Athletes and Eating Disorders
In a sense, eating disorders are diets and fitness or sports programs gone horribly wrong. A person wants to lose weight, get fit, excel in his or her sport, but then loses control and ends up with body and spirit ravaged by starvation, binge eating, purging, and frantic compulsive exercise. What may have begun as a solution to problems of low self-esteem has now become an even bigger problem in its own right.
Several studies suggest that participants in sports that emphasize appearance and a lean body are at higher risk for developing an eating disorder than are non-athletes or folks involved in sports that require muscle mass and bulk.
Eating disorders are significant problems in the worlds of ballet and other dance, figure skating, gymnastics, running, swimming, rowing, horse racing, ski jumping, and riding. Wrestlers, usually thought of as strong and massive, may binge eat before a match to carbohydrate load and then purge to make weight in a lower class.
One study of 695 male and female athletes found many examples of bulimic attitudes and behavior. A third of the group was preoccupied with food. About a quarter binged at least once a week. Fifteen percent thought they were overweight when they were not. About twelve percent feared losing control, or actually did lose control, when they ate. More than five percent ate until they were gorged and nauseated.
In this study, five and a half percent vomited to feel better after a binge and to control weight. Almost four percent abused laxatives. Twelve percent fasted for twenty-four hours or more after a binge, and about one and a half percent used enemas to purge.
Another research project done by the NCAA looked at the number of student athletes who had experienced an eating disorder in the previous two years. Ninety-three percent of the reported problems were in women's sports. The sports that had the highest number of participants with eating disorders, in descending order, were women's cross country, women's gymnastics, women's swimming, and women's track and field events.
The male sports with the highest number of participants with eating disorders were wrestling and cross country.
Male and female athletes: different risk factors
The female athlete is doubly at risk for the development of an eating disorder. She is subject to the constant social pressure to be thin that affects all females in western countries, and she also finds herself in a sports milieu that may overvalue performance, low body fat, and an idealized, unrealistic body shape, size, and weight. Constant exposure to the demands of the athletic subculture added to those bombarding her daily on TV, in movies, in magazines, and transmitted by peers, may make her especially vulnerable to the lures of weight loss and unhealthy ways of achieving that loss.
Males also develop eating disorders but at a much reduced incidence (approximately 90% female; 10% male). Males may be protected somewhat by their basic biology and different cultural expectations.
Many sports demand low percentages of body fat. In general, men have more lean muscle tissue and less fatty tissue than women do. Males also tend to have higher metabolic rates than females because muscle burns more calories faster than fat does. So women, who in general carry more body fat than men, with slower metabolisms and smaller frames, require fewer calories than men do.
All of these factors mean that women gain weight more easily than men, and women have a harder time losing weight, and keeping it off, than men do. In addition, women have been taught to value being thin. Men, on the other hand, usually want to be big, powerful, and strong; therefore, men are under less pressure to diet than women are -- and dieting is one of the primary risk factors for the development of an eating disorder.
Special concerns: wrestlers and quick weight loss
Everyone who uses drastic and unhealthy methods of weight loss is at risk of dying or developing serious health problems, but the deaths of three college wrestlers in the latter part of 1997 triggered re-examination of the extreme weight-loss efforts common in that sport. Athletes in other sports have died too; runners and gymnasts seem to be at high risk. The deaths of three young men in different parts of the U.S. in the late 1990s has put the problem once again before the public.
News reports say that the three were going to school in North Carolina, Wisconsin, and Michigan. Authorities believe they were trying to lose too much weight too rapidly so they could compete in lower weight classes. The wrestling coach at Iowa State University has been quoted as saying, "When you have deaths like this, it calls into question what's wrong with the sport. Wrestlers believe that, foremost, it's their responsibility to make weight, and that mind set may come from the fact that they find themselves invincible." They share that mind set with others who use dangerous methods of weight loss, both athletes and non-athletes.
Two of the young men were wearing rubber sweat suits while they worked out in hot rooms. One died from kidney failure and heart malfunction. The other succumbed to cardiac arrest after he worked out on an exercise bike and refused to drink liquids to replenish those he lost by sweating. One was trying to lose four pounds, the other six.
Wrestlers share a mentality with people who have eating disorders. They push themselves constantly to improve, to be fitter, to weigh less, and to excel. They drive themselves beyond fatigue. One coach reports that "wrestlers consider themselves the best-conditioned athletes that exist, and they like the fact they can go where no one's gone before. The instilled attitude among these kids is that if they push and push, it'll pay off with a victory." No one expects to die as a consequence of weight loss, but it happens.
When a clamor arose for the NCAA to do something, to make rules prohibiting drastic methods of weight loss, a representative said, "We could make every rule in the book, but we can't legislate ethics. That's where the wrestlers and coaches have to put the onus on themselves."
What price victory? It takes wisdom indeed to realize that in some circumstances the price is too high.
Update: August 2001
Researchers at Toronto General Hospital and York University in Toronto have reported a study which indicates that "there is little valid support for the theory that athletes with eating disorders are psychologically different from their non-athlete counterparts, nor any justification for the label 'anorexia athletica' or 'activity anorexia.' Scores on test instruments were no different in groups of non-athletic ED patients and groups of elite athletes with EDs. "There is no support for the concept that athletes with eating disorders are less ill than other eating disorders patients, or that their symptoms are simply due to over-training and the intensive training frequently required of elite athletes." (reported at the Academy for Eating Disorders conference, May 2001, Vancouver, and excerpted in Eating Disorders Review, July/August 2001, Gurze Books)
© 2002, Anorexia Nervosa and Related Eating Disorders, Inc.