Eating Disorders

The most serious side effect from the pressures females face in their athletic careers is eating disorders. Eating disorders have risen drastically in the last ten years, especially among young female athletes. Athletes obviously have to perform publicly in highly competitive situations, but this is something that, for the most part, they enjoy. But too much outside pressure can lead to many negatives, including eating disorders. One reason female endurance athletes are so susceptible to eating disorders is that they are lead to believe that there is only one body type that will be successful - the 12 year old look. Therefore, they must have very low body weight in order to be competitive. Eating disorders, however, are not that simple. It is far more complicated than just wanting to be thin. "Anorexia nervosa is much more than just a diet gone awry and the sufferer more than an obstinate, skinny person refusing to eat. It is a complex problem with intricate roots that often begins as a creative and reasonable solution to difficult circumstances, and is thus a way to cope." Lindsey Hall and Monika Ostroff. Anorexia Nervosa A Guide to Recovery (Carlsbad, CA: Gurze Books. 1999). 17. When pressures become too much or get distorted they can lead to psychological issues that can be life threatening. To make matters worse, many athletes have A-type personalities. The very traits that make them so successful in the first place, perfectionism, high achievement expectations, self-disciplined, competitive and driven characteristics are also associated with eating disorders. These young women expect a lot from themselves and they are willing to put in the time, the work, and the sacrifice to get what they want. They don't mind sacrificing much to accomplish their goals. They are take-charge, driven, disciplined young women, evidenced by the things they willingly give up for their sport and the hard work they do day in and day out. They feel empowered by being in control of their life and accomplishing their goals. Unfortunately, that A-type personality can sometimes be a double-edge sword for some of them. Their need for control and perfectionism can lead many down a dangerous path. When they feel like things are getting out of their control they feel desperate and insecure. In order to try to get the feeling of control back, they sometimes resort to desperate measures such as not eating. The ironic thing about these young achievers is the control they do have over themselves. They would not or could not accomplish the things they have without having self-control. They were in control but they didn't realize it or came to believe they no longer had it because of too much pressure, whether from within or outside of themselves. The control they were desperately seeking is totally lost in their eating disorder. Eating disorders have nothing to do with food per se, but with the need of feeling in control or the need of controlling something they feel will harm or has harmed their performance level, entering into womanhood, or too much outside pressure from coaches or parents. For whatever reason, emotional and/or psychological, they feel desperate in their need to control this aspect of their life. Sadly, eating disorders have the opposite effect--they lose the very control they so desperately want and need. The very thing they desperately needed during this period of their life is now in control of them. They no longer have the control they once had. There are huge demands placed on young athletes today. They are expected to specialize at a very young age, leading many to heartbreak as the sport they excelled at as a pre-pubescent youth no longer holds for the now young-adult athlete. Their strengths and abilities shifted. What once worked well for them as a child is no longer working for them as a young adult. Their new body is better suited for another sport than the one they specialized in when just a child. But since they specialized so young they were never given the chance to know if they possibly could have been better suited for other sports as well. This specializing as children can be very limiting as young adults. They are also expected to perform at a high level at a very young age, and perform a lot. Society hates losers, and they know it! It is not good enough to be their best--they must be the best, especially if they are gifted, and have already had success. They know they are not being judged on the effort of their performance, but on the outcome of their performance. We live in a society where it no longer matters how or what you have done to be successful, only that you be successful. The end, not the means, is what is important. And to many young athletes this spells disaster. If you don't believe me, take some time to go around and be a spectator at sport competitions and listen to the parents and coaches. It's scary! We must educate ourselves in all aspects of youth coaching and competing, especially eating disorders. The warning signs are sometimes subtle, but can easily be spotted if the coach or parent is aware and educated. Here are some of the warning signs that an athlete may be feeling too pressured in their sport -- performance stagnates or drops, they lose the love for their sport they once had, they start making excuses for poor performances, they never feel good before competition, they harbor anger or resentment towards their coach or parent/s and sometimes both. Their running goals lessen dramatically or they no longer talk about running in their future. They do not want to discus running at all with either their coach or parent, especially when it personally involves them. They resent advice or constructive criticism, and are overly sensitive in issues regarding their sport. They have reached a point where the reason for participating in their sport no longer exists, or they no longer find joy and fulfillment in their sport. They are at a point where they feel their sport is serving everyone but themselves. If your child or athlete has reached this point, it is best for the parent or coach to take a giant step back and really look at the situation honestly, closely and clearly. Ask yourself if you are too close, expecting and pushing too much.

It is vital that you let them be the captain of their ship, that they are in control of their sport, and that they have the right to succeed or not. It is their success or their failure, and as young adults they need our support and guidance in sport and life, but not our pushing and control. They need to have both success and failure to learn and to grow into healthy sound adults. They need to experience and learn to handle all what sport throws at them. They are valuable lessons in life and if we interfere in that process we are hurting them in the long run. Our well-meaning intentions can actually hurt the future success of their sport career.

