Recognizing Unhealthy Eating Behaviors in Student Athletes

Student athletes need proper nutrition and good eating habits not only for their health, but to achieve the best results on the field and in the classroom.

Disordered eating can greatly affect a student athlete’s physical, emotional, and psychological well-being.

Unhealthy behaviors, which are not typically self-reported, may be difficult to distinguish from normal diet behaviors that facilitate performance.

So, it's important for individuals who frequently interact with student athletes to:

• Recognize disordered eating patterns
• Understand the causes and adverse effects of disordered eating
• Appropriately manage those who exhibit disordered eating patterns

Types of Eating Disorders

The three types of eating disorders are:

• Anorexia nervosa
• Bulimia nervosa
• Eating disorders not otherwise specified (EDNOS)

These disorders are relatively common in athletes, with estimates as high as 62 percent for females and 33 percent for males. Recent literature also suggests that prevalence of these disorders is not necessarily dependant on participation in weight-sensitive sports, such as gymnastics and wrestling.¹

Disordered eating occurs on a large spectrum and includes factors such as:

• Body image
• Poor nutrition
• Binging (including excessive exercise and the use of laxatives)
• Fasting
• Using diuretics and diet pills

Anorexia nervosa involves a refusal to maintain a healthy body weight through restriction, whereas bulimia nervosa is characterized by restriction, binging, and purging.²

Regardless of the type of disorder, athletes who suffer from any of these conditions are at risk.

In females, the reproductive system is particularly susceptible. Disordered eating can lead to changes or elimination of the menstrual cycle, as well as significant decreases in bone mineral density.¹

Despite gender, disordered eating affects other body systems, such as the skeletal and cardiovascular systems.

Left untreated, these changes can result in the development of serious health conditions or even death.

“As a sports dietitian, I always try to help my athletes ‘SHOP’: Safeguard Health, Optimize Performance,” remarks Leslie Bonci, MPH, RD, CSSD, LDN, Director of Sports Nutrition at UPMC.

“That being said, no athlete can be his or her best mentally, physically, or emotionally if they exhibit disordered eating behaviors or have full blown eating disorders.

“It takes a team approach to get an affected athlete healthy and happy, so everyone involved in the athlete's care needs to step up to the plate to help that athlete sit down at the table,” Leslie says.

Signs of an Eating Disorder

While many signs associated with disordered eating — such as vital signs, body composition, and function of body systems — must be evaluated clinically by a specialist, the following signs can be observed by those interacting with student athletes^{1, 2}:

If You Suspect an Eating Disorder

Because of the sensitive nature of these conditions, athletes suspected to be disordered eaters should be confronted privately and with vigilance. Whoever has the best rapport with the athlete (athletic trainer, coach, teacher, or parent) should confront the athlete, focusing on the athlete’s feelings rather than eating habits or weight.²

It's not uncommon for these individuals to respond negatively, so it's best to have referral options in place.¹

Athletes with these conditions require comprehensive care that should be designed and implemented by a licensed psychologist. There must also be open communication between health care professionals involved in the case and cooperation from all parties involved (parents, coaches, etc.).

Disordered eating can occur on a broad spectrum and is not always clearly defined. These disorders can be detrimental to performance, as well as physical, emotional, and psychological health.

Therefore, it's important for coaches, parents, teachers, and even teammates to know how to recognize the signs and symptoms associated with disordered eating and to refer individuals to the appropriate health care professional for evaluation, diagnosis, and treatment.

For more information on disordered eating, where to refer athletes, or to schedule an appointment related to sports nutrition, call Leslie Bonci of the UPMC Sports Nutrition Program at 412-432-3674.

Sources

¹ Bonci, C.M., Bonci, L.J., Granger, L.R., Johnson, C.L., Malina, R.M., Milne, L.W., Ryan, R.R., Vanderbunt, E.M.
National Athletic Trainers’ Association Position Statement: Preventing, Detecting, and Managing Disordered Eating in Athletes. (PDF)
Journal of Athletic Training. 2008; 43(1):80-108.

² Weinberg, R.S., Gould, D.
Foundations of Sport and Exercise Psychology. Third ed.
Champaign, IL: Human Kinetics; 2003.