Eating Disorders in Sports Part 1 - What is an Eating Disorder?
Trigger warning: This post covers eating disorders, disordered eating, and mentions suicide.
Hi everyone! Today’s blog post is heavier and longer than our usual content because we are covering a serious issue in the athletic community: eating disorders. Whether you struggle with an eating disorder or know someone who does (Spoiler alert: everyone knows someone who is struggling, whether you realize it or not), eating disorders need to be discussed, especially among female athletes who are highly vulnerable to developing them. This is the first installment of a series on eating disorders in sports, which will cover the different types of eating disorders, common myths and misconceptions, strategies for navigating recovery as an athlete, and how we can address the toxic culture in sports as a whole. Please read this entire post and it with your peers - you never know who this may help.
What is an eating disorder?
Eating disorders are serious, deadly mental illnesses that cause mental and physical harm through an unhealthy relationship with food and body.
Who develops eating disorders?
Eating disorders do not discriminate: they affect people of all ages, genders, sexual orientations, races, ethnicities, body shapes, and weights. Approx 10% of the US population suffers from an eating disorder in their lifetime (1), yet only 10% will seek and receive professional treatment (4). This number is likely higher, as millions of people are never formally diagnosed.
Athletes are at a higher risk for developing eating disorders compared to the general public. 35% and 58% of female college athletes are at risk for anorexia and bulimia, respectively (1), and 20% of elite female athletes suffer from eating disorders (2). Disordered eating, a precursor to eating disorders, affects 62% of female athletes and 33% of male athletes (1).
What causes eating disorders?
Eating disorders are complex diseases caused by various factors, often a combination of psychological, biological, and sociocultural factors. Some factors include:
Underlying mental illnesses (depression, anxiety, OCD, bipolar disorder, etc.)
Genetic predisposition to mental illness
Having a history of dieting
Poor body image
Bullying and trauma
Social, familial, and cultural weight stigma and body shaming (5)
For athletes, participating in aesthetic, weight-class, or endurance sports where there is an emphasis on body shape and size increases one’s susceptibility to developing an eating disorder. Some of these sports include:
Symptoms of eating disorders
The earlier an eating disorder is detected, the higher the chances that the individual will recover. Eating disorders present themselves differently for every individual and can change over time. It is important to understand the various ways to identify and support someone who is struggling. Common symptoms include
A preoccupation with food, calories, macronutrients, dieting, weight, and body size
A strong concern with body shape and size
Skipping meals, fasting, and engaging in diets (food elimination diets, low carb/fat, etc.)
Excessive, compulsive exercising, despite weather, illness, injury, or fatigue
A strong concern with eating “healthy” or “clean.”
Eating alone or in secret
Irritability and mood swings
Weight fluctuations (NOTE: Not everyone with an eating disorder will present with weight changes, but large fluctuations can indicate an eating disorder)
Feeling cold and tired all the time
Dizziness, lightheadedness, and fainting
Evidence of binge eating (hiding food, eating in secret)
Evidence of purging behaviors (frequent bathroom use after meals, smells of vomiting, calluses on the back of hands)
Laxative, diet tea/pills, and anabolic steroid use
Self-worth tied directly to body image and food behaviors
(For those with Type 1 Diabetes) Neglect of diabetes management and restricting insulin
Health consequences of eating disorders
Eating disorders have the highest mortality rate of any mental illness, killing one person every 62 minutes (3). Women suffering from anorexia nervosa are 56 times more likely to commit suicide, 12 times as likely to die than other women the same age, and 1 in 5 will die as a direct result of their disorder (4). Mortality rates for other eating disorders are similarly high (6).
Eating disorders also wreak havoc on one’s mental and physical health and can cause long-term damage. Some consequences include:
Heart failure and cardiovascular issues
Cardiac arrhythmia (irregular heartbeat)
Bradycardia (a dangerously slow heartbeat)
Orthostatic hypotension (drop in blood pressure when standing)
Kidney and organ failure
Hair loss, brittle nails, dry skin
Weakened immune system
(For adolescents) Growth stunting
For female athletes, eating disorders can result in amenorrhea (loss of menstrual cycle). This serious condition leads to osteoporosis (bone loss) and reproductive harm, collectively called the Female Athlete Triad. We will cover this in more detail in future blog posts.
How to support someone with an eating disorder
Educate yourself on eating disorders using reputable resources
Set up a private place and time to talk
Be honest and use “I” statements - show that you care, but remain firm
Dismantle any stigma and create a safe, open space
Avoid giving overly simplistic solutions (ex. “Just eat,” “Just stop”)
Encourage them to seek professional support (therapist, doctor, dietitian, psychiatrist, treatment programs)
Tell a trusted individual (parent/guardian, teacher, therapist, counselor)
Avoid discussing topics such as calories, "good foods" and "bad foods", dieting, weight loss, and negative body-talk
Raise awareness about eating disorders in your communities
If you are concerned about a medical or psychiatric emergency (fainting, heart arrhythmias, seizures, a threat of suicide), immediately call 911 or seek medical support.
While their reaction may be angry or hostile, do not let this stop you from reaching out to them. They may deny the issue, but showing that you care tells them that you are there to support them.
Understand and acknowledge that you cannot “fix” their eating disorder, and that is ok. The best way you can support someone is by showing compassion, respect, empathy, and dignity.
I hope that this article can start the conversation on eating disorders in the athletic community and serve as a resource to educate athletes. If you are struggling with an eating disorder, know that you are not alone. Help is out there, and with the right support and mindset, full recovery is possible. The journey will not be linear, but it will ultimately allow you to reclaim the fulfilling life you deserve to live.
If you or someone you know is struggling with an eating disorder, call the National Eating Disorders Association hotline at (800)-931-2237. If you are experiencing a crisis, text NEDA to 741741 or call 911.
(1) "Eating Disorders and Athletes." National Eating Disorders Association, 18 Apr.
2019, www.nationaleatingdisorders.org/athletes-eating-disorders. Accessed
28 July 2020.
(2) Currie, Alan. "Sport and Eating Disorders - Understanding and Managing the
Risks." Asian Journal of Sports Medicine, vol. 1, no. 2. PubMed Central,
www.ncbi.nlm.nih.gov/pmc/articles/PMC3289170/. Accessed 28 July 2020.
(3) "Eating Disorder Statistics." National Association of Anorexia Nervosa and
Associated Disorders, anad.org/education-and-awareness/
about-eating-disorders/eating-disorders-statistics/. Accessed 28 July 2020.
(4) "Eating Disorders Statistics." Mirror-Mirror, Mirror-Mirror.org,
mirror-mirror.org/facts-staticstics. Accessed 28 July 2020.
(5) "Risk Factors." National Eating Disorders Association,
www.nationaleatingdisorders.org/risk-factors. Accessed 28 July 2020.
(6) "Health Consequences." National Eating Disorders Association, National Eating
Disorder's Association, www.nationaleatingdisorders.org/
health-consequences. Accessed 28 July 2020.
(7) "How to Help a Loved One." National Eating Disorders Association,
www.nationaleatingdisorders.org/learn/help/caregivers. Accessed 28 July