Sport, Exercise & Eating Disorders: Cause, Consequence, or Cure?

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1 Sport, Exercise & Eating Disorders: Cause, Consequence, or Cure? Anthony Papathomas,

2 Mental Illness

3 Eating Disorders: Setting the Scene Morbidly Obese Underweight

4 Eating Disorders: Setting the Scene Anorexia nervosa Weigh < 85% expected weight Intense fear of weight gain Place undue importance of weight on selfevaluation. Bulimia nervosa Recurrent binge-purge cycles Binge-purge on average once a week for three months Place undue importance of weight on selfevaluation

5 Do your symptoms fit the box?

6 The Disordered Eating Spectrum Unhealthy weight worries and dieting Strict dieting and obsessing over weight Anorexia nervosa and bulimia nervosa

7 Compounding Issues can be the Most Troublesome

8 Can participation in sport cause disordered eating?

9 9 A Multi-causal Phenomenon?

10 Sport as a cause?

11 Youth Football Example Well, he s probably the best in this team, look at his physique, look how fit he is. So I had the perfect diet; wouldn t eat McDonalds, you know, wouldn t eat chocolate... what I perceived to be the perfect diet for a sportsman. (from Papathomas & Lavallee, 2006)

12 Youth Swimming Example That coach comment about being fat really affected me. But I still wanted to be a good swimmer. So, I think that I probably subconsciously decided, Right, I ll show you. Although I didn t really know what I was doing, I started by starving myself. You know, to me a diet now was not eating. But I had to eat though, so a way for me to control it was purging, just to get rid of it. That s how I started binging and purging, and within a month it had become a regular thing. (from Jones, Glintmeyer & McKenzie, 2006)

13 Can participation in exercise cause disordered eating?

14 Exercise as a cause?

15 Unhealthy Exercise as a Consequence Excessive Compulsive Compensatory

16 Unhealthy exercise as a symptom of anorexia When questioned whether I enjoyed the exercise, I would convince everyone that yes, I do, it is a time to escape, a time to think, oh, and it is not exercise it is training. I wasn t training for anything. Training just didn t sound unhealthy like excessive exercise did. I experienced little enjoyment. Exercise was simply a distraction a way to numb my feelings, to stop my guilt. It was something I felt compelled to do rather than want to do (from Axelson, 2009).

17 Sport as a consequence?

18 Can participation in sport/exercise encourage recovery from disordered eating?

19 Freiberg Sport Therapy Programme (Shlegal et al. 2015) 12 week sport/exercise/education-based intervention Participants = 34 eating disorder patients Commitment to exercise scale Quality of life Eating psychopathology

20 Fitspiration Movement

21 Yoga Support for Outpatient Treatment RCT: Population = adolescent ED outpatients Standard care v Standard care + Yoga Yoga twice/week for 8 weeks Yoga group significantly lower global scores on the Eating Disorder Examination at 4 week follow-up (Carei et al., 2011)

22 Conceptualising Recovery Medical model defined as a period without diagnostic symptoms of the disorder (Arthur-Cameselle & Quatromoni, 2014) Social model a way of living a satisfying, hopeful and contributing life even with the limitations caused by illness. Recovery involves the development of a new meaning and purpose in one s life as one grows beyond the catastrophic effects of mental illness (Antony,1993: p. 21).

23 Recovery as functional living? it s nowhere near the extent that it was that s why it s still an eating disorder however way you look at it but I don t see it too much as a struggle. I don t feel I m particularly struggling. Maybe that s why I haven t rung the therapist back because I don t think it s making me think God, you know what? This is really bringing me down, really impacting me. Because I don t feel down and I don t feel rundown by it. (from Papathomas, Smith & Lavallee, 2015)

24 Conclusion?

25 The Role of Sport & Exercise in Eating Disorders: Cause, Consequence, or Cure? Anthony Papathomas,

Why does every single girl on the earth at least once have a desire to be skinnier even

Page 1 Increasing Adolescent Anorexia Increasing Adolescent Anorexia Why does every single girl on the earth at least once have a desire to be skinnier even though they really don't have to be? And why