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Under the Radar: How Eating Disorders Impact Athlete Mental Health

It’s a Friday night or Sunday afternoon, what are you doing? I’d be willing to bet many of us are watching our favorite sports teams play, yelling at the television when someone makes a mistake. Or maybe, you’re attending a kid’s game. Perhaps you showed up to support your best friend in their championship meet. Watching our favorite athletes compete is not just a pastime; it's an engaging experience where we, as fans, invest hours, sharing in the excitement of the game and the ups and downs of our favorite teams.

We get to see the product of hours of literal blood, sweat, and tears these athletes put into their sport. In the world of athletics, this relentless pursuit of excellence is lauded and celebrated. However, beneath the surface of seemingly perfect physiques and peak performances, many of these athletes are wrestling with a fierce opponent: eating disorders. 


The Prevalence

Eating disorders and disordered eating behaviors are alarmingly prevalent among athletes, cutting across all levels of competition and sports. The pressure to maintain a certain physique, combined with the intense drive for peak performance, often pushes athletes towards unhealthy eating habits. From restrictive dieting and excessive exercise to binging and purging, these harmful practices can severely impact both physical health and mental well-being. 

Let's look at the numbers, shall we? In a 2004 study by Dr. Jorunn Sundgot-Borgen and Monica Klungland Torstveit, results showed that more elite athletes (13.5%) than non-athletes (4.6%) had subclinical or clinical eating disorders. Now, I know what you’re thinking: that research study was from 20 years ago. I hear you, so let’s consider a study done in 2012 by the same Dr. Jorunn Sundgot-Borgen. In this later study, researchers found that the prevalence of disordered eating and eating disorders varied from 0-19% in male athletes and 6-45% in female athletes. Equally concerning, another study found that the prevalence of disordered eating and eating disorders in adolescent athletes is statistically significant, with the highest rate being 9.6% in the 15-18 age group. Clearly, the issue of eating disorders among athletes remains a critical concern that demands ongoing attention and action.


The Risk Factors

Several factors contribute to the heightened risk of eating disorders in athletes. These include:

  1. Performance Pressure: Athletes often face immense pressure to maintain a certain weight or body composition to optimize performance. This pressure can come from coaches, teammates, family members, or the athletes themselves.

  2. Sport-Specific Aesthetic Ideals: Certain sports have aesthetic ideals that athletes feel compelled to conform to, which can drive unhealthy eating behaviors.

  3. Perfectionism and High-Achievement Orientation: The majority of athletes possess personality traits such as perfectionism and a high drive for success. While this is what makes them so good at what they do, these characteristics can also give way to disordered eating.

  4. Body Image Di stortion: Athletes may develop a distorted body image, believing that losing more weight or altering their body shape will improve their performance. Conversely, they may feel the physique they need to perform does not match societal ideals. Both mindsets distort athletes’ perception of their bodies and may contribute to harmful habits.


The Impact

The consequences of eating disorders in athletes can be profound. Physically, they can lead to nutritional deficiencies, decreased bone density, menstrual dysfunction in female athletes, and an increased risk of injury. Psychologically, they can result in anxiety, depression, and preoccupation with food and eating. One study published in the International Journal of Eating Disorders highlighted that athletes with eating disorders, both clinical and subclinical, often experience a decline in performance due to the physical and mental toll of their disordered eating behaviors. This decline can create a vicious cycle, where decreased performance leads to increased stress and further disordered eating.

A 2016 study in the Journal of Sports Sciences found that female athletes with eating disorders were significantly more likely to experience stress fractures compared to their peers without eating disorders. Additionally, research published in the British Journal of Sports Medicine in 2019 emphasized that male athletes are not immune to these issues, with a substantial number reporting symptoms of eating disorders and related psychological distress. Moreover, a 2018 study in the Journal of Adolescent Health revealed that adolescent athletes with disordered eating behaviors faced higher risks of long-term health problems, including cardiovascular issues and persistent psychological challenges. These findings underscore the urgent need for targeted interventions and support systems to protect the health and well-being of athletes at all levels of competition.


So, what?

The physical and psychological consequences of eating disorders in athletes are not just short-term issues but can lead to long-lasting health problems that affect their overall well-being and career longevity. Recognizing the severity of these issues, medical and mental health professionals must play a pivotal role. We need to work collaboratively to provide comprehensive care, including early screening, timely intervention, and ongoing support. Educating coaches, athletic trainers, and athletes about the signs of eating disorders and promoting a culture that values health over performance, the human over the athlete, are crucial steps. By addressing these issues head-on, we can help athletes achieve their peak potential without sacrificing their health and happiness.


References


Ackerman, K. E., & Misra, M. (2016). Bone health and the female athlete triad in adolescent athletes. Journal of Sports Sciences, 34(15), 1509-1517. doi:10.1080/02640414.2015.1136623


Giel, K. E., Hermann-Werner, A., Mayer, J., Diehl, K., Schneider, S., Thiel, A., ... & Zipfel, S. (2016). Eating disorder pathology in elite adolescent athletes. International Journal of Eating Disorders, 49(6), 553-562. doi:10.1002/eat.22504


Gouttebarge, V., Jonkers, R., Moen, M., Verhagen, E., & Wylleman, P. (2019). Psychosocial factors associated with symptoms of depression in adolescent athletes. British Journal of Sports Medicine, 53(9), 592-597. doi:10.1136/bjsports-2018-100040


Martinsen, M., Bratland-Sanda, S., Eriksson, A. K., Sundgot-Borgen, J., & Pettersen, G. (2018). Treatment seeking for eating disorders in female athletes and non-athletes. Journal of Adolescent Health, 62(4), 352-358. doi:10.1016/j.jadohealth.2017.09.029


Sundgot-Borgen, J., & Klungland Torstveit, M. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25-32. doi:10.1097/00042752-200401000-00005


Sundgot-Borgen, J., & Torstveit, M. K. (2012). Prevalence of eating disorders in elite athletes is higher than in the general population: A systemic review with meta-analysis. International Journal of Eating Disorders, 45(6), 759-771. doi:10.1002/eat.22042


Walter, N., Heinen, T., & Elbe, A.-M. (2022). Factors associated with disordered eating and eating disorder symptoms in adolescent elite athletes.Sports Psychiatry: Journal of Sports and Exercise Psychiatry, 1(2), 47–56. https://doi.org/10.1024/2674-0052/a000012






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