Spotting Disordered Eating in Athletes: Red Flags and Risks

Athletes are at a higher risk of developing eating disorders compared to the general population. The prevalence of eating disorders in athletes, including anorexia nervosa, bulimia nervosa, and disordered eating, is concerning due to its association with physical and mental health risks, as well as impaired performance.

As a sports dietitian, it is crucial to be vigilant for signs of disordered eating in athletes and physically active individuals. Aiming for peak performance does not come without risks. Among others, factors such as the pressure to achieve an "ideal" body, performance improvements, and sociocultural influences contribute to the increased prevalence of disordered eating and eating disorders in elite athletes.

Recognizing 5 of The Bigger Red Flags

  1. Self-reported restrictive eating: including calorie restriction, limited food variety, or strict dietary rules that result in inadequate energy intake. This behaviour can lead to nutrient deficiencies, fatigue, and impaired recovery, affecting performance and overall health.

  2. Unsafe weight loss practices: Rapid or excessive weight loss methods, such as severe calorie restriction, excessive exercise, or the use of supplements or substances (including sauna suits and laxatives) to manipulate weight, can indicate disordered eating. These practices can lead to muscle loss, dehydration, and electrolyte imbalances, increasing the risk of injury and compromising performance.

  3. Poor body image: Athletes may express dissatisfaction with their body shape or weight, often striving for an unrealistic "ideal" physique. This dissatisfaction can lead to negative body image, low self-esteem, and psychological distress, impacting both mental well-being and performance.

  4. Menstrual function: Irregular or absent menstrual periods in female athletes, known as menstrual dysfunction, can be a sign of energy imbalance due to disordered eating or excessive exercise. This condition can lead to hormonal imbalances, affecting bone health and overall well-being.

  5. Low bone mineral density and injuries: Prolonged energy imbalance and inadequate nutrition can lead to low bone mineral density, increasing the risk of stress fractures and other bone-related injuries in athletes.

Less Obvious Red Flags

  1. Obsessive focus on food and exercise: While dedication to nutrition and training is essential for athletes, an obsessive preoccupation with these aspects, to the detriment of other life areas, can indicate a problem. This may include excessive planning of meals, rigid exercise routines, and anxiety about deviating from these patterns.

  2. Social withdrawal or avoidance of social events involving food: Athletes with disordered eating may avoid social situations that involve food or eating, as they feel uncomfortable or anxious about food choices, portion sizes, or being observed while eating.

  3. Changes in mood or behaviour: Disordered eating can affect an athlete's mood and behaviour. They may become irritable, withdrawn, or exhibit signs of depression or anxiety related to their body image or food.

  4. Denial or secrecy about eating habits: Athletes with disordered eating may be secretive about their food intake or deny any problems when asked about their eating habits, even if others have observed concerning behaviours.

The Continuum of Disordered Eating

Disordered eating occurs on a continuum, starting from dieting and restrictive eating, progressing to abnormal eating behaviour, and potentially culminating in clinical eating disorders. This continuum model emphasizes the importance of early intervention and support for athletes at various stages. The consequences of disordered eating and eating disorders extend beyond physical health, impacting emotional well-being and overall quality of life.

When to Seek Help

If you suspect that you or someone you know may be exhibiting signs of disordered eating, it is important to seek help from a psychologist and/or sports dietitian. These professionals can provide the necessary support, guidance, and interventions to address the issue and prevent it from escalating into a more serious condition. Remember, early detection and intervention are key to effectively managing disordered eating and promoting a healthy relationship with food and body image.

By being aware of the red flags and understanding the continuum of disordered eating, sports dietitians can contribute to the well-being and success of athletes both on and off the field.

Final Words

As a sports dietitian, it is imperative to stay informed about the prevalence, risk factors, and red flags of eating disorders in athletes and physically active individuals. By being vigilant for these red flags and understanding the psychological and physical implications of eating disorders, sports dietitians can play a crucial role in early detection, intervention, and the overall well-being and performance of athletes.

Hope this helped!

Maria Tanielian
Registered Dietitian/Nutritionniste
ODNQ # 7223, CDBC # 2815, SDA # 949, CDO #16856

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References

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  3. Byrne, S. and McLean, N. (2001). Eating disorders in athletes: a review of the literature. Journal of Science and Medicine in Sport, 4(2), 145-159. https://doi.org/10.1016/s1440-2440(01)80025-6

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  7. Korkmaz, N., Ozturk, I., Mutlu, S., Akbas, G., & Hasturk, M. (2022). Examination of the relationship between tendencies of narcissism and eating disorders in elite athletes.. https://doi.org/10.21203/rs.3.rs-1456714/v1

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  9. Niekerk, R. and Card, M. (2018). Eating attitudes: the extent and risks of disordered eating among amateur athletes from various sports in gauteng, south africa. South African Journal of Psychiatry, 24. https://doi.org/10.4102/sajpsychiatry.v24i0.1179

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  13. Thompson, A., Yingling, F., Boardley, D., & Rocks, J. (2007). Collegiate athletic trainers' knowledge and perceptions of disordered eating behaviors in athletes. Psychological Reports, 101(3_suppl), 1173-1178. https://doi.org/10.2466/pr0.101.4.1173-1178

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