DR Vaithehy shanmugam,

Lecturer in sport psychology,,

UCLan

DR Vaithehy shanmugam

Eating disorders appear to be a common problem within competitive sport. This isn't surprising given that athletes face not only societal demands and pressure to attain and maintain the perfect body, but also pressure from their sport and teammates to achieve the optimum body for their event.

Increased exposure to pressure from both, can result in dissatisfaction with body shape and weight, feelings of shame and guilt – especially if their body doesn't meet the set ideal – increased rumination and low self-image, which can sometimes trigger the onset of depression.

Athletes also equate weight loss or low weight with peak performance. Therefore, to enhance performance, they may engage in unhealthy methods to control their weight, such as excessive exercising, using laxatives or self-induced vomiting.

Awareness and knowledge about eating disorders, healthy nutritional practices and positive coaching are all key strategies to prevent eating disorders in sports people. Therefore, it's imperative that significant others and professionals who work closely with athletes, such as coaches, nutritionists and physiologists, are appropriately informed and educated, so that they're in a position to identify, help and support athletes.

Professional bodies and sport organisations have an ethical and legal obligation to ensure the physical and psychological health of their athletes. Therefore, they need to invest time, resources and money to comprehend the pressures faced by competitive athletes, so that the contributors and consequences of eating disorders within sport can be identified, contained and managed.

Amanda Woodrow ,

Former athlete
,

Amanda Woodrow 

Focus, commitment, determination and single-mindedness are all attributes which made me an excellent distance runner in my youth. Conversely, they also made me a rather successful anorexic. After a throwaway comment from a coach about my ‘thick thighs’ my adolescent self became particularly focused on my weight, size and shape in relation to the other athletes I would race against. This ‘focus’ descended rapidly into obsession and I found myself meticulously controlling every calorie I consumed, and logging every minute of exercise.

Perhaps I was a particularly sensitive or susceptible individual, but this one single comment triggered a battle which spanned nearly 10 years. It was a decade of skipped meals and secret workouts; of deceiving others and kidding myself.

In the beginning the weight loss meant faster times on track, but within a mere few months I experienced blackouts and palpitations, barely able to run at all. I had to walk away from the intense competitiveness of the sports environment, and it took many years, many failed attempts, and a lot of outside help to return to competition. It’s in my nature to work hard and try to be the best I can possibly be. Identifying these traits in athletes, and being aware of that fine line between dedication and obsession is vital for early intervention and the prevention of eating disorders. I kept my ill health hidden for so long, blaming the weight loss on my strict training programme. I found myself under dangerous illusions that the only way to remain at the top was to be the lightest, leanest and therefore the fastest.

As a coach now, I believe communication, education and awareness goes a long way, especially with vulnerable athletes.

Debbie Lawrence ,

Development manager,

Active IQ

Debbie Lawrence 

There are a whole myriad of factors which may contribute to eating disorders and depression. Depression is a mood disorder which is diagnosed when these symptoms are reported. Eating disorders involve behaviours, such as food restriction and self-starvation or binge and purging (vomiting, over-exercise or use of laxatives) which may be a mechanism for managing the underlying feelings. Athletes are human beings – they're not immune to neurosis. They experience the same stresses and strains of daily living as the rest of us.

They also have to learn to cope with the pressure of competition and performing to the expectations of self and others; and when performance is under par, the public and media response (including comments on social media) is often very negative and critical and athletes have to find ways to handle this, along with their own feelings of disappointment and failure. For young athletes, it's a real challenge and awareness and support from their respective coaches, governing bodies and family will be crucial.

Discipline and sacrifice are part of an athlete’s lifestyle. They commit to gruelling training routines and sacrifice some of the pleasures that others enjoy. They also have to manipulate and control their diet to meet energy demands, as well as aesthetic or weight restriction which are required for certain sports.

Eating disorders may develop as an extension of that control. Restricting food intake and controlling weight may be the only coping strategies the person feels they have. Ultimately, there is much to learn and understand and listening to the individual will be key to understanding how they respond to their world.

Dr Alan Currie,

Consultant psychiatrist
,

Dr Alan Currie

It seems to come as a surprise to some that elite sports people can suffer the same sort of mental health difficulties as the rest of us. It seems to be a particular surprise that there are a few mental health problems, such as eating disorders, that are especially common in athletes. Once we recognise that athletes are people too and that many exist in a psychologically hostile environment, then the observations appear easier to understand.

Athletes are subject to most of the same risk factors for eating disorders as the rest of us – the same genetic vulnerability, the same personal and cultural attitudes to shape, weight and diet and so forth. There are additional risk factors in the sports environment. Examples include perfectionism and determination which is misdirected into compulsive overtraining, misunderstandings over nutrition and weight management, competing in revealing clothing and being judged on your appearance, pressure to make weight, unhelpful critical comments from coaches and specialising too early.

Once we accept that there’s a problem we can start to make appropriate treatment available by making links with the right therapists and the best clinical services. Most athletes and sports clubs understand the risk of injury. In consequence they know the most helpful professionals to consult. We can’t yet say the same about treatment for athletes with eating disorders.

If the question had been ‘what can sport do to support people with sports injuries?’ the answer would be to recognise the risks and manage them and ensure that good treatment and rehabilitation is readily available. Substitute ‘mental health issues’ for ‘sports injuries’ and you have your answer.