Adolescent athletes are especially vulnerable to developing disordered eating behaviors. Risk factors include participation in sports where weight and lean body type are important, high-intensity training, pressure from coaches, and training and dieting beginning at an early age. Medical complications associated with these unhealthy dietary and weight-control practices and eating disorders can be potentially dangerous. Prevention strategies include minimizing the importance of weight, increased sensitivity on the part of those working with athletes for issues around weight and dieting, and appropriate education on proper weight-control methods and nutrition. The long-term prognosis is not known.
Get full access to this article
View all access options for this article.
References
1.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders-Text revision (4th ed.). Washington, DC: Author.
2.
Anderson, R. E., Barlett, S. J., Morgan, G. D., & Brownell, D. D. (1995). Weight loss, psychological, and nutritional patterns in competitive male body builders. International Journal of Eating Disorders, 18, 49-57.
3.
Beals, K. A., & Manore, M. M. (1994). The prevalence and consequences of subclinical eating disorders in female athletes. International Journal of Sport Nutrition, 4, 175-195.
4.
Beals, K. A., & Manore, M. M. (2000). Behavioral, psychological, and physical characteristics of female athletes with subclinical eating disorders. International Journal of Sport Nutrition, and Exercise Metabolism, 10, 128-143.
5.
Bickford, B. A. (1991, July). A deadly image. College Athletic Management, pp. 14-17.
6.
Brewerton, T. D., Stellefson, E. J., Tibbs, N., Hodges, E. L., & Cochrane, C. E. (1995). Comparison of eating disorder patients with and without compulsive exercising. International Journal of Eating Disorders, 17, 413-416.
7.
Brownell, K. D., Rodin, J., & Wilmore, J. H. (1992). Eating, body weight and performance in athletes: Disorders of modern society. Philadelphia, PA: Lea and Febiger.
8.
Centers for Disease Control. (2000). Youth risk behavior surveillance, United States, 1997. Morbidity and Mortality Weekly Reviews, 49(Suppl. 5), 1-94.
9.
Coen, S. P., & Ogles, B. M. (1993). Psychological characteristics of the obligatory runners: A critical examination of anorexia nervosa analogue hypothesis. Journal of Sport Exercise Psychology, 15, 338-354.
10.
Comerci, G. D., & Greydanus, D. E. (1997). Eating disorders: Anorexia nervosa and bulimia. In A. D. Hoffmann & D. E. Greydanus (Eds.), Adolescent medicine (pp. 683-702). Stamford, CT: Appleton-Lange.
11.
Cumming, D. C. (1996). Exercise-associated amenorrhea, low bone density, and estrogen replacement therapy. Archives of Internal Medicine, 156, 2193-2195.
12.
Davis, C., Kennedy, S. H., Ravelski, E., & Dionne, M. (1994). The role of physical activity in the development and maintenance of eating disorders. Psychological Medicine, 24, 957-967.
13.
De Cree, C. (1998). Sex steroid metabolism and menstrual irregularities in the exercising female. A review. Sports Medicine, 25, 369-406.
14.
Depalma, M. T., Koszewski, W. M., Case, J. G., Barile, R. J., Depalma, B. F., & Oliaro, S. M. (1993). Weight control practices of light-weight football player. Medicine & Science in Sports & Exercise, 25, 694-701.
15.
Dick, R. W. (1991). Eating disorders in National Collegiate Athletic programs. Athletic Training, 26, 136-140.
16.
Drinkwater, B. L. (1996). Exercise and bones. Lessons learned from female athletes. American Journal Sports Medicine, 24, 33-35.
17.
Drummer, G. M., Rosen, L. W., Heusner, W. W., Roberts, P. J., & Councilman, J. E. (1987). Pathogenic weight-control behaviors of young competitive swimmers. The Physician and Sportsmedicine, 15, 75.
18.
