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Eating Disorders and Gymnastics


Does your child rave about becoming the next Cathy Rigby, Nadia Comaneci or Kathy Johnson? ‘What wonderful exemplary idols’, you may marvel, surely your daughter in on the right track. Well, think again. Know who these gymnasts really are, and the dangerous habits they subjected themselves to in order to reach the top.

All three of these gymnasts have admitted to eating disorders. Cathy Rigby, a 1972 Olympic gymnast, suffered from anorexia nervosa and bulimia for more than a decade. In fact, because of these eating disorders, she went into cardiac arrest not once, but twice!

To reach the top of her game, your daughter needs to pay close attention to what she eats. You also need to be aware that some female gymnasts are constantly worrying about food and the results of eating food. This develops into an unhealthy obsession: “what am I going to eat, where am I going to eat it? Will this pile on the pounds? How much exercise do I have to do to get rid of the weight? Does this mean I can’t go out for a meal anymore?”

Unhealthy obsession with food and gaining weight can be considered an eating disorder. In recent years, eating disorders in the rest of the population has increased to new levels. A London hospital reports that cases of anorexia and bulimia have gone up by 360% in the last nine years. Studies have shown that media-related pressure has contributed to the quest for the ideal figure, which is seen to have pointed more towards thinness in the last four decades.

Traditionally, women have been the target of these body-related ideals. Now, even men are growing more concerned with their bodies, prompted by tri-media advertisements which showcase the ideal male form in its fat-free state. Awareness of these supposed ideals, and the growing number of those suffering from eating disorders, contribute to the statistics.

Investigations into the realm eating disorders have looked at other predicates that can bring about the advent of these unhealthy habits. In a study of twins, it was discovered that eating disorders can be genetic in origin, as with an imbalance in the brain’s neurotransmitters. Psychological factors may also play a part in the development of eating disorders. It is mainly seen as a coping mechanism in family related-conflicts like an inability to express anger or other emotions, a fear of real or imagined sexual abuse, stress, and low self-worth (with the perception that being thinner will gain love and approval). As there are many other causes of eating disorders, one-dimensional assumptions should be avoided.

Why Athletes Are More At Risk

A lot of studies have shown that gymnasts, more than any other athletes, are more at risk to eating disorders like anorexia nervosa and bulimia. This may be due to the fact that gymnasts, especially the females, are put under constant pressure to maintain a certain body weight and mass for aesthetic presentation. A lithe and graceful form in a gymnast will earn more points from the judges. Gymnasts are under the impression that body size influences performance results.

As gymnasts have a more sensitive awareness about their body, they are more prone to develop an eating disorder. In addition, the traits that make a successful gymnast – perfectionism, compulsiveness and high expectations of self – are prime traits particularly associated with eating disorders.

Your apprehensions are correct in assuming that it is the female gymnast who has the propensity to develop this deviancy. Gymnastics is a sport where slender body size and low body weight is seen as an aesthetic ideal and is considered significant in terms of presentation and performance. It is less so in males where the incidence of eating disorders is 1 in 10.

Anorexia Nervosa, Bulimia and other Eating Disorders

These types of disorders have been diagnosed as psychiatric types of illnesses, described by a series of conditions. These conditions are more than just an obsession with eating and body weight. Several studies have looked into the subject of eating disorders in gymnasts, and they have found that a portion of those who suffer from these disorders also suffer from other “subclinical” forms of anorexia or bulimia that meet these series of conditions. Experts have proposed looking at eating disorders from the point of view of a spectrum. For instance, those who diet excessively have the potential to develop an eating disorder condition.

Subclinical eating disorders were first explored in 1970. Researchers later localized the condition as prevalent among teenagers who exhibited delayed growth patterns and arrested puberty as a result of “self-imposed calorie restriction”, or too much dieting, caused by a morbid fear of gaining weight.
Based on the 1970 studies, another researcher patterned the subclinical eating disorder concept in relation to athletes. The male athlete is pictured as a strongly motivated individual highly committed to his sport such that he would undertake massive weight loss to optimize his performance. It would come to a point when constant dieting to assume a very low and unrealistic weight would cease to become a means to an end, but the end itself. The descriptive term used is “subclinical anorexic”.

What is Anorexia Nervosa?

Experts define anorexia athletics (its scientific name) based on the presence of absolute criteria, a series of conditions which should be manifested, and relative criteria, a series of conditions which may be manifested.

And the Criteria Are…

The series of conditions include weight loss, absence of medical conditions associated with weight loss, gastrointestinal afflictions, a great fear of weight gain, and excessive dieting. There is also a manifestation of impeded puberty, menstrual disorders, poor body image, gorging on food then purging the food consumed, and obsessive exercising. It is also worth mentioning the incident involving the then-USSR Olympic team which got sanctioned for providing their gymnasts with hormones that caused puberty delay, making 17-year-old gymnasts appear extremely young.

Arizona State University Researchers have compiled a list of absolute and relative indicative criteria. These criteria are still under research phase and may be amended in the future:

Absolute Criteria (must be present):
1.) Fixation over food, food consumption and body mass
2.) Poor body image
3.) Deathly fear of gaining weight or becoming fat, despite relative slenderness
4.) The gymnast maintains a subnormal body weight (5 – 15% underweight) within the span of at least a year due to one or several factors, namely:
a.) limiting energy intake
b.) Severely minimizing consumption of or totally avoiding food, or several food groups
c.) Compulsive exercise beyond that required of the sport, and in comparison with fellow athletes of the same level
5.) Absence of infirmities or other medical conditions associated with weight loss
Relative Criteria (may be present):

1.) Gastrointestinal afflictions
2.) Menstrual disorders
3.) Purging, self-induced vomiting or the use of laxatives within a span of at least one month
4.) Bingeing and gorging on food (with a frequency of 8 times a month within the span of at least 3 months).

