Anorexia nervosa is not maintaining a normal weight because a person either refuses to eat enough or exercises excessively. It’s characterized by limited food intake, problems with body image, or denial of low body weight.
Anorexia causes the body to go into starvation, resulting in a ceasing of menstruation, osteoporosis, mild anemia, severe constipation, and depression, amongst other symptoms.
Bulimia nervosa is characterized by episodes of binge eating and subsequent purging, either by inducing vomiting or taking laxatives.
During a binge, someone might consume thousands of calories and feel completely out of control while doing so.
People suffering from bulimia can be underweight, overweight, or at a normal weight for their height, so it’s more difficult to notice than anorexia.
There are some symptoms, however, including chronically inflamed throat, developing gastroesophageal reflux disorder, intestinal problems due to laxative abuse, or severe dehydration from purging fluids.
The female athlete triad is a syndrome in which female athletes suffer from three interrelated symptoms:
Low energy availability
Decreased bone mineral density.
According to the Academy of Nutrition and Dietetics, disordered eating describes a “range of irregular eating behaviors that may or may not warrant a diagnosis of a specific eating disorder.”
#The NCAA’s Risk Factors for Eating Disorders and Disordered Eating
The National Collegiate Athletic Association (NCAA) recognizes that many of its college athletes struggle with eating disorders or disordered eating patterns.
The NCAA provides resources for coaches and athletes regarding disorders, including how to spot them and major risk factors.
According to Ron Thompson, a psychologist and consultant on eating disorders to the NCAA, there are four major risk factors that college athletes face concerning eating disorders:
Prevalence: Women who participate in sports where a “lean” body is believed to provide a biomechanical advantage – long-distance running, gymnastics, diving, etc. – are the most at risk for eating disorders. Even more so than the men who also participate in these sports.
Genetics: Studies show that genetics often account for predisposition to an eating disorder. Often, several members of one family will show signs of the same disorder.
A family member with an eating disorder doesn’t mean an individual is sure to develop an eating disorder, however.
Sociocultural factors: Societal and cultural pressures are often cited as the reason behind eating disorders in non-athletes. It’s easy to imagine that athletes feel influenced by these pressures regarding weight and appearance as well.
Many student-athletes may develop eating problems in response to stressors, such as being away from home and the demands of course work and sport participation.
Sport-related factors: Society puts pressure on people to look a certain way that often leads to an eating disorder, but so does the sporting environment.
Student-athletes might develop disordered eating patterns because they feel reducing body weight enhances their performance.
For some athletes, revealing uniforms – such as swimsuits for swimmers or spandex for volleyball players – are stressors that can lead to an eating disorder as well.
The sport-related risk factors above highlight an important issue when it comes to eating disorders – body image.
This negative body image may lead to changes in dieting and eating habits, which may then develop into bulimic symptoms.
Petrie and Greenleaf discuss the same effects, and associate internalization of body ideals, body dissatisfaction, dietary restraint, and bulimic symptoms with sociocultural and sport-specific pressures.
Reel and Voelker identify three major factors that influence negative body image in athletes specifically:
Weight requirements: Sports teams that require certain weight limits, like cheerleading, might make participants think a body above or below the weight requirements is unacceptable.
In sports like wrestling, competitors chronically try to stay in one weight class or another by restricting dietary intake, leading to dehydration.
Uniforms: As I mentioned earlier, athletic uniforms lead to body image issues. The uniform is one of the most widely cited factors leading to pressure about body image.
Specifically, cheerleaders, swimmers, and dancers have reported experiencing negative body image and feelings of self-consciousness from their uniform – some dancers even considered it a distraction to their performance.
Pressure from teammates, coaches, and judges: Comments about changes in weight from fellow teammates and coaches can trigger body self-consciousness among athletes.
Many athletes are afraid of teammates and coaches noticing weight gain, and cite this as a top reason for feeling weight pressure.
The environment a coach creates may contribute to increased eating pathology among athletes as well. Low-support and high-conflict relationships between athletes and coaches could be a stressor that leads to disordered eating.
In sports with judges, such as gymnastics and figure skating, athletes may feel that appearance and weight are factors in their score. This pressure also contributes to negative body image.
High-level male athletes might feel similar pressures from friends, family, teammates, and coaches, as well as from their sport’s weight requirements.
It’s also important to note that not all eating disorders among athletes are linked to negative body image.
In fact, some studies have found that athletes in endurance, weight class, and aesthetic sports have a more positive body image than non-athletes.
But Reel and Voelker suggest that although some athletes might have bodies that conform to socially and culturally accepted standards, they might still engage in unhealthy eating and weight control behaviors to improve athletic performance.
Negative body image should not, therefore, be the only predictive factor of an eating disorder that coaches, parents, and practitioners look for.
Eating disorders take a serious toll on physical and psychological health.
