- More than 5 million Americans experience eating disorders.
- 10 to 15 percent of those diagnosed with bulimia are men.
- 15 percent of young women have disordered eating behaviors or attitudes.
- Anorexia nervosa, bulimia nervosa, and binge-eating disorder affect the mind
and body simultaneously.
- 86 percent report onset of illness before the age of 20.
- Eating disorders are significantly higher (15 to 62 percent) in the athletic
population than the general population.
It is imperative that coaches,
administrators, parents, and officials know the signs and symptoms of disordered eating. Disordered eating ranges from mild and/or
occasional abnormal eating behaviors to the severe conditions of anorexia and bulimia. Disordered eating is a result of a combination of
physiological, psychological, social, and familial components.
General Signs & Symptoms of
- Repeatedly expresses concerns about being fat
- Preoccupation with food, caloric intake, and weight
- Increase in the criticism of ones body
- Lack of self-identity, low self-esteem, and role-conflict
- Mood swings (irritability, inability to concentrate, fatigue)
- Extreme loss or fluctuations in weight
- Change in menstrual cycle (may include lack of
- Avoidance of eating in public
- Making trips to the bathroom after large meals
- Excessive use of laxatives
- Engaging in physical activity above and beyond the
requirements of training program
- Wearing layered or baggy clothing
- Bloodshot eyes, swollen parotid glands
- Hair thinning or loss
- Headaches, dizziness, numbness, and tingling down the limbs
(as a result of electrolyte imbalances)
- Associated conditions of amenorrhea or osteoporosis (i.e.,
Female Athlete Triad)
What sports are at risk for having
athletes with disordered eating?
- Are scored subjectively (e.g., figure skating,
- Favor lower body weight (e.g., cross-country
- Require the athlete to wear body-revealing clothing
(e.g., swimming, diving, running, cheerleading)
- Have weight classes (e.g., wrestling, crew,
- Favor pre-pubertal body composition for success
(e.g., diving, gymnastics)
The role of the coach.
Be sure to identify the athletes who may be at risk for disordered eating and the
trigger factors that are associated with the problem.
If an athlete is showing signs and symptoms of disordered eating, refer them to a
medical professional that is trained or specializes in disordered eating in adolescents.
- Educate all involved with the athletic program (including
parents and officials) about the signs and symptoms of disordered eating.
- Take special care when working with athletes involved in the
at-risk sports, as well as those who have weight problems.
- Avoid placing too much emphasis on body weight, leanness or
size as a key component of optimal performance.
- To avoid unhealthy weight-control practices, weight
modifications should be managed under the supervision of the athletic trainer or
- If weigh-ins are required in the sport, have someone other
than the coach perform the weigh-ins.
- Have communication and plan of action in place for managing
and handling athletes with disordered eating.
and Social Factors
- Perfectionism, compulsion, determination, control
- Lack of self-esteem
- High family expectations/family dysfunction
- High achieving
- Pressure to optimize performance
- Emphasis on thinness
- Inability to cope with stress
- Lack of sense of identity
- Decreased strength and endurance
- Decreased anaerobic and aerobic capacity
- Decreased speed, agility, and concentration
- Decreased heart rate
- Low blood pressure
- Iron deficiency
- Electrolyte imbalances
A serious psychological disorder that includes the following
- Weight 15 percent below average for height and age-refusal to
maintain or be above appropriate weight for height and age
- An intense and extreme desire to be thin and fear of becoming
fat even though the individual is underweight
- Belief that oneself is fat or overweight even when the
individual is underweight
- Amenorrhea (no menstruation)
- Strong denial when confronted
Characterized by the binging on food in gross quantities
followed by vomiting or use of laxatives or diuretics.
Bodyweight may be underweight, overweight, or normal. Bulimia nervosa includes the following behavioral
- Binge eating accompanied by lack of control and physical or
- Purging (self-induced vomiting, diet pills, laxatives
diuretics, heavy exercise) in an attempt to rid the body of the calories consumed
- Binging and purging occurs two times per week for at least
- Visits bathroom after meals
- Body image (self-evaluation and self-esteem) is overly
influenced by body shape and weight
- Recognition that eating problem is out of control
This condition is specific to athletes and is similar to anorexia nervosa, but
without the self-starvation. Athletes with this condition will display all of the
- Weight loss >5 percent of body weight
- Gastrointestinal complaints
- Absence of medical illness explaining the weight reduction
- Excessive fear of becoming obese
- Caloric intake restriction
will also display one or more of the following:
- Delayed puberty (amenorrhea)
- Menstrual dysfunction
- Disturbance in body image
- Use of purging methods
- Binge eating
- Compulsive eating
Eating Disorders Not Otherwise Specified includes disorders that are not
categorized and are less severe. Athletes
with EDNOS will display the following characteristics:
- Average Weight
- Preoccupation with body image and weight
- Guilt experienced with eating
- Absence of amenorrhea
- Absence of binge-purge eating patterns
This is serious condition that involves three inter-related conditions. These are serious,
- Disordered eating
- Amenorrhea caused by extreme body weight loss or weight
- Osteoporosis secondary to amenorrhea
Sources: Harvard Eating Disorders
Center (HEDC); National Association of Anorexia Nervosa and Associated Disorders,
California Interscholastic Federation (CIF)
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