Eating Disorders in Athletes

During the last two decades a substantial number of publications have been attributed to aspects of eating disorders such as anorexia and bulimia as well as to severe dieting practices among athletes involved in sports disciplines in which a low body weight is assumed to be essential for performance (365-373).

Sundgot-Borgen and Corbin (370) reviewed the prevalence of eating disorders in elite female athletes by using questionnaires, interviews and clinical examination in 522 athletes from 35 sports and 448 non-athletic controls in the Norwegian population. A significant higher number of athletes (18%) were found to suffer from eating disorders compared to controls (5%). Especially affected are athletes competing in sports requiring a specific weight or body leanness, such as aesthetic, endurance or weight-class sports.

Pathogenic weight control methods and their frequency are described. Such methods include diet pills, laxatives, diuretics, vomiting, severe fasting, bingeing and excess exercise.

Beals and Manore (380) reviewed the existing literature on the prevalence and consequences of subclinical eating disorders in female athletes. Dietary habits, sports attitudes, body image, energy expenditure and energy intake are dealt with in great detail and the interested reader who wants to learn more about these aspects should consult this review.

The authors conclude that restrictive eating or obsessive weight control behaviour may be self-defeating because severe energy restriction may cause an increase in energy conservation or energy efficiency, which, in itself, may render further attempts at weight loss or weight control less effective. Nevertheless, these athletes compete at a high performance level, which may suggest that a higher efficiency of the body in energy metabolism has taken place (381). A number of recommendations are given for further research on both physiological and psychological aspects. A sport discipline in which the effects of severe diet restriction on performance have been studied is wrestling and aspects of dieting and eating disorders related to the realization and maintenance of a certain body physique have been studied most among female dancers. Both will be discussed in more detail below.

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