Eating Disorders and Athletic Participation

With the passage of Title IX, more and more women have been participating in athletics. Although participation in sports has many benefits--including teamwork, fitness, and fun--it also brings a risk of eating disorders, especially at an elite level. A recent study from the International Journal of Eating Disorders, led by Jill Holm-Denoma (now of the University of Denver), looked at eating disordered attitudes and behaviors in relation to level of athletic participation and sports anxiety.

Women who participate in intercollegiate varsity athletics have much higher rates of eating disorder symptomatology when compared to women in club sports, independent exercisers and non-exercisers. Furthermore, higher levels of sports anxiety (that is, anxiety about physical activity and/or sports) were predictive of increased levels of bulimic symptoms and a drive for thinness.

Varsity athletes have devoted much of their recent lives to their sport, increasing both their identity with athletics and the pressure to perform well. As well, it could be that eating disordered attitudes and behaviors are normalized, tolerated, or even encouraged. Traits of obsessionality and perfectionism are risk factors for eating disorders, that may also cause a woman to excel at the varsity level.

Yet the results show an interesting variation. Writes Holm-Denoma:

Despite the trend for women who participated in higher levels of athletic competition to have higher levels of eating disorders, our data do not suggest a clear dimension ranging from nonexercisers to varsity athletes. In some cases, for instance, independent exercisers appear to have similar traits to varsity athletes (e.g., see Fig. 1). Thus, some independent exercisers may engage in exercise as frequently and/or intensely as women who participate in competitive athletics.

It appears that some women with eating disorders (or their accompanying attitudes) exercise alone, independently, and perhaps obsessively. This could perhaps come from a desire to hide their disorder.

The researchers conclude that:

Coaches and clinicians should be aware that athletes experience higher rates of eating disorder symptoms than nonathletes. Moreover, sports anxiety should be considered as a possible target of therapy among athletes.

(cross-posted at ED Bites)

Sobering Statistics

A recent story from the News Observer had these startling statistics to remind everyone why early treatment of eating disorders is essential:

• 20 percent of adults overcome their eating disorder, compared with an 80 percent recovery rate among adolescents.

Given that most eating disorders start in adolescence (most estimates range from 13-18 as the peak years of onset, with bulimia generally beginning at a later age than anorexia), most adults have been suffering for years, if not decades. The disease at this point has become entrenched, a part of the sufferer's life.

There are also no researched, effective treatments for adults, in part due to the chronicity, as well as the difficulties in compelling a loved one into treatment for long enough to reach a stable, healthy weight.

In the book "Hunger: An Unnatural History," a famine relief worker said that malnutrition in children is always easier to treat than in adults. Part of it is, he says, the greater resilience of young bodies. But the other part is the simple power of a mother urging her child to eat.

Other statistics from the story:

• 80 percent of eating disorders start out as diets.
• Ten million women in the U.S. have an eating disorder, according to the National Eating Disorders Association.
• 79 percent of deaths from anorexia occur in people who are over the age of 45.

Administrative Update

Sorry for the lack of posts lately- I'm trying to find a place to live and apply for jobs, so I have been both busy and stressed.

At any rate, I just posted a huge list of links of free full-text research articles on the right-hand side of the page. Please email me any other articles you might have that you think will be of use to parents at carrie [at] edbites [dot] com and I will post them as soon as I am able.

Lastly, I found that the parent book that accompanies "Next to Nothing" is now available for free download online:

If your adolescent has an eating disorder

You will need Adobe Acrobat to read the book (and no, I didn't write a single word of it!).

I'm hoping to have one or two things up this week, depending on how quickly I can pack up my apartment.