Assessment of Athletes With Eating Disorders: Essentials for Best Practice

Abstract

It is estimated that 1.6 million people in the United States are currently diagnosed with an eating disorder. Eating disorders (EDs) have high rates of morbidity and mortality and remain the most severe mental illness. Unfortunately, rates of EDs and disordered eating behaviors (DEBs) among athletes appear to be increasing. In this study, authors summarize ED-related risks that pose compromises in psychological and social functioning, medical health, and overall quality of life. The importance of early detection and formal evaluation in preserving the athlete’s health, well-being and sustaining successful sport participation, and performance are highlighted. Athlete-specific factors, which challenge the ease and accuracy of ED detection and assessment, are noted. The recommended components of effective ED assessment are identified, including use of self-report measures and clinical interviews conducted by ED certified and licensed professionals. The importance of being well informed in tenets of ED awareness, prevention and supporting early detection, and referral for formal ED assessment are noted. Conclusions reflect the vital roles that both the multidisciplinary sport personnel and the sport environment/culture play in reducing the serious health risks of DEBs and EDs. Each is needed to protect an athlete’s well-being while fostering safe and successful sport participation.

Perfectionism, Body Satisfaction and Dieting in Athletes: The Role of Gender and Sport Type

“…Disordered eating is shown to have a higher prevalence among athletes than general population, even reaching 45% in female athletes [2] and this condition is especially emphasized in sports where weight controlling behaviour is expected, such as martial arts, running, synchronized swimming and gymnastics [3,4]. Moreover, patterns related to eating disorders might be difficult to detect among some athletes [5], which is a problem because eating disorder consequences are oftentimes far-reaching and could impair metabolism, bone health, cardiovascular health and mental health [6]. In addition, a decrease in food intake frequently leads to lower energy availability among athletes, a state that causes hormonal alterations, menstrual irregularities and impaired bone health, which consequently has a negative impact on sport performance as well [7].…”

Factors associated with disordered eating and eating disorder symptoms in adolescent elite athletes

“…Consequently, particularly coaches should be aware of the potential consequences when making comments that suggest an association between leanness/thinness and performance (i.e., athletes use methods to lose weight fast). Instead, coaches should educate athletes about the negative short- and long-term psychological and physiological consequences of fast and unhealthy weight loss and give appropriate advice for healthy dieting or refer athletes to an expert [9, 25, 26]. Results also indicated that athletes’ attitudes and expectations regarding an ideal body are modeled by friends and team norms.…”

“…Short-term physiological effects such as weakness, injuries, or stress fractures impact performance. More alarming are the long-term psychophysiological consequences of an adolescent eating disorder, such as heart palpitations, dyspnea, depression, anxiety, or even suicidal thoughts, which can seriously impact an athlete’s well-being [9, 25, 26]. Therefore, and according to previous suggestions, we call for the timely screening of disordered eating and eating disorders in male and female athletes, for all types of sports, and particularly during athletes’ transition from early to late adolescence [5, 6, 17, 18, 28].…”

“…Our results highlight that athletes’ disordered eating behaviour can precursor eating disorder symptoms. Therefore we recommend that not only coaches but also athletes, parents, and relevant personnel (e.g., physicians, physiotherapists, teachers) should be made aware of the symptoms of disordered eating (i.e., regular use of unhealthy weight control methods) and that it is a warning sign that should not be taken lightly or ignored [25, 26]. 33% of participants use at least one weight control method regularly, and athletes use up to six weight control methods at the same time, which both can be described as disordered eating [5, 7, 8, 9, 18].…”

“…Table 1. Risk factors for eating disorders and investigated aspects in the present study [1,3,4,5,18,25,27,29,30,31]…”