October/November 2020 - 18

Nutrition
Eating Disorders in Athletes
By Stacey Fairey, MPH, RD
Contributing Writer
W
..ith the uncertainty created by the
..COVID-19 pandemic, athletes at all levels
..of competition are facing challenges to
their physical and mental health. Social isolation, limited
access to training facilities, fewer food options, and delays
of competition are just a few of the stressors impacting
athletes. These disruptions may increase weight and fitness
concerns, causing many to put extra focus on
their eating and exercise behaviors.
This has the potential to worsen existing
eating disorders, or even cause new
cases, in a group that already experiences
higher rates than the general population.
A recent survey of just under 6,000
NCAA student-athletes found that 11
percent and 29 percent of male and
female athletes, respectively, reported
disordered eating along with high
levels of body dissatisfaction due to
COVID-19. These rates are likely even
higher when considering the wide
range of athletes impacted by the
ongoing pandemic.
Eating disorders have major
implications on the physical health
and performance of athletes, and
the clinical symptoms can present
differently from person to person.
Electrolyte imbalances, hormonal
disruptions, and repeated stress
fractures and other injuries are just
a few possible symptoms. Most
concerning, eating disorders
also have the second-highest
mortality rate of all mental
health disorders. This
further highlights that all
professionals who work
with athletes have the
responsibility to educate
themselves on the risks,
know how to identify warning signs, and offer needed
support and referral as early as possible to prevent
damage to both health and performance.
WHAT ARE SOME WARNING SIGNS?
One of the top contributors to the high rates of eating
16 | Training & Conditioning | October/November 2020
disorders in athletes is the pressure associated with the
sport. Competitiveness and a drive for perfectionism
are often expected and praised in athletes, but these
traits can also trigger disordered eating and exercise
behaviors that may intentionally or unintentionally lead
to inadequate energy intake. The expectation to fit the
idealized " athletic body " increases the risk of body
image dissatisfaction, a main contributor
to the development of eating disorders.
Although commonly thought to only
affect female athletes, male athletes
are also at risk of both body image
dissatisfaction and eating disorders,
with almost equal rates of
subclinical disordered eating
behaviors as females. The
highest rates have been
found across both genders
in weight-class sports,
aesthetic sports, and sports
that emphasize a lean physique.
Athletes who participate in other
sports are still at risk, however, and
should not be overlooked.
To many, it may seem easy to
identify the athlete with the eating
disorder, as we tend to picture an often
described thin body. But in reality,
eating disorders come in all shapes and
sizes and can be hard to detect. Not
only may there be secrecy and shame,
but fixating on food and body weight
is unfortunately often normalized
in sport culture. Athletes with
eating disorders may be able
to maintain a high level of
physical performance while
restricting their energy
intake and reducing their
body mass, and sports
professionals may be
the first line of defense when it comes to identifying
these athletes and offering support.
Knowledge of the clinical presentations and diagnostic
criteria for the most common eating disorders is
important for all who work with athletes (see sidebar),
but there remains a wide spectrum of disordered eating
October/November 2020

Table of Contents for the Digital Edition of October/November 2020