Parents and coaches must wear many hats and figuring out which one to wear is not easy at times. Coaching and parenting athletes can be very stressful, very complicated, very demanding, but learning when to step forward and when to step back is vital for the health and welfare of our young athletes. Coaches truly walk tight ropes at times, but if we stay attuned to our athletes we will learn and know better how to deal with the complexities of athletes and their sport. If we don't learn to read the warning signs of an athlete feeling too much pressure we can unintentionally push them into quitting their sport, or worse, into an eating disorder to try and gain some control of their life. Eating disorders are a deadly epidemic that is rising among our wonderful athletes, especially our females. The three most common eating disorders found in athletes are anorexia nervosa, bulimia nervosa, and compulsive exercise. Anorexia is self-starvation, bulimia is eating large quantities of food then purging, and compulsive exercise is doing more exercise than is needed for quality performance. All three disorders could have life threatening consequences.

"Anorexia nervosa has a multitude of medical complications ranging from mild to severe. In fact, it is believed that 5-20% of anorexics die, usually from complications associated with self-starvation, such as: heart, kidney, or multiple organ failure, or illnesses like pneumonia, which may be due to an inability to fight infection--all ultimately due to the anorexia. Studies show that the longer one has anorexia, the higher the mortality rate." Hall and Ostroff. Anorexia Nervosa A Guide to Recovery 31.

Health complications from anorexia include malnutrition, abnormal heart rhythms, amenorrhea (interruption of the menstrual cycle in females), osteoporosis (a decrease of bone mass), liver and kidney damage, hypoglycemia, low body temperature, muscle cramps and weakness - due to electrolyte imbalances, loss of hair on head, low blood pressure, sleeping disorders, destroyed body protein, decreased potassium level, constipation, high cholesterol, etc. Signs and symptoms of anorexia are excessive weight loss--15% below normal for age, height, and body type, always thinking about food, calories, and body weight, wearing layered or baggy clothing, mood swings, avoiding activities that involve food, complaining of always being cold, distorted body image, absence of at least three consecutive menstrual cycles, or if the athlete has not started menstruating at all by the age of 15 or 16.

Health complications from bulimia include laceration of the oral cavity (injury due to self-induced vomiting), esophageal inflammation (acid from vomiting may cause the tears in the esophagus), dental erosion (acid from vomiting erodes the dental enamel), cardiac arrest, dehydration, and electrolyte imbalance. Signs and symptoms of bulimia are excessive weight loss or gain, being overly concerned with one's weight, visiting the bathroom after meals, depression, excessive dieting, followed by binge eating, and always criticizing one's body.

Compulsive exercise warning signs are numerous--forcing exercise when tired or not feeling well, never exercises for fun or to relieve stress. Every time they exercise they go as fast or hard as they can. They experience severe stress and anxiety if they miss a workout. They miss family obligations and social events because they have to exercise. They calculate how much exercise to do based on how much they have eaten, would rather exercise than get together with friends, cannot relax because they think they are not burning calories, and worry that they will gain weight if they miss a workout. All three disorders will require someone close to the athlete to recognize these warning signs. Identifying athletes with an eating disorder is not easy. They are often secretive or blame their eating and exercise regiment on their training goals, and they are leaner then the non-athlete due to their sport when healthy and normal, but they have crossed that thin line into self-starvation. Many will resent interference because they feel you don't understand them or their needs. They feel you are attacking the very thing that is making them feel good about themselves. They feel they are finally in control and you want to take that away from them. As a coach or parent you must get them professional help. Unless you are a certified nutritionist, psychologist and doctor you are not qualified to treat them. They need your love, support, understanding, encouragement, and patience but they most definitely need professional help.

As coaches if you suspect you have an athlete that is anorexic or walking the thin line of anorexia nervosa you must deal with it promptly. A few athletic programs are now implementing standards that require medical clearances specifically for eating disorders; a required amount of calories to be consumed daily for participation; bone density testing; nutrition counseling, and, if necessary, counseling from a licensed therapist who is familiar with eating disorders. It is imperative for recovery that an athlete with an eating disorder restores their body weight as soon as possible. The longer they have an eating disorder, the harder and longer the recovery phase. It is also highly suggested that the athlete's whole family be involved in their therapy.

Be patient with the recovery process because you must remember they did not get to this point overnight and they will not heal overnight. Eating disorders are serious and can become life threatening. For more information, contact: Anorexia Nervosa and Related Eating Disorders, Inc.: (541) 344-1144. National Association of Anorexia Nervosa and Associated Disorders: (847) 831-3438. I am aware that there are many reasons for eating disorders; however, I only addressed eating disorders in regards to the female endurance athletes.

Please feel free to e-mail me at RSparks951@aol.com

Penny Sparks