The Female Athlete Triad

Size: px

Start display at page:

Download "The Female Athlete Triad"

Brook Crawford
5 years ago
Views:

Norwegian Olympic Sports Centre The Female Athlete Triad Disordered

1 The right balance between the needs of body and practice of sport Jorunn Sundgot-Borgen The Norwegian School of Sport Sciences The Norwegian Olympic Sports Centre The Female Athlete Triad Disordered Eating Amenorrhea Osteoporosis IOCMC Medical & Scientific Working Group 1

2 Outline Definitions Prevalence Risk factors Prevention Conclusion What are the benefits of regular physical activity? Reduces the risk of: Dying from heart disease Dying from diabetes Dying from hypertension Developing colon cancer Dying prematurely 2

3 What are the benefits of regular physical activity? Helps: Control weight Build & maintain healthy bones, muscles, and joints Older adults become stronger & better able to move without falling Promote psychological well-being Genetic Optimal training Motivation Nutrition Elite Athletes 3

4 Sports also present health risks: Some are obvious, treatment is usually successful, and the athlete returns to her sport. BUT Eating disorders are secretive, treatment is difficult, and the effects on health may be permanent. Energy Availability/Disordered Eating Optimal Energy Availability Preoccupation with weight and shape Food restriction and dieting Bingeing Vomiting Abuse of laxatives, diuretics and diet pills Reduced Energy Availability and / or Disordered Eating Low Energy Availability and/ or Eating Disorders 4

Disordered Eating Low energy availability Clinical eating disorders: Anorexia Nervosa Bulemia Nervosa EDNOS An inadequate energy intake may: 1.

5 Disordered Eating Low energy availability Clinical eating disorders: Anorexia Nervosa Bulemia Nervosa EDNOS An inadequate energy intake may: 1. Impair performance 2. Lead to insufficient carbohydrate protein, vitamin, and mineral intake 3. Increase risk of injury and/or illness In addition 5

6 Dying to Win Prevalence of clinical eating disorders % *p<0.001 Athletes Controls Leanness Non-leanness * Sundgot-Borgen & Torstveit,

7 Prevalence of eating disoders diagnosis Bulimia nervosa Anorexia nervosa Controls Athletes EDNOS % Sundgot-Borgen & Torstveit, 2004 Eating Disorders in Female Elite Athletes (n=574, n=572) and Controls (n=572, n=574) % Aesthetic Weight class Endurance Ball game Technical Power Anit Grav Control Sundgot-Borgen et al.,1994, Sundgot-Borgen & Torstveit

BMD and risk factors; athletes 0-1 -2 % -3-4 -5-6 * Total body Total femur

8 BMD and risk factors; athletes % * Total body Total femur Lumbar spine * EDs No EDs MD No MD Torstveit & Sundgot-Borgen, BJSM,

9 Elite Athletes Disordered eating/eating disorders n=50 (26.9%) n=8 (4.3%) n=19 (10.2%) Menstrual dysfunction n=10 (5.4%) Low BMD Torstveit & Sundgot-Borgen, MSSE, 2006 Risk and trigger factors Dieting and restrictive eating Injuries Overtraining Casual comments Coaching behavior Decline in performance level Lack of motivation Sundgot-Borgen et al., 1994,

10 Dress code Treatment Multidisciplinary team Physician Psychiatrist Physiotherapist Physiologist Nutritionist Coach 10

amenorrhea is a normal sign of athletic training Key issues to succes in prevention and treatment disordered eating She and her coaches have to

11 Prevention: What health professionals do to help Advocate health and well-being De-emphasize weight Use normal weight role models Reinforce sensible body composition Educate athletes about the Triad Refer clients at risk for the Triad Dispel the myths that thinner is better & that amenorrhea is a normal sign of athletic training Key issues to succes in prevention and treatment disordered eating She and her coaches have to trust the experts Learn to develop healthy attitudes towards training, nutrition, and body composition, while realizing her full athletic potential 11

12 Conclusions The prevalence of DE is higher among athletes competing in leanness sports as compared to athletes competing in sports focusing less on leanness. Energy restriction and pathogenic weight control behaviors predispose the female athlete to menstrual dysfunction, subsequent decreased bone mineral density, stressfractures and low bone mass. Psychological problems usually accompany disordered eating, including decreased self-esteem, anxiety, depression, abuse and death owing to suicide. EDs pose a significant present and future medical problem. These problems effect performance and long term health. Athletes have to learn how to develop healthy attitudes towards training, nutrition, and body composition, while realizing her full athletic potential 12

Eating Disorders and Psychology

England Athletics: Coaching the Female Endurance Athlete Seminar, 21 st January 2012 Eating Disorders and Psychology Carolyn Plateau National Centre for Eating Disorders in Sport Loughborough University