Many athletes with disordered eating behaviors might construe their actions as “normal” and healthy within the sporting environment – where excessive training and dieting are sometimes perceived as part of being a good athlete.
What they don’t realize is that disordered eating patterns have detrimental consequences.
His disordered eating patterns eventually turned into bulimia and by his sophomore year in high school, he had started an inpatient/outpatient and counseling program for his eating disorder.
He wanted to raise awareness about youth athletes and eating disorders, especially in boys and men. As a teenage boy suffering from an eating disorder, he felt that he didn’t have as many resources as teenage girls have.
For him, it’s important to end the stigma around men and eating disorders and realize that many men might be suffering from body image issues just as much as women and girls do.
As an Arizona commit before her sophomore season of high school softball even started, she had a lot of eyes on her as an up-and-coming star.
So the pressure to be perfect and perform well started young for Bowling.
After getting treatment, she returned to the Arizona team with a much more balanced outlook on life, and was happy to be around her teammates again.
For these two examples of ballplayers who overcame their eating disorders, there are scores of others who still struggle.
Both Marjama’s and Bowling’s stories illustrate the importance of having a support network around you. As they both admitted that having a community, whether it was parents, friends, coaches, or teammates, helped them eventually develop healthier mindsets.
#Preventing Eating Disorders Among Your Baseball or Softball Players
As a coach, what can you do to help prevent, identify, and address eating disorders amongst your ballplayers?
As many sufferers of eating disorders hide their behaviors, identifying an eating disorder can be difficult.
There may be no apparent, outward signs in bulimia, for example, and distinguishing disordered eating from athletic eating isn’t easy either.
Athletic eating focuses more on what an athlete should consume to improve performance, whereas disordered eating emphasizes forbidding certain foods.
Using body mass index to detect an eating disorder among athletes isn’t reliable either. Muscular individuals will weigh more, but be leaner.
If a muscular athlete starts losing weight, there might not be a sign that it’s due to anorexia until the disorder has progressed considerably.
But coaches should still always be on the lookout for the tell-tale signs of an eating disorder:
Anxiety or depression
Excessive exercise habits
Excessive restroom use
Actively avoiding eating or eating situations
Laxative or diet pill use
Preoccupation with weight and eating, i.e claims of “feeling fat” despite being thin
Lastly, coaches can use screening programs and questionnaires to identify the presence of eating disorders among their athletes.
One of the most effective and simplest to administer to your ballplayers is called the SCOFF questionnaire.
It’s just 5 yes or no style questions – 1 point for each “yes” answer – that speak to the core features of both anorexia and bulimia.
If a player on your team scores greater than or equal to 2 points, then the presence of one of these eating disorders is likely. And you should consider taking further action.
Here’s the questionnaire below for you to use with your team.
#How Baseball or Softball Coaches Can Take Action Against Eating Disorders
Once you suspect one of your ballplayers has an eating disorder, what should you do?
If you want to approach an athlete with an eating disorder, you should do so early, directly, supportively, and confidentially.
If you’re approaching them for the first time, and the issue seems serious, you'll likely want to enlist the help of a medical professional or psychiatrist, for an evaluation.
If the issue is more minor, you might be able to deal with it by offering nutritional resources and support, including devising a personalized nutritional strategy with help of a qualified nutritional expert.
If a ballplayer has to sit out for a season to get treatment, they’ll usually be able to come back afterward.
Their reintegration to the team should mimic rehabilitation after an injury. Meaning start with a light training load at first with progressively more intense sessions.
Coaches should work closely with the designated therapist or physician, along with the athlete, to ensure a smooth recovery.
Good rehabilitation programs should include the following:
Medical stability – bone density and electrolyte recovery
Abstinence from disordered eating
Consideration of the psychological stressors – that may have triggered the eating disorder in the first place
Nutritional stability – nutrition should be sufficient to maintain weight with increased energy expenditure
In order for an athlete to recover and return to the team, there should be honest, open communication between the player, the coaches, and physicians or therapists.
🚨 Important Note: If your athlete is younger than 18 years old, anything and everything you do as a coach in regards to addressing an eating disorder must be run through the ballplayer's parents or guardian, of course.
One program that’s recently shown efficacy for serious athletes who are college-aged and up is the Walden GOALS Intensive Outpatient Eating Disorder Treatment Program.
This program was built specifically for adult athletes (18+) who need guidance on how best to optimize the balance between nutritional needs and performance goals.
But here’s the tenets of their program – which can be usual for athletes of all ages.
#Final Thoughts on How Coaches Can Address and Manage Eat Disorders Among Ballplayers
As a coach, you have a responsibility to look out for the welfare of your players when it comes to athletic performance and overall well-being.
When a potential eating disorder is hindering your player’s success, both on the field and off, you can’t sit by and do nothing.
Get the facts about eating disorders and devise a strategy for dealing with them amongst your players. Don’t be afraid to bring the subject up and, above all, let your players know that you support them.
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