Dueck, C. A., Matt, K. S., Manore, M. M., & Skinner, J. S. (1996). Treatment of amenorrhea with a diet and training intervention program. International Journal of Sport Nutrition, 6, 24-40.
19.
Epling, W. F., & Pierce, W. D. (Eds.). (1996). Activity anorexia: Theory, research, and treatment. Hillsdale, NJ: Lawrence Erlbaum.
20.
Estok, P. J., & Rudy, E. B. (1996). The relationship between eating disorders and running in women. Research in Nursing and Health, 19, 377-387.
21.
Fisher, M. (1992). Medical complications of anorexia and bulimia nervosa. Adolescent Medicine State of the Art Reviews, 3, 481-502.
22.
Fisher, M., Golden, N. H., Katzman, D. K., Kreipe, R. E., Rees, J., Schebendach, J., et al. (1995). Eating diosorders in adolescents: A background paper. Journal of Adolescent Health, 16, 420-437.
23.
Fogelholm, M. (1994). Effects of body weight reduction on sports performance. Sports Medicine, 18, 249-267.
24.
Fogelholm, M., & Hilloskorpi, H. (1999). Weight and diet concerns in Finnish female and male athletes. Medicine & Science in Sports & Exercise, 31, 229-235.
25.
Franseen, L., & McCann, S. (1996, Summer). Causes of eating disorders in elite female athletes: The United States Olympic Committee Study. Olympic Coach. Available from http://www.usolympicteam.com/education/coach_fall1996
26.
Fruth, S. J., & Worell, T. W. (1995). Factors associated with menstrual irregularities and decreased bone mineral density in female athletes. Journal of Orthopedic & Sports Physical Therapy, 22, 26-38.
27.
Garner, D. M. (1991). Eating Disorders Inventory-2. International Journal of Eating Disorders, 4, 701-726.
28.
Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273-279.
29.
Garner, D. M., Rosen, L. W., & Barry, D. (1998). Eating disorders among athletes: Research and recommendations. Child & Adolescent Psychiatric Clinics of North America, 7, 839-857.
30.
Hergenroeder, A. C. (1995). Bone mineralization, hypothalamic amenorrhea, and sex steroid therapy in female adolescents and young adults. Journal of Pediatrics, 126, 683.
31.
Horswill, C. A. (1992). Applied physiology of amateur wrestling. Sports Medicine, 14, 114-143.
32.
Horswill, C. A. (1993). Weight loss and weight cycling in amateur wrestlers: Implications for performance and resting metabolic rate. International Journal of Sports Nutrition, 3, 245-260.
33.
Kann, L., Kinchen, S. A., Williams, B. I., Ross, J. G., Lowry, R., & Kolbe, L. J. (1998). State and local YRBSS coordinators: Youth Risk Behavior Surveillance: United States, 1997. Morbidity and Mortality Weekly Report, 47(Suppl. 3), 1-89.
34.
Kazis, K., & Iglesias, E. (2003). The female athlete triad. The Spectrum of Disordered Eating: Anorexia Nervosa, Bulimia Nervosa and Obesity: State of the Review, 14(1), 87-95.
35.
Marshall, J. D., & Harber, V. J. (1996). Body dissatisfaction and drive for thinness in high performance field hockey athletes. International Journal of Sports Medicine, 17, 541-544.
36.
Myburgh, K. H., Hutchins, J., Fataar, A. B., Hough, S. F., & Noakes, T. D. (1990). Low bone density is an etiologic factor for stress fractures in athletes. Annals of Internal Medicine, 23, 754-759.
37.
Opplinger, R. A., Case, H. S., Horswill, C. A., Landry, G. L., & Shelter, A. C. (1996). American College of Sports Medicine position stand on weight loss in wrestlers. Medicine & Science in Sports & Exercise, 28, ix-xii.
38.
Otis, C. T., Drinkwater, B. L., Johnson, M., Loucks, A., & Wilmore, J. (1997). American College of Sports Medicine position stand on female athlete triad. Medicine & Science in Sports & Exercise, 25, i-ix.