A lot of conjecture has gone into trying to find out why athletes have a greater potential for eating disorders, both clinical and subclinical. It’s been difficult to pinpoint which factor precedes which. Does it come with a certain type of personality? Is it a lifestyle which naturally leads to sports participation and subsequently an eating disorder? Or is it just participation in specific sports a reason for the eating disorder?

A Norwegian study involving elite female athletes was undertaken to discover the underlying factors that increased the risk eating disorders, as well as other elements which caused their development and aggravation (Sundgot-Borgen, ‘Risk and trigger factors for the development of eating disorders in female elite athletes’, Medicine and Science in Sport and Exercise, Sept. 1993, pp 414 – 419).

The first part of the study involved a preliminary qualifying questionnaire sent out to Norwegian elite female athletes. Elite athletes were defined to be among those who were eligible for the national team at junior or senior levels, or was a recruiting squad member for teams from the ages of 12 to 35. Slightly over 500 athletes responded to these questionnaires. They represented six groups of sports, namely: technical, endurance, aesthetic, weight dependent, ball games and power sports. An Eating Disorder Inventory was used to identify the respondents at risk for eating disorders (Manual of Eating Disorder Inventory, Odessa, FL: Psychological Assessment Resource, Inc., 1984). 117 or 22.4 % were classified to be at risk, and 103 of these agreed to be subjected to a quantifiable interview to determine the existence of eating disorders. Another group was picked at random from the segment of respondents who were not at risk. The low risk respondent group had scored low on the preliminary questionnaire on Eating Disorders; they made up the control group. These control respondents were compared with the at-risk group on the basis of age, residence community and sport played.

Of the 103 high risk respondents who agreed to the interview, 92 of them tested positive for anorexia nervosa, bulimia nervosa or anorexia athletics. Their opinions were asked on the possible factors that brought out the onset and development of their eating disorders, and 85% of the remaining 92 were able to supply answers. All data compiled during the interviews were analyzed in comparison with the reasons supplied by the athletes regarding the factors which sparked off the start and progression of eating disorders.

It was revealed that athletes who competed in aesthetic and endurance-related sports had thinner builds and a considerably tougher training regimen compared to athletes participating in other sports. It was also discovered that these athletes rated high among the high-risk group for eating disorders.

What impact does this have on gymnastics? Not a positive one, apparently. Gymnastics is both an aesthetic and endurance-related sport – both factors considered high-risk for eating disorders. Be constantly aware of your daughter’s eating habits to determine whether she has developed and eating disorder or not.
Eating Disorders and the Risk Factors Involved.

A number of risk factors that launch the start of eating disorders have been pinpointed. Early dieting among young athletes has been found to be the result of a desire to improve performance. A majority of these stem from recommendations from their coach that they lose weight. This sends a message to young and receptive athletes that losing weight will enhance their sports performance. Worse still, it is viewed as one of the requisites to remain in the sport. Another discovery made by researcher was that 75% of gymnasts who were advised by coaches to lose weight resorted to unhealthy means of doing so.
There is a vital lesson to be learned here: if you feel you daughter is being given the wrong messages – talk to her coach.

Another of the findings in the study of Norwegian athletes implied that the risk for eating disorders increased if dieting went unsupervised. Gymnasts who suspected they had eating disorders did not seek counsel for fear that their disorder would be uncovered. Also, a majority of gymnasts were largely ignorant of how to lose weight safely. Most of the information they had came from friends, women’s magazines and home remedies. This may cause great apprehension on your part to discover that your daughter has heard of the no-carb diet from classmates, and has embarked on this diet in secret.

These types of diets cannot help the body cope with the high energy requirements of sports. They are unable to provide for the special nutritional requirements needed for the growing female body. Crash diets may seem like an appealing option for young gymnasts who may perceive that a rapid weight loss will help them gain a place or remain in the team. What they fail to realize is that going on repetitive crash diets and the resulting rise and fall in body weight will eventually lead to the development of an eating disorder.

Starting training in a specific sport at an early age was also identified as one of the risk factors in the development of eating disorders. From a comparison of the high-risk group and the low-risk group in the study, it was discovered that the low-risk group played several different sports before specializing in a specific sport. The high-risk group, meanwhile, had started training in only one sport at an early age. Generally, a person’s body type will determine his success in a particular sport. Starting very early in a specific sport before the body matures sufficiently will take away the choice a person has to determine which sport is suitable for his body type. This creates a conflict whereby the athlete tries to suppress the natural growth of his body which may be inconsistent of the ideal required in his sport.
Excessive exercise is one of the factors that potentially cause anorexia nervosa. A majority of the athletes who did not mention any specific reason for the start of their eating disorders also recounted an increase in exercise and training volume, and a considerable decrease of weight as a result of this. Athletes who exercise or train excessively will experience calorie deprivation, not realizing that an increase in energy output will require an increase of calorie intake to maintain the body’s demand. Most times, excessive exercise also results in a decrease in appetite due to changes in the body’s endorphins.

This calorie deprivation can create a physiological or emotional atmosphere conducive to the development of eating disorders. As mentioned previously, excessive dieting can carry manifestations of eating disorders, like obsessions with food and body weight. One trigger is the loss of a coach whom the athlete perceives to be an sports mentor vital to his or her athletic career, bringing on a depression-like state in the athlete.

Illness or injury is also a trigger, as it left some gymnasts unable to continue with their training in the same or at a higher level. In conclusion, loss of a coach, injury and illness are seen as trigger factors that bring about the start of an eating disorder.


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