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Experience and Strength with Eating Disorder Recovery in Female Athletes

By Kimberly Dennis, MD

Eating disorders and disordered eating are commonly experienced by female athletes, but sorely under recognized by coaches, teachers, parents, therapists and physicians. I use the term disordered eating to include sub-clinical eating disorders as well as eating disorders which meet full DSM-IV-TR criteria for anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified, and binge-eating disorder.

Eating disorders and disordered eating are commonly experienced by female athletes, but sorely under recognized by coaches, teachers, parents, therapists and physicians. I use the term disordered eating to include sub-clinical eating disorders as well as eating disorders which meet full DSM-IV-TR criteria for anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified, and binge-eating disorder.

There are several core features of the illness of eating disorders, which may be particularly exacerbated in the athletic arena for females.

Denial is one core feature of eating disorders and other addictive processes. In my clinical experience, the level of institutional denial of eating disorders in athletes exceeds that of non-athlete females with eating disorders. The fire of denial can be fed by coaches who rely on the exceptional talent and extreme drive for success that many athletes possess to win games, titles, awards, etc. When a female athlete is still winning or competing and ill, it may be easier to disavow an active problem with food or eating. Read More

Academy of Eating Disorders

By The Academy for Eating Disorders

In light of the 29^thOlympiad, the Academy for Eating Disorders (AED) takes this opportunity to raise awareness of both the positive impact that competitive sports can have on self-esteem and body-esteem of participants as well as some of the risks that can be associated with less supportive aspects of athletics. Research has shown that participation in athletics can serve as a positive influence in the development of self-esteem in young women and young men. Yet, many of the qualities that contribute to becoming an elite athlete such as dedication, perseverance, and perfectionism, when taken to an extreme or applied to dieting, can also contribute to eating disorders risk. Unhealthy approaches to athletic success such as extreme measures to make weight and meet performance goals can compound the risk of eating disorders. The AED is not suggesting that sport participation is the problem; rather, the problem is the risks associated with some aspects of the sport environment regarding weight, body composition, and exercise. In that regard, the AED calls for greater awareness among sports governing bodies, coaches, trainers, athletes, and families of some of the following concerns which can be used as talking points:

• Individual sports federations should carefully examine their practices for "weigh ins" to ensure athlete safety and wellbeing in terms of the time between weigh-in and competition, as well as the appropriateness of lower weight classes; that is, can they be attained and maintained without unhealthy and extreme weight control methods.
• Athletes should refrain from making disparaging comments about the size or physical appearance of their competitors Practice sportsmanship rather than "gamesmanship."
• Athletic apparel should be evaluated regularly, as excessively revealing apparel can lead to increased self-consciousness, detracts from a focus on performance, and leads to a focus on the thin-body ideal, as well as competitive thinness and unhealthy body comparisons.
• Coaches and athletes should critically evaluate the pervasive and inaccurate notion that lower weight and body fat leads to better performance as this can lead to unhealthy attempts at weight and body-fat reduction Sport performance is multiply determined. Coaches, teammates, trainers, and families should take care not to attribute non-winning performances to body weight, shape, or size.
• Emphasis should always be placed on the overall well-being and h ealth of the participant, rather than to minimize weight. Aside from genetics, good health is probably the major contributor to good performance, with good nutrition in turn being the major contributor to good health.
• Athletes may experience reinforcement for thinness from peers and coaches while experiencing severe and potentially life threatening eating disorder behaviors. Everyone involved in athletics should be educated in the detection of eating disorders and feel comfortable with referring athletes for evaluations.
• Treatment for an eating disorder should never be delayed in order to achieve an athletic goal. It is not only potentially dangerous; it is also a communication that says performance is more important than health.
• After retiring from their sport when their bodies are no longer able to perform, athletes are sometimes left without an identity. This is a high risk period for eating disorders and depression. Attention should not only be given to elite athletes after retirement. Planning for life after sport should begin well before retirement.

We should make every effort to support the healthy aspects of sport while simultaneously monitoring untoward effects that may increase the risk of developing syndromes such as the female athlete triad, anorexia nervosa, bulimia nervosa, and related conditions. Anorexia nervosa has the highest mortality rate of any psychiatric illness. The emergence of signs and symptoms should always be taken seriously.

*reprinted with the permission of the Academy of Eating Disorders

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Timberline Knolls

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Lemont, Illinois 60439
Phone: (877) 257-9611
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At Timberline Knolls we believe every woman has the potential to be the best she can be, even if she's been affected by an eating disorder, addiction, self-harming or other destructive behavior.

At our innovative residential treatment center on 43 beautiful acres just outside of Chicago, we use an individualized, strengths-based approach to help create emotionally strong, responsible, radiant women who overcome problems, believe in themselves and have the ability to thrive in the real world.

At Timberline Knolls, we approach recovery a little differently. In fact, the way we combine clinical services, education and expressive therapies enhances the continuum of our life-changing care. We design individualized programs to meet each woman's needs. We believe this is one key reason so many women have found success in our program.