to stop weight loss and then begin weight gain. There is also a need to work through the psychological and social issues the individual has towards food. They also have to work on the patient’s relationships with themselves and their body.

The affects of anorexia will cause diminished athletic performance as well as life threatening complications. Most often, people with anorexia do not believe they have a problem. As a coach, trainer, teammate and friend, you need to watch out for some of the above changes and encourage someone who needs help to get it. Below are some resources related to eating disorders.

Academy for Eating Disorders
National Eating Disorders Foundation
NIMH Eating Disorders
Eating Disorders and Athletes
http://helpguide.org/mental/eating_disorder_treatment.htm

Eating Disorders and Athletes: Know Your Risks

Eating disorders affect people of all ages, backgrounds, and gender. Approximately 5 million Americans, both men and women, suffer from the eating disorders Anorexia Nervosa and Bulimia Nervosa. Americans are obsessed with the way we look, always striving to be thinner with more tone and bigger muscles. Eating disorders have very serious effects on athletic performance, overall and lifelong health, and mental state.

Studies have shown that athletes are at a higher risk of developing eating disorders. Some of these risk factors include:
-Participation in sports where weight is emphasized such as gymnastics and wrestling.
-Participation in sports focusing on the individual versus the team.
-Involvment in endurance sports.
-Holding the inaccurate belief that a lower body weight will lead to better performance.
-Having coaches who focus on the success and performance rather than on the athlete as a person.

Females are at risk of developing the Female Athlete Triad, which includes disordered eating, loss of menstrual periods, and osteoporosis. The loss of calcium and bone can increase the risk of stress fractures and other injuries. The triad affects all aspects of the individual’s health and can lead to life-threatening situations.

To perform at a high level, your body needs fuel (food). If you deprive your body of food and nutrients, as happens when an individual has an eating disorder, your body can’t handle the demands you are placing on it. You will feel fatigued, weak, and tired more often than not. A lower body weight does not guarantee better performance, especially in cases where your body is not getting enough fuel to carry out its daily processes, let alone the extra training demands you place on it.

Disordered eating comes in many forms; eating too few calories, over-exercising, taking diet pills or laxatives, etc. Full blown eating disorders are diagnosed mental disorders, many of which have symptoms that crossover between the different diagnosed diseases. It is important to be aware of your own attitude towards your body and towards food so that you can monitor your individual risk of developing one of these diseases. This month we will take a look at a few different eating disorders, their signs and symptoms, and the effects they can have on the body. Be educated, not only to protect yourself, but to recognize when someone else may be struggling and need help.