Weight Focused Sports Associated With Disordered Eating

The general outlook on athletes is the healthy physique and optimal strength they acquire, they are considered the superheroes of sport, pushing new limits in their field and going beyond what non-athletes would deem themselves incapable of.

Despite how we may perceive these individuals, there is literature claiming that unhealthy eating behaviours are very real within the sporting industry.

Eating disorders:

Eating disorders are characterised by severe disturbances in eating habits that are associated with physiological changes. Those with eating disorders develop an unhealthy relationship with food, body size and appearance. Examples of eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge eating disorder. Other Specified Feeding or Eating Disorder is applied to cases when an individual engages certain behaviours which cause impaired functioning but does not meet the full diagnosis of an eating disorder. This is where disordered eating comes in, although it is not technically an eating disorder it has high potential to fall into more problematic eating disorders and can cause the individual suffering with it a great deal of distress.

Higher in women:

The prevalence of eating disorders is shown in research to be higher in female athletes as opposed to male athletes. Disordered eating and eating disorders range from 0-19% in male athletes and 6-45% in female athletes.

Eating disorders and disordered eating in athletes:

There is consistent evidence to show eating disorders and disordered eating to be prevalent amongst athletes, particularly in sports emphasizing leanness and weight sensitive sports including aesthetic, weight category, jumping and endurance. Lower, non-lean sports also have increased rates of disordered eating.

The literature shows conflicting data on the influence of athletic sport on disordered eating behaviours;

In a study on disordered eating in athletes and nonathletes, lean sport athletes had higher mean scores for ‘drive for thinness scale’ compared to non-lean sport athletes and nonathletes. This supports previous reports to suggest some detrimental food behaviours in athletes.

However, in the same study female athletes did not present more disordered-eating symptoms compared to women who did not participate in collegiate sports. This study does have limitations that could impact the validity of the results such as study population and inaccurate self reporting.

Trigger factors of disordered eating:

Trigger factors associated with the cause of eating disorders in athletes’ appear to be related to aspects such as sudden increase in training volume, traumatic events such as injury, consistent weight fluctuations and prolonged periods of dieting. Swimmers in a study attributed the pressure of weight loss to aspects such as team-mates, themselves and coaches. Disordered eating attitudes are shown to increase with perfectionism. Exercising to be attractive and improve appearance has also been presented as a cause for unhealthy eating behaviours in athletes.

Prevention and management:

The prevention and management of disordered eating behaviours is especially dependent in weight sports, and a collaborative effort should be made within the athletic community of physicians, and athletic coaches to take measures to decrease the onset of these behaviours in athletes. A study found 60% of elite athletes from lean focused as well as non-lean focused sports reported to experience pressure from their coaches concerning body shape. This is an example of how those around the athlete may be unintentionally encouraging the onset of these behaviours, and highlights the importance of early intervention. Recognising these detrimental behaviours in athletes is crucial for providing them with professional assistance, as athletes might be less likely to seek out help due to stigma issues.

According to the National Athletic Trainer Association and International Olympic Committee screening tools used for eating disorders in all female athletes are suggested to be an important part of preparticipation examination, and should be done using a tool that is specifically validated for the athlete.

Another prevention method which can be implemented for female, particularly younger athletes are clinical treatment programs for different sports, athletes may benefit from having education on body appreciation and functionality.

The female triad:

The female triad is a combination of three conditions seen in physically active female athletes consisting of menstrual dysfunction, low bone mineral density, as well as low energy availability. It is caused by what is referred to as metabolic injury. Athletes involved in lean-dependent sports are at a higher risk. Research has reported a higher frequency of menstrual dysfunction in athletes opposed to control non-athlete groups. This condition can be caused by a range of disordered eating habits from not having sufficient calories to meet energy requirements to serious eating disorders. Disordered eating appears to be central in the triad.

Examples of how disordered eating habits can affect different athletes:

Society plays a role in influencing the stereotypes of the female body being thin, which combined with pressure from the media, may cause pressure in sports, especially when aesthetic leanness is the goal. In a study done on body image and eating behaviour of female student dancers, there were significantly higher scores for dancers in all questionnaires including ‘drive for thinness’ and ‘body dissatisfaction’. Female dancers were presented to be at risk of disordered eating behaviour due to striving for a desirable look for both performance and appearance.

Female physique athletes such as bodybuilders are also shown to be at one of the highest risks within developing disordered eating or eating disorders. In a study done on female physique athletes approximately half of the participants out of 348 were engaged in at least one of the concerning pathogenic weight control measures such as binge eating, self induced vomiting and laxative use. The ‘drive for thinness’ and ‘body dissatisfaction’ were also factors associated with these behaviours. Another study found the prevalence of eating disorders among female athletes taking part in aesthetic sports to be 42% higher than other sports.

Unhealthy behaviours in the relationships between perfectionism, body esteem dimensions and restrained eating were observed in synchronized swimmers. Participants reported to perceive themselves as overweight and some admitted to the use of weight loss methods such as fasting, self induced vomiting, skipping meals and excessive exercise. Results also showed there to be a link between self orientated perfectionism and dietary restraint.

Water polo is an example of a team sport which emphasises the control of body weight for international distinctions and is also associated with a higher risk of developing disordered eating in comparison to other team sports.

Mental health and disordered eating in athletes:

Anxiety levels in Turkish athletes with and without eating disorders were compared in a study and found that both state and trait anxiety scores were higher in athletes with disordered eating behaviours.

100 athletes took part in questionnaires to investigate the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression. The results showed exercise addiction to be correlated with scores across the study sample. Athletes engaging in individual sports scored significantly higher depression scores compared to group athletes. Analysis also revealed that abnormal eating attitudes played a key role in the high ratings of exercise addiction. This further supports previous evidence that shows the link between exercise addiction and eating disorders.

So to sum up everything mentioned so far, it is not so much being an athlete which puts the athlete under greater risk of developing a eating disorder/disordered eating, it is athletes competing in sports which heavily emphasise the importance of a specific lean body standard/low weight which can result in a increased vulnerability to these habits.

Overall the effects of disordered eating on athletes has been well documented, but it is important to be aware of the specific categories within sport such as lean sports and how women in particular are shown to be more susceptible to developing a negative relationship with food and their body. By educating ourselves on the implications, we are better equipped to take preventative measures and avoid the onset of these life changing psychological and physiological effects.