Eating disorders in

Sports
Nutrition and Physical Activity
Dra. Marissa Islas Romero
Eating disorders

They are debilitating

psychiatric illnesses

Persistent alteration of
eating habits or weight
control behaviors

Significant alteration of
physical health and
psychosocial functioning
Eating disorders

Nervous Bulimia
Anorexia Nervosa
(NA) (NB)

Unspecified Binge
Eating eating
Disorder disorder
(UED) (BED)
Nervous Anorexia

• Two diagnostic subtypes:

Restrictive Compulsive / Purgative

• Food restriction without • It is characterized by periodic

bingeing or purging episodes of binge eating or
purgative behavior.

AN may initially manifest in a restrictive manner, but as the disease progresses

over time it may become the compulsive / purgative subtype
 PSYCHOLOGICAL CHARACTERISTICS OF NA

NA can coexist with other psychiatric conditions:

• Perfectionism
Depression
• Compulsiveness
• Feeling of inefficiency
Consumption Anxiety
• Inflexible thinking of drugs disorders

• Contained and hidden

emotional expression
Obsessive-
Personality compulsive
disorders disorders
(OCD)
HEALTH EFFECTS CAUSED BY NA
 Bulimia Nervosa
• Binge-eating episodes followed by one or more
inappropriate compensatory behaviors that try
to avoid weight gain

Vomiting behaviors,
laxative and
diuretic abuse,
compulsive exercise
or fasting.

Typical of normal
weight

Frustrated by their
inability to achieve
an underweight
state
Characteristics of NB
Characterized by binge eating
They develop compensatory
behaviors to counteract
compulsive eating

Eating an abnormally large amount of food

Specific period (generally 2 hours)

Feeling of loss of control

HEALTH EFFECTS CAUSED BY NB
 EATING DISORDERS IN SPORTS
• Eating disorders occur relatively Rhythmic gymnastics,
frequently in sports in which body weight figure skating, or
control is important endurance sports.

The incidence is higher in women

• Food handling
• Use of inappropriate
weight control methods

low self-esteem inefficiency

sense of self control
distorted body image
perfectionism
 Causes
• The athlete with eating disorders is a member of a special
population with a specific problem to which various factors
may have contributed:

• Such as the nature of sports discipline, sports regulations,

training frequency, training load, food restriction, sub-culture
linked to sports discipline, injuries, overtraining or coach
behavior.

• In addition, the sports environment can not only precipitate

or worsen a pathology, but also legitimize it, making it easier
for athletes to suffer and hide it and more difficult to identify
and treat.
 Sports and Eating Disorders
• The information currently available on the relationship between sport and eating
disorders is still insufficient.
• The main reasons could be summarized in the scarcity of studies with populations of
athletes and the absence of strict criteria at the diagnostic and measurement level.

• The two usual questionnaires have been used in the diagnosis of eating disorders:
the EAT and the EDI3 (Eating Disorder Inventory).
• A few years ago, an instrument called the Exercise Orientation Questionnaire
(EOQ) was developed, specifically designed to identify athletes at risk.
 Sports and eating disorders groups
• It is known that the sports in which more pathological eating
behaviors have emerged can be considered divided into four groups
in which low body weight is important for different reasons.

• First, there are the sports that establish categories by weight. This is the
case of boxing, taekwondo or weightlifting.

• In wrestlers, a high frequency has been described in the tendency to lose

weight, food restriction and purging behaviors compared to other sports.

• On the other hand, there are sports in which a low weight is

beneficial for the development of movements.
• Gymnastics, or to improve performance in competition such as rowing.
 Sports and eating disorders groups
• A third category is made up of aesthetic sports, in which
thinness and good looks are important factors in being able to
win and be successful, such as rhythmic gymnastics and figure
skating.
• The incidence of eating disorders is especially important in this
group of sports, having reached 42%.

