Are Elite Athletics a Breeding Ground for Eating Disorders?

Athletes have a unique relationship with their body. Success or failure is dependent on their body’s performance at a specific moment in time. Many athletes are on a quest to improve their body’s functioning through nutrition, exercise, and weight control. In the body-focused subculture of elite athletics, it is often difficult to parse out eating disordered behaviors from more benign performance enhancing behaviors. Adolescent elite athletes may be at an especially high risk of eating disorders due to the higher prevalence of eating disorders generally during the developmental period of adolescence combined with the body-focus of elite athletics.

In a study published in International Journal of Eating Disorders, Giel et al (2016) used data from the German Young Olympic Athletes’ Lifestyle and Health Management Study (GOAL-study) to assess 1138 athletes competing in 51 different Olympic sport disciplines born between 1992 and 1995 (mean age was 16 years old). The objective of the study was to investigate potential vulnerabilities for eating disorder pathology in a large nationally representative sample of German elite athletes. As a secondary aim, the authors sought to assess the psychopathological burden (depression and anxiety symptoms) in athletes reporting eating disorder symptoms. The authors posited that the presence of depression and anxiety symptoms in athletes engaging in eating disorder symptoms would support the notion that these symptoms are indeed pathological, rather than being functional behaviors that the athletes are engaging in to improve their performance.

Results of this study indicate that 32.5% of the total sample endorsed eating disorder pathology and this subgroup did score significantly higher on measures of depression and anxiety when compared to athletes without eating disorder pathology. Eating disorder rates were highest in female athletes and athletes competing in weight dependent sports (boxing, weightlifting, judo, taekwondo, and wrestling).

Specifically, compensatory behaviors were higher in female athletes and athletes competing in weight dependent sports. Approximately 8% of the overall sample reported that they are constantly trying to lose weight and 12% reported engaging in compensatory behaviors, most commonly dehydration (eg. sauna, exercise in clothing designed for excessive perspiration). In comparison, nearly 80% of athletes competing in weight dependent sports reported compensatory behaviors. The authors note that these athletes report different compensatory strategies (dehydration) than the predominant compensatory behaviors used by eating disorder patients (self-induced vomiting, laxative, and diuretic use). This may represent a sport specific subculture, which is no less alarming than more traditional compensatory behaviors. Athletes competing in ball sports and endurance sports were least likely to report compensatory behaviors.

Overall, athletes reported positive body image. However, these scores were significantly lower for female athletes when compared to male athletes. The authors speculate that this may be due to the difference in societal body ideals. For male athletes, their strong and muscular body matches with societal ideals while for female athletes their body is stronger and more muscular than societal ideals allow.

Olympians, marathoners, and other elite athletes are often looked upon as the paradigm of good health. While this may be true for many athletes, this study underscores the risky behaviors that some elite athletes engage in to achieve success in their sport. Athletes' use of performance enhancing drugs gets a lot of coverage in the news media; however we far less often hear about the equally dangerous practice of manipulating your body through the use of eating disorder behaviors in elite athletics. While some of these behaviors may be normalized amongst subgroups of elite athletes, the results of these behaviors are dangerous and impact the athletes' physical and emotional wellbeing.

Reference: Giel K, Hermann-Werner A, Mayer J, et al. (2016) Eating Disorder Pathology in Elite Adolescent Athletes. International Journal of Eating Disorders. Online First.

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