39.
Petrie, T. A. (1996). Differences between male and female college lean sport athletes, nonlean sport athletes, and nonathletes on behavioral and psychological indices of eating disorders. Journal of Applied Sport Psychology, 8, 218-230.
40.
Pope, H. G., Jr., Katz, D. L., & Hudson, J. I. (1993). Anorexia nervosa and “reverse anorexia” among 108 male body builders. Comp Psychiatry, 34, 406-409.
41.
Powers, P. S., & Johnson, C. (1996). Small victories: Prevention of eating disorders among athletes. Eating Disorders, 4, 364-376.
42.
Pugliese, M. T., Lifshitz, F., Grad, G., Fort, P., & Mark-Katz, M. (1983). Fear of obesity: A cause for short stature and delayed puberty. New England Journal of Medicine, 309, 513-518.
43.
Reijonen, J. H., Pratt, H. D., Patel, D. R., & Greydanus, D. E. (2003). Eating disorders in the adolescent population: An overview. Journal of Adolescent Research, 18(3), 209-222.
44.
Rosen L. W., & Hough, D. O. (1988). Pathogenic weight-control behaviors of female college gymnasts. The Physician and Sportsmedicine, 16, 141.
45.
Selby, R., Weinstein, H. M., & Bird, T. S. (1990). The health of university athletes: Attitudes, behaviors, and stressors. Journal of American College Health, 39, 11-18.
46.
Smolak, L., Murnen, S., & Ruble, A. E. (2000). Female athletes and eating problems. A metaanalysis. International Journal of Eating Disorders, 27, 371-380.
47.
Strober, M. (1997, November 20-22). Survival analysis of recovery, relapse, and outcome predictors in anorexia nervosa over 10-15 years. Presented at the Eating Disorders Research Society annual meeting, Albuquerque, New Mexico.
48.
Sundgot-Borgen, J. (1994a). Eating disorders in female athletes. Sports Medicine, 17, 176-188.
49.
Sundgot-Borgen, J. (1994b). Risk and trigger factors for the development of eating disorders in female elite athletes. Medicine & Science in Sports & Exercise, 26, 414-419.
50.
Sundgot-Borgen, J. (1996). Eating disorders, energy intake, training volume, and menstrual function in high-level modern rhythmic gymnasts. International Journal of Sport Nutrition, 6, 100-109.
51.
Swoap, R. A., & Murphy, S. M (1995). Eating disorders and weight management in athletes, In S. M. Murphy (Ed.), Sport psychology interventions (pp. 307-330). Champaign, IL: Human Kinetics.
52.
Thiel, A., Gottfried. H., & Hesse, F. W. (1993). Subclinical eating disorders in male athletes. A study of the low weight category in rowers and wrestlers. Acta Psychiatry Scandinavia, 88, 259-265.
53.
Tofler, I. R., Stryer, B. K., Micheli, L. J., & Herman, L. R. (1996). Physical and emotional problems of elite female gymnasts. New England Journal of Medicine, 280, 281-283.
54.
Voss, L. A., Fadale, P. D., & Hulstyn, M. J. (1998). Exercise-induced loss of bone density in athletes. Journal of American Academic Orthopedic Surgery, 6, 349-357.
55.
West, R. V. (1998). The female athlete: The triad of disordered eating, amenorrhoea and osteoporosis. Sports Medicine, 26, 63-71.
56.
Williamson, D. A., Netemeyer, R. G., Jackman, L. P., Anderson, D. A., Funsch, C. L., & Rabalais, J. Y. (1995). Structural equation modeling of risk factors for the development of eating disorder symptoms in female athletes. International Journal of Eating Disorders, 17, 387-393.
57.
Yates, A., Leehey, K., & Shisslak, C. M. (1983). Running-An analogue of anorexia? New England Journal of Medicine, 308, 251-255.
