The crisper, cooler winter months are finally winding down and, with the approach of March, some of us may start to feel an enticing pull of warmer days, longer hours, and even summer’s distant wave. Many anticipate these promising lures and yet, with them, there also rises a potential for dark internal chatter. We are inundated with ads, images, and conversation surrounding ‘beach bodies,’ ‘bikini readiness,’ and ‘form fitness.’ For those already battling low self-esteem, mental health dips, and personal difficulty, this chatter sometimes climbs louder and louder. More and more deafening, until that internal critic potentially manifests in the form of an eating disorder (ED).
At least 30 million people in the United States are currently battling an ED. Every 62 minutes at least one person dies from ED complications. EDs have the highest mortality rate of any mental illness. 50-80% of the risk for anorexia and bulimia is genetic (ANAD). These are stats we may or may not have heard before and terrifying to comprehend. Yet, within the group of those affected by eating disorders, there exists a sub-category not always considered seriously: athletes. Especially those of prestige, competing at a high level. Did you know that 1/3 of NCAA athletes report attitudes and symptoms placing them at risk for eating disorders? That, given their particular demands and expectations, athletes are more than 3 times more likely to develop an eating disorder than the average person (Bowers, 2014)?
Athletes have the tenacity and competitive drive to daily push their bodies to new limits. They have mental grit, commitment, ‘coachability,’ and an ability to perform despite discomfort, all traits expected of elite athletes. These are qualities that herald success and, as such, are expected in first-class competitors. Unfortunately, we also frequently fail to recognize athletes are human and fallible. They, too, fall prey to a variety of disordered eating habits as well as the three main eating disorders, each recognized by distinct psychological and physical markers.
The first of these is Anorexia, defined as extreme weight loss through food restriction and excessive exercise. The qualities previously mentioned as requisite for a “good” athlete are twisted and exacerbated in anorexia’s case: mental toughness becomes perfectionism, the ability to perform despite pain/discomfort becomes denial of any comfort, and commitment to training becomes dangerous over-training. Anorexia especially leaves female athletes vulnerable to the “Female Athlete Triad;” this triad is comprised of disordered eating, amenorrhea, and osteoporosis. The Female Athlete Triad can lead to serious health complications, injuries and even death.
Bulimia is defined by disordered eating as well as cyclical food binging/purging sessions. Bulimia is clinically recognized as ‘self-destruction’ and a means for victims to ‘handle’ emotions. Those with bulimia frequently find they do not have an outlet for emotions and, therefore, ‘purge’ their feelings. Desire to avoid failure becomes internal berating over perceived ‘shortcomings.’ Aggression becomes internally unleashed rather than externally, ‘on the field.’
Binge Eating Disorder (BED) is identified by a couple factors: 1) Eating more food in a two hour period than the average person would, and 2) Feeling out of control while doing so (and exhibiting distress regarding over-eating). Binge-eating is frequently done secretly due to shame associated with said binges (Bowers). Defeats on the court appear insurmountable without constructive solutions, and an athlete may use food to bury fear, insecurity, and instability. Desire to win becomes intolerance of ‘losing.’
Athletes with eating disorders do not differ from non-athletes suffering from EDs in that they are typically secretive regarding their battles; they hope to avoid disappointing family members, teammates, and coaches. They also do not want to be prevented from using these behaviors. However, due to an already heightened physical activity, athletes can incur more serious injuries and an expeditiously declining health as calories potentially dwindle and exercise increases. Additionally, behaviors might be ignored or even encouraged by a competitor’s inner circle (coaches, parents) due to bursts of success. However, success spikes are often brief and limited. The human body cannot forever withstand damage wrought by an eating disorder. In a competitive world, there exists such a mantra as ‘success at any cost.’ This mindset is very difficult to change and, within the athletic population, the following populations are particularly vulnerable:
Those participating in sports with an emphasis on appearance, weight requirements, or muscularity (such as gymnastics, diving, and wrestling)
‘Individual sport’ athletes (running, figure skating, diving)
Endurance sports (track and swimming)
Those with an overvalued belief a lower weight equates greater success
Those who have been training at an elite level since youth
Those with low self-esteem, family dysfunction, a history of chronic dieting, history of physical abuse, family/cultural pressures to be thin, and other traumatic life experiences
Again, this list is not exhaustive. Though men are far from immune, females are statistically most at risk and further susceptible in the following circumstances:
Given the grievous danger eating disorders pose to an athlete’s ability to train and perform, not to mention their very life, they must be regarded with absolute seriousness. Athletes are seen as paradigms of strength and control and, as mentioned, often unravel unnoticed. Therefore, upon commencement of recovery, a decision must be made: does the athlete wish to return to their sport? In some cases, this is not possible (unstable vitals, imbalanced electrolytes, substantial weight loss, a regular engagement in ED behaviors, or relapse upon previous returns to sport would so prevent), but, if a ‘come-back’ is preferred, a full treatment team is ideally laced together: health physician, psychiatrist, therapist, and dietician. Recovery must be the primary objective.
Luckily athletes already harbor traits that beneficially seat them in terms of recovery success; they are used to being coached/taking instruction, have built-in support systems (families, coaches, teammates), and love for sport/the desire to compete provides huge motivation (Eating Disorder Hope). The hope is to stop eating disorders before they begin, but a first step may be to build awareness into thought and behavior. We at TOPPS support the movement of building awareness and providing resources. The National Eating Disorder Association (NEDA) has developed a list of recommendations for stymying these silent killers before they take initial root:
Positive, people-oriented coaching rather than negative, performance-oriented coaching
Social influence of and support from teammates with healthy attitudes toward body shape
Coaches who emphasize motivation and enthusiasm for personal success
Coaches and parents who educate, talk about, and support changing bodies (NEDA)
This NEDA Week, we hope to raise awareness. We hope to give those struggling, athletes or otherwise, a voice. We hope to eliminate stigma and to build, in its place, compassion and love. We know it’s “time to talk about it” (NEDA). And we’re talking. Are you?
ANAD. Eating Disorder Statistics. Retrieved from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/.
Bowers, Elizabeth Shimer. (11 July, 2014). Why Athletes Develop Eating Disorders. Retrieved from http://www.everydayhealth.com/news/eating-disorders-athletes/.
Eating Disorder Hope. (1 Mar, 2011). Getting Back in the Game of Life. Retrieved from https://www.eatingdisorderhope.com/treatment-for-eating-disorders/special-issues/athletes/risks-recovery.
NEDA. Athletes and Eating Disorders. Retrieved from https://www.nationaleatingdisorders.org/athletes-and-eating-disorders.