Copyright Nancy Clark MS RD CSSD March 2008
Athletes with Eating Disorders: Tips for Coaches, Parents, Friends &
Teammates
“I am worried about my daughter. She exercises too much and eats too
little. She says she's fine, but I think she’s becoming anorexic.”
“My Dad yells at me when I binge/purge: “You're wasting my money!!!” I
am working hard to recover from my eating disorder, but he just doesn't
get it. I don't even try to talk to him anymore.”
Eating disorders can be devestating to not only teams but also to
families. Coaches and parents alike want their athletes to eat well and
be healthy. The struggling athletes just want people to stop policing
their eating and exercise. The athletes have difficulty talking about
why they struggle with food; they instead communicate unhappiness by
starving or stuffing their bodies. This distracts them from the pain of
feeling “not good enough” and other hard feelings.
Unfortunately, too many athletes struggle with food issues. A survey of
more than 400 female collegiate athletes indicated they typically
believed their bodies were not good enough and wanted to lose five pounds.
• 43% reported feeling terrified of becoming overweight
• 22% were extremely preoccupied with food and weight
• 31% had irregular or absent menstrual periods (a sign of inadequate
fueling)
• 34% had had a stress fracture or broken bone. (Weakened bones and
stress fractures are common in athletes who experience loss of regular
menstrual periods).
• 18% of the women had/were at risk for having anorexia
• 34% had/were at risk for having bulimia. (Beals, Int'l J Sports Nutr
2002)
While there are no easy answers to resolving disordered eating, Dr.
David Herzog, a psychiatrist at Harvard Medical School who specializes
in the treatment of eating disorders, has addressed common issues in his
book Unlocking the Mysteries of Eating Disorders: A Life-Saving Guide to
Your Child's Treatment and Recovery. Here are some key points that might
be helpful if you are the parent, coach or friend of an athlete with
food issues. The goal is to help you understand what's really going on.
If you yourself are the struggling athlete, you might want to highlight
pertinent information in this article (or Dr. Herzog’s book), and then
ask those who care about you to read the passages. This is one way to
start a conversation.
• First of all, eating disorders (such as anorexia and bulimia) are a
psychological diagnosis, not a nutritional diagnosis. Eating disorders
have little to do with food. Food is just the symptom, not the problem.
• Eating disorders affect both girls and boys alike. For boys, society's
rule “men don't cry” means they are not allowed to express sadness,
fears, or hurt. If they do, they can easily be ridiculed and rejected.
So instead, they may starve or stuff themselves to numb difficult
emotions. Some exhaust themselves with excessive exercise. Others take
up body building, believing a muscular body means a perfect life. They
need to be assured that having feelings in not a sign of weakness.
• Athletes with eating disorders tend to dislike themselves and their
bodies. They feel inadequate, not “good enough.” Dieting seems a good
way to fix what is wrong with them and allows them to be good at
something—losing weight!
• If the athlete had at one time been pudgy and nagged by parents to
slim down, he can now feel praiseworthy and acceptable. Remind him of
the many good inner qualities he has that makes him special—kindness,
caring, humor, leadership. The athlete needs to learn he is valued as a
person, not for what he looks like.
• Athletes with eating disorders tend to be very talented, hardworking
people who ache inside and fail to see their strengths. Something inside
them says they should always be working or studying or exercising.
Taking time to hang out and chat with others makes them feel guilty.
They need to learn being “human”—like the rest of is—is a more
attainable goal than being “perfect.”
• Athletes with eating disorders commonly fear they won't be able to
stop eating if they start, so they try to avoid eating. Some
consistently restrict their intake; others yoyo between starving and
stuffing. In either case, they endure not just physical hunger but also
the mental anguish of feeling alone. It's hard to have much of a social
life if you are afraid of (over)eating food.
• If the athlete does not want to eat with the team, nor join family
meals, don't try to force the situation. Rather just acknowledge “It
must be so hard for you when something inside you holds you back.”
• If the athlete starts talking to you about how fat she is, don't try
to correct the misinformation because the athlete will not believe what
you say. Rather, try to understand the turmoil. “It sounds like you are
very unhappy with your body…” Allow an opening to share her concerns.
• If an athlete shares the dark secret of having an eating disorder,
acknowledge the effort. “I know this was hard for you to tell me, but I
am really glad you did.”
• On the other hand, if you want to confront the athlete who denies,
let's say, struggling with bulimia, do not become a detective to prove
him wrong. Rather, try to understand why the athlete hides this and has
trouble letting you know. Is he trying to safeguard you from being
stressed? Or does he feel ashamed?
• Telling an athlete to “just eat” does not solve the inner emptiness
that is intense, enduring, hard to recognize, and hard to talk about.
Plus, the athlete believes eating will make her feel worse. Recommend
counseling, not as a means to “fatten her up,” but to end the loneliness
of the disorder and to find inner peace. Just as it’s important to have
a good coach to improve athletic performance, it’s also important to
have a good “mental coach” (therapist skilled with eating disorders) to
improve quality of life.
Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports
Dietetics) counsels both casual and competitive athletes in her practice
at Healthworks, the premier fitness center in Chestnut Hill MA > (617-383-6100). Her NEW 2008 Sports Nutrition Guidebook, Food Guide for
Marathoners, and Cyclist’s Food Guide are available via
www.nancyclarkrd.com. See also sportsnutritionworkshop.com.
Reference:
Beals, K. and M. Manore. Disorders of the female athlete triad among
collegiate athletes. International Journal of Sports Nutrition and
Exercise Metabolism 12:281-293, 2002.