Athletes with Eating Disorders: Tips for Coaches, Parents, Friends & Teammates
By Nancy Clark, RD, CSSD
“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 devastating 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 nervosa and bulimia nervosa) 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 or she can now feel praiseworthy and acceptable. Remind him or her of the many good inner qualities that makes him or her special—kindness, caring, humor, and leadership. The athlete needs to learn he or she is valued as a person, not for what he or she 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 it—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 Sports Nutrition Guidebook and food guides for new runners, marathoners, soccer players and cyclists are available via www.nancyclarkrd.com. See also sportsnutritionworkshop.com for information about upcoming and online workshops.
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.