The Prevalence and Consequences of Subclinical Eating Disorders in Female Athletes

Abstract

A growing body of evidence suggests that the prevalence of eating disorders and excessive concerns regarding body weight in certain subpopulations of female athletes are increasing. The pressure on female athletes to improve their performances and physiques, coupled with the general sociocultural demand placed on all women to be thin, often results in attempts to achieve unrealistic body size and body weight goals. For some female athletes the pressure to achieve and maintain a low body weight leads to potentially harmful patterns of restrictive eating or chronic dieting. This paper seeks to further delineate the characteristics of a recently identified subclinical eating disorder in female athletes: anorexia athletica. Research studies that support the existence of subclinical eating disorders will be reviewed. In addition, the possible physiological and psychological consequences of subclinical eating disorders will be explored.Key Words: anorexia athletica, dieting, body image, energy intake, energy expenditure, exercise performance For millions of women dieting has become a way of life. It is estimated that currently 40% of all American women are trying to lose weight (49). This national obsession for weight loss is fueled primarily by the intemperate value that society places on physical perfection and the subsequent unrelenting pressures on women to achieve the archetype of perfection, a thin physique (69). Indeed, over the last three decades there has been a marked trend toward an increasingly, almost unrealistically, thin ideal of women's beauty (70). Consequently, pressure is put on young women to restrict their food intake-to diet-to achieve this consummate thinness. Unfortunately, studies indicate that most attempts at longterm weight loss fail (14,50,55,95,96). Efforts to achieve and maintain an excessively thin body shape are often futile because body weight and shape are strongly influenced by biological and physiological variables that predestine women to be heavier than the current sociocultural ideal (9,82

Susceptibility to Eating Disorders Among Collegiate Female Student–Athletes

“…[1][2][3] Determining the exact prevalence of eating disorders and disordered eating behaviors is difficult because those affected may not report the behavior or not seek treatment, thus making occurrence estimates somewhat unreliable. 4 Researchers [5][6][7][8][9] have been studying the nature and scope of eating-related problems among female athletes for many years, and identifying at-risk athletes remains a challenge. Interestingly, results are mixed as to which female athletes are more susceptible to eating disorders and disordered eating behaviors and whether athletes are at a higher risk compared with females in the general population.…”

Eating Disorders in Athletes: Managing the Risks

“…One of the following symptoms must also be present: delayed puberty, menstrual dysfunction, disturbance in body image, use of purging methods, binge eating, or compulsive exercising. Beals and Manore [9] presented similar criteria, except that distorted body image and limiting food choices or food groups were in the criteria absolutely necessary for diagnosis, and gastrointestinal complaints were in the relative criteria, only one of which is required for diagnosis. Beals and Manore suggested that further research was needed to determine what number of symptoms should be required to meet the criteria for AA.…”

“…There is literature on "anorexia athletica" (AA) that removes the criterion of the 85% cutoff, and therefore it might be considered an EDNOS. Although AA may be a subclinical eating disorder, it can still lead to medical and mental health complications [9]. Sundgot-Borgen [3] set criteria for AA that must involve weight loss, gastrointestinal complaints, the absence of medical or affective disorder explaining the weight loss, excessive fear of becoming obese, and restriction of caloric intake.…”

“…Sundgot-Borgen and Torstveit [6] have suggested that for some lowweight athletes, nutritional education may be all that is required, especially in view of the high prevalence of misinformation regarding diet in athlete populations-so-called "food myths" [21]. Others have stressed the need for screening programs for eating disorders [6,9,12,31] and importantly, the necessary diagnostic evaluation in response to a positive screen [12].…”

Reducing the Risk of Disordered Eating Among Female College Students: A Test of Alternative Interventions

“…In these instances, individuals may have some eating and body-weight problems but fail to meet all of the DSM criteria for anorexia, bulimia, or EDNOS (Beals & Manore, 1994). These symptoms may include behaviors such as restricting food intake or bingeing on food, excessive exercise, occasionally purging, or the use of laxatives or weight loss pills.…”