• Finally, there are endurance sports such as mid-distance, cross-

country and marathon races. In them there is great pressure
from coaches to reduce weight and body fat percentage.
• Values of 13% prevalence of eating disorders have been given in
elite female runners
 Risk factor's
• It is important to identify those risk factors, to recognize
which conditions or triggers are responsible for the
pathological behavior.
• Dieting at an early age
• Lack of supervision
• Lack of proper guidance
• Please the coach
• Body appearance in the eyes of the judges
• Taking diuretics and laxatives
• Extreme exercise
• Traumatic events
• Perfectionism, compulsiveness, and high expectations
 The triad of the female athlete
• Women who train with intensity and place
importance on weight loss, often have eating
disorders that, by decreasing the availability of
energy, reduce weight and body mass to a
point where irregularities appear in:
• The menstrual cycle (oligomenorrhea with 35 to
90 days between periods) or menstruation stops
(disappearance at least 3 consecutive months)
• Osteoporosis occurs.
• This set constitutes what the American College
of Sports Medicine called in 1992 the triad of the
female athlete.
 Consequences of amenorrhea
• Amenorrheic women are infertile due to the absence of
ovarian follicular development, ovulation, and luteal function.
• As a consequence of hypoestrogenism, the presence of
alterations in the arterial vasodilation capacity is frequent in
amenorrheic athletes, which reduces muscle perfusion.
• There are alterations in muscle oxidative metabolism,
elevations in plasma levels of cholesterol and triglycerides,
and vaginal dryness.
• The cessation of menstruation is frequently associated with
the disappearance of the protective effect of estrogens on
bone, making women more vulnerable to calcium losses.
• Bone formation is reduced in parallel with alterations in insulin,
T3, and IGF-1 levels, and effects mediated by other
hormones, such as cortisol and leptin, may also contribute.
 More health effects
• Reduction of muscle protein and depletion of glycogen
stores and body fluid levels:
• It can very negatively affect muscle power and endurance,
and therefore performance.
• In the short term it is true that weight loss can be beneficial for
sports performance, especially in sports in which a certain
weight or fat levels are required, but the eating disorder ends
up being physically and emotionally destructive for the
individual and their environment.
 The Male Athlete Triad

• The Male Athlete Triad refers to three health

problems that are related to each other:
energy deficiency (“under-fueling”),
reproductive suppression, and poor bone
health.
• Altered Hypothalamic-Pituitary-Gonadal Axis &
Hypogonadotropic Hypogonadism in Men
• The reproductive problems associated with the
Triad in men include reduced/low testosterone,
oligospermia, and decreased libido.
 Bigorexia
• They are people who do a lot of physical exercise, with the
declared objective of reaching a certain muscle mass greater
than what they have.
• The amount of time they dedicate to exercise (doing it or
thinking about doing it) hinders their social, work, academic
and even family and partner adaptation.
• Those affected have an alteration in body image, so they
believe they are weaker and thinner than they are.
• Most are men between the ages of 18 and 25.
• More frequently than in the general population, other
maladaptive behaviors appear, such as an inadequate diet or
the use of drugs that are dangerous to health.
https://www.filo.news/espectaculos/Miguel-Herran-sigue-luchando-contra-la-
vigorexia-y-llego-a-querer-quitarse-la-vida-20200811-0019.html
Similarities and differences between vigorexia
and anorexia
Nutritional treatment in athletes

• The nutritional study requires determining the characteristics of the diet

followed by the athlete:
• Whether the diet it is balanced or not,
• If specific foods are ingested or if food is restricted during the day and or after
training.
• If the diet appears perfect, it may be suspected that the subject is voluntarily
providing distorted information.
• Keep training diaries, establish a regular meal pattern, and record what they
consume as well as their experiences with food
• What emotions or situations are at the origin of these disorders
Nutritional treatment in athletes

• Athletes should be trained early in their career or season.

• The main objective in the education of the athlete is to clarify myths and
errors due to misinformation in relation to weight loss and ideal weight,
body composition and its relationship with sports performance

https://www.youtube.com/watch?v=oZXSbucXPsw
Bibliography

• Kathleen, Mahan L. Krause. Dietoterapia. 14ª Edición. Ediorial ELSEVIER; 2017.

• Tayne, Samantha. Female Athlete Triad and RED-S. Springer, The Sports
Medicine Physician. 2019 : 395-411.
• Hooper DR, Kraemer WJ, Saenz C, et al. The presence of symptoms of
testosterone deficiency in the exercise-hypogonadal male condition and
the role of nutrition. Eur J Appl Physiol. 2017;117:1349–75.
• The Female and Male Athlete Triad Coalition 2020.
https://www.femaleandmaleathletetriad.org/about/ Accessed 22 Mar
2021.
Referencia de Video

Autor: Wegener Fermi

Título: TRANSTORNOS DE LA CONDUCTA ALIMENTARIA
Fecha: 1 dic 2015
https://www.youtube.com/watch?v=oZXSbucXPsw