Transcript Understanding Eating Disorders and Athletes

Understanding Eating
Disorders and Athletes
Stephanie Chervinko, Ph.D.
University of West Florida
Counseling Center
Overview
Definitions, diagnostic criteria
Prevalence
Factors unique to athletes
Warning signs
Intervention
Diagnostic Criteria
Anorexia Nervosa
– Refusal to maintain minimally healthy
body weight for age and height
– Intense fear of gaining weight, even
though underweight
– Disordered body image
– Amenorrhea (absence of 3 consecutive
menstrual cycles)
Diagnostic Criteria
Bulimia Nervosa
– Recurrent episodes of binge eating
– Recurrent inappropriate compensatory
behavior in order to prevent weight gain
– Binge eating and compensatory
behaviors occur on average twice a
week for 3 months
– Self-evaluation unduly influenced by
body shape and weight
Diagnostic Criteria
Eating Disorders Not Otherwise
Specified (EDNOS)
– Atypical or subclinical eating disorder
Criteria for anorexia met except amenorrhea
or weight
Binge eating disorder
Anorexia Athletica
Subclinical eating disorder frequently
found in athletes
Individuals <5% of expected body weight
Fear of becoming fat
Restriction of food to <1200 kcal
Compulsive exercise
Amenorrhea
Occasional binge/purge
Female Athlete Triad
Disordered eating (AN, BN, EDNOS)
Amenorrhea
Osteoporosis – loss of bone density
Prevalence
Normative for young women to experience
body dissatisfaction and desire weight loss
Sociocultural demands placed on women
to be thin along with pressure from sport
to meet weight standards or body size
expectations of sport
~33% of female college athletes report
disordered eating
Prevalence and Men
Sociocultural demands placed on men to achieve
a particular physique along with pressure from
sport to meet weight standards or body size
expectations of sport
~16% of individuals with eating disorders are
male (increasing)
~25% of individuals with binge eating disorder
are male
Gay men particularly at risk
NCAA Study on Athletes and
Eating Disorders
1,145 student athletes from 11
Division 1 schools
Females-mean desired body fat 13%
& mean actual body fat 15.4%
(healthy = 17% - 25%)
Females-173 had BMI 15-20
Males-mean desired body fat 8.6% &
mean actual body fat 10.5%
(healthy = 10% - 15%)
Factors Unique to Athletes
No single cause for eating disorders
Sport body stereotype – “thin-build
sports”
– Expectation for athletes in certain sports
to display a characteristic body size and
shape
– Fitted uniforms, body on display
– Belief that thinness enhances
performance
Factors Unique to Athletes
Symptoms vs desired characteristics
of athletes
– Driven personality
– Perfectionists
– People pleasers
– Obsessive-compulsive tendencies
– High pain tolerance
– Size increase due to weight training
Factors Unique to Athletes
Stress of being in the spotlight
Balancing multiple role demands
Warning Signs
Physical
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Intolerance to cold
Dizziness, fainting spells
Constipation
Loss of muscle tone
Frequent weight fluctuations
Impaired concentration
Swollen salivary glands, puffiness in cheeks
Broken blood vessels in eyes
Complains of sore throat, fatigue, & muscle
aches
– Tooth decay, receding gums
Warning Signs
Behavioral
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Restricted food intake
Eliminating specific foods or whole food groups
Fear of food, avoiding situations where food is present
Excuse of “picky” eater, despite previous flexible eating
Excessive exercise
Regular weighing
Frequent comments about own weight, calories, food fat
content
– Frequent bathroom visits following meals
– Moodiness
– Withdrawal from others
Warning Signs
Attitudinal
– Dichotomous thinking
– Denial of eating problems
– Perfectionistic standards
– Harsh self-criticism
– Self-worth determined by weight
Intervention: What to Do
Set aside time for a private, respectful meeting to
discuss your concerns openly and honestly in a
caring and supportive way.
Describe what you have seen and heard that has
lead to your concerns.
Ask the person to explore these concerns with a
counselor, doctor, or any health professional s/he
feels comfortable enough to see.
Expect denial, rationalization, & anger.
Intervention: What to Do
Offer to accompany athlete to first medical or
therapy appointment for support.
Emphasize place on team will not be endangered
by admitting an eating disorder (coaches).
Add that participation will only be curtailed if
eating disorder has compromised athlete’s health
or put athlete at risk for injury (coaches).
Remember most athletes with eating disorders
have tried and failed to solve the problem on
their own.
Intervention: What to Do
Arrange for regular, private follow-up meetings
apart from practice times.
Remember that many athletes who develop
eating disorders have been told to lose weight.
Past or present coaches may have contributed to
eating disorder.
Let the athlete know that the demands of the
sport may have played a role in the development
of the problem.
When in doubt about how to intervene, consult,
consult, consult
Intervention: What Not to Do
Don’t question teammates or talk to them
about the athlete. Talk directly to athlete.
Don’t ignore the problem. Intervene
Never conclude that an athlete just isn’t
trying hard enough to overcome an eating
disorder.
Don’t try to keep the problem hidden or
try to deal with it yourself.
Intervention: What Not to Do
Don’t get into a power struggle about
whether there is a problem.
Don’t be deceived by excuses.
Questions?