Eating Disorders in Female and Male Athletes

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Shannon Whitehead
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1 Slide 1 Eating Disorders in Female and Male Athletes Ashley Gilmore, LCSW Texas Health Behavioral Health Slide 2 Prevalence A study of Division 1 NCAA athletes found that more than one-third of female athletes reported attitudes and symptoms placing them at risk fo anorexia nervosa. Male athletes are also at risk especially those competing in sports tha tend to emphasize diet, appearance, size and weight. In weight-class sports (wrestling, rowing, horseracing) and aesthetic sports (bodybuildin gymnastics, swimming, diving) about 33% of male athletes are affected. In female athletes in weight class and aesthetic sports, disordered eating occurs at estimates of up to 62%. NEDA Toolkit for Coaches and Trainers Slide 3 Types of Eating Disorders Clinical Diagnoses Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder (BED) Avoidant Restrictive Food Intake Disorder (ARFID) Other Specified Feeding or Eating Disorder (OSFED) Unofficial, but recognized Anorexia Athletica Orthorexia Nervosa Excessive Exercise Diabulimia Drunkorexia

2 Slide 4 Risk Factors: Personal Inaccurate belief that lower body weight will improve performance Imbalance between energy input and output resulting in weight loss Perfectionism, unreasonably high standards for self A history of depression or anxiety, and/or a family history of eating disorders. Performance anxiety and fear of failure. Participation in aesthetic or weight class sports Multiple team or sport participation without adequate recovery tim NEDA Toolkit for Coaches and Trainers Slide 5 Risk Factors: Environmental Mind, Body and Sport: Eating disorders by Ron Thompson Excerpts from the Sport Science Institute s Mind, Body and Sport - Understanding and Supporting Student-Athlete Mental Wellness Emphasis on reducing body weight/fat to enhance sport performance can result in weight pressures on the stude athlete from coaches (or even teammates) Student-athlete s perception that the coach thinks she needs to lose weight can heighten weight pressures and increase the risk Revealing uniforms can increase body consciousness, body dissatisfaction, and the use of pathogenic weight loss methods Relationship between body image and body dissatisfaction in female student-athletes is more conflicted and confused than in the general population Coaches have considerable influence with their athletes, and it appears that their relationship with their student athletes and more specifically their motivational climate can influence the risk of disordered eating Eating disorder symptoms (such as dieting, weight loss and excessive training) may be misperceived as "normal" even desirable in the sport environment Slide 6 Case Example: Jump for Your Dinner Cheerleader captain completing 50 jumps at the end of practice or games to earn dinner as directed by her coach Completed in front of squad as an example to them of her leadershi and dedication Would attract student body, especially other athletes, to cheer or heckle All meals at school were scrutinized by student body Jump for Your Dinner was also completed on weekends

3 Slide 7 Broad Themes Within The Case Meals are earned by being good and taken away as punishment fo being bad Social influence supporting the practice of ED behaviors, both family and peers Highly scrutinized meals and calorie intake by self and others Highly scrutinized body parts and sizing muscular thighs were thunder thighs Patient was so high functioning, she would not be considered mentally ill Slide 8 Case Example: Two A Days Basketball player completed two a days with team Weight was taken by coach before and after practice with goal t see reduction; Lean and Mean After two-a-days, became fearful of gaining weight Added daily 20 mile bike rides to maintain weight Meals were variations on cleanses, detoxes, flushes, restrictive diets and eventually purging through vomiting and laxatives Slide 9 Broad Themes Within The Case Patient came into sports with ED and it was amplified by Lean and Mean attitude The disordered mind did not react in the same way as a nondisordered mind Progressive nature of the disease two a days become excessive exercising, which become extreme dieting, which became purging, which became bone density loss, disruption of organ function, hair loss, and tooth decay ED behaviors will persist in the face of medical problems

4 Slide 10 What will be hidden from you The most dangerous ED behaviors will be intentionally guarded by the patient Purging Starving/Restricting Bingeing Excessive Exercise Stimulant abuse Laxative abuse Slide 11 What you can intentionally notice ED patients are so skilled at hiding behaviors, the depth of their illness will often go unnoticed until it progresses beyond what they can control. Our job is to notice things on purpose. Skipping meals, not eating when others are eating and/or eating significantly smaller portion Increased anxiety and avoidance when faced with meal times and/or unexpected food Restrictive dieting, cutting out entire food groups, fasting, detoxing, cleansing, fad diets Training or exercising when ill or exhausted Language about training, food and weight that is fear-based and/or obsessive Decreased energy, focus, performance Recovery time is inadequate; injuries and complaints are increased Decreased mood stability Slide 12 Core Issues you can influence Whole person approach Physical, mental, emotional, spiritual, social Emotional resilience Allow and experience emotions without avoiding or becoming destructive Self care Prioritized, learned and engaged Values A goal is something to work towards. A value is something to live. Gratitude The antidote to perfectionism, despair, and poor self esteem Seeking treatment Both physical and mental illness can be acknowledged and treatment is encouraged

5 Slide 13 Resources National Eating Disorders Association NEDA Toolkit for Coaches and Trainers National Collegiate Athletics Association Sport Science Institute s Mind, Body and Sport - Understanding and Supporting Student-Athlete Mental Wellness

Binge Eating Disorder. Ashley Gilmore, LCSW Binge Eating Disorder Therapist Texas Health Behavioral Health Dallas

Binge Eating Disorder. Ashley Gilmore, LCSW Binge Eating Disorder Therapist Texas Health Behavioral Health Dallas Binge Eating Disorder Ashley Gilmore, LCSW Binge Eating Disorder Therapist Texas Health Behavioral Health Dallas 1 Binge Eating Disorder in Patients 3x more common than Anorexia Nervosa and Bulimia Nervosa