Eating Disorders in Athletes: What are the Risk Factors?

July 6, 2004 11:16 AM

By Jim Brown, Ph.D., Executive Editor, Sports Performance Journal (

Successful athletes often seek perfection, are goal-oriented, and driven to excel. They may also be independent, persistent, and able to tolerate pain. Unfortunately, those are the same personality traits seen in people who develop two clinical eating disorders — anorexia and bulimia. The circumstances provide a “perfect storm” for destructive eating behavior.

In her book, Disordered Eating Among Athletes (Human Kinetics Publishers), Katherine Beals, Ph.D., R.D., looked at the research and identified the risk factors associated with both conditions. These variables are associated with the conditions, not necessarily causes of them.

Family Environment
“Individuals who develop eating disorders often come from dysfunctional families, particularly those involving overbearing or controlling parents,” says Dr. Beals, who is an associate professor of nutrition at Ball State University. “Athletes who don’t have the coping skills to handle stressful situations may focus on controlling body weight as a means of getting some degree of control over a chaotic family life.”

Women outnumber men ten to one in eating disorder prevalence. Among the factors could cause this disparity are 1) different expectations from society regarding body weight of women versus that of men; 2) excessive focus on the female athlete’s weight and shape; and 3) biological and hormonal differences between men and women.

Dr. Beals found that eating disorders could occur at any time in life, but they typically begin in adolescence. Anorexia nervosa often develops earlier than bulimia nervosa. Adolescence is a period of both physical and psychological vulnerability, especially for girls who are experiencing changes that accompany growing into womanhood. Many of those changes move them away from society’s concept of an acceptable body shape.

The research also indicates that athletes who begin serious training for sports at early ages are at increased risk of developing disordered eating. Says Beals,

“It may be that athletes who begin training for their sport early in life are less able to choose a sport that matches their body size, weight, or shape than those who begin training later in life. The more an athlete’s body weight or shape deviates from the ideal of his or her sport, the greater the risk of developing these conditions.”

In the general public, the prevalence of clinically diagnosed eating disorders is significantly higher among whites than non-whites. Again, this may be related to cultural expectations regarding body weight, economic factors, and biological differences. Few studies have looked into eating disorders among non-white athletes, possibly because their participation in sports associated with those problems is generally low.

Sport-Specific Factors
“The demands that are inherent in some sports may trigger the development of an eating disorder in psychologically susceptible athletes,” adds Beals. Swimming, cross-country running, diving, figure skating, wrestling, weightlifting, rowing, martial arts, and gymnastics are among the sports where disordered eating seems to be more prevalent. Following are some of the specific trigger factors that appear to put athletes at risk:
** Prolonged periods of dieting or weight cycling (trying to make weight)
** Sudden increases in training volume (among endurance athletes, for example, who dramatically increase their training load)
** Stress and trauma (injury, illness, change of coach, moving away from family and friends)
** Pressure from coaches and trainers (being encouraged to lose weight without guidance during weight loss)

No Absolutes
There are no absolutes in predicting which athletes will develop eating disorders. It could happen to anyone, regardless of family background, gender, age, race, or sport. That being said, the profile of an athlete most likely to be affected comes from a dysfunctional family (although this may not be outwardly apparent), and is young, white, female, psychologically vulnerable, and engaged in a sport that emphasizes weight control and body shape. Teaching pros, coaches, trainers, parents, and friends should be careful not to overreact, but they would be wise to watch out for those warning signs.

© 2004 HMS Publishing, Inc.
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