Many people are familiar with anorexia nervosa. Anorexia nervosa is a form of disordered eating that, at any given time, affects between one and four percent of women. Approximately one percent of women and .5 percent of men will experience anorexia in their lifetime. Unfortunately, the number of adolescents and teens struggling with disordered eating continues to grow. Data from The National Institute of Mental Health shows that nearly 3% of teens between the ages of thirteen and eighteen struggle with an eating disorder. Someone with anorexia will drastically restrict their food intake to the point of elevated health risks. Those with anorexia have a severely distorted view of their body image and an intense fear of gaining weight.

Anorexia athletica is a similar type of disordered eating that pertains specifically to athletes. This may seem odd as many look to athletes as being healthy and in shape. However, some athletes choose unhealthy methods for attaining their desired physical appearance. Data from the same National Institute of Mental Health report shows as many as forty-two percent of female athletes competing in aesthetic sports (those which require well developed physical capabilities, technical skill, and artistry) demonstrated behaviors consistent with disordered eating.  As many as fourteen percent of athletes, regardless of gender identity, struggle with disordered eating.

Understanding Anorexia Athletica

Anorexia athletica is a type of eating disorder that specifically impacts athletes. Teens (or adults) who struggle with anorexia athletica take in a very limited number of calories despite participating in increased levels of physical activity. This ongoing behavior eventually leads to very (sometimes dangerously) lean body type and low body weight. The National Eating Disorder Association states that people with anorexia athletica have lost at least five percent of their healthy body weight due to calorie restriction and excessive exercise. Unfortunately, a teen who suffers from anorexia athletica may not realize they have a problem because they likely do not recognize or believe their behaviors are concerning, unhealthy and unsafe. Someone with anorexia athletica generally meets some but not all of the criteria for other eating disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). For this reason, anorexia athletica often falls into the category “eating disorder not otherwise specified” or EDNOS. If your teen struggles with this particular category of disordered eating, you may find they are more prone to muscle and bone injuries than their teammates.

What are the Symptoms of Anorexia Athletica?

The symptoms of anorexia nervosa are typically well known. Both illnesses share some common symptoms; however, anorexia athletica has some symptoms that are distinctive from other forms of disordered eating.

Like anorexia nervosa, a teen with anorexia athletica will actively restrict their calorie intake. They do this to maintain an already low body weight or to lose what they perceive to be extra weight. Specific to anorexia athletica, calorie restriction is often seen in the form of a specialized diet instead of simple calorie restriction. In some cases, self-induced vomiting and inappropriate use of diuretics and laxatives also occur. Ongoing, significant calorie reduction can result in several noticeable physical and behavioral changes in your teen. Some of the most common include fatigue, reduced energy, difficulty concentration, dizziness, irritability, increased occurrences of injury, and difficulty “recovering” from workouts, practices, or competitive events.

The symptoms of anorexia athletica differ from anorexia nervosa in a few ways. First, someone with anorexia athletica actively engages in a high level of physical activity. Such activity can be in the form of exercise at the gym, training, team practice, or competitive events. Such intense levels of physical exercise while actively restricting calories increases your teen’s risk for physical injury. Also, where anorexia nervosa focuses on one’s distorted perception of body image or fear of weight gain, anorexia athletica is more focused on performance. Someone with anorexia athletica may be dissatisfied with their shape or weight; however, this satisfaction is often rooted in the belief that shape or weight contributes (or potentially contributes) to poor physical performance. Changes may also be apparent in athletes who have regular menstrual cycles. For these individuals, cycles may become irregular, sporadic, or even cease altogether. This alteration in the regular cycle is due to significantly reduced body mass.

What Causes Anorexia Athletica?

Teens, especially those participating in team sports, often feel an overwhelming need or obligation to perform. They likely experience pressure (either actual or perceived) to maintain a specific physical weight and shape. These pressures can come from many sources, including coaches, trainers, family, media (including social media), and other team members. Other circumstances that can increase the push to maintain particular body shape and weight standards may be associated with the sporting event itself. For example, judging criteria and standards, weigh-ins, or revealing and form-fitting uniforms.

Who is at Risk for Anorexia Athletica?

Due to how anorexia athletica presents and is diagnosed, the actual prevalence overall is unclear. However, as with many eating disorders, the prevalence of anorexia athletica is higher in female athletes than in males. This is not to say, however, that male athletes are not at risk. A study conducted of Division One National Collegiate Athletic Association athletes found that more than one-third of female athletes reported behavioral patterns, symptoms, and practices that put them at an increased risk for anorexia nervosa. In sports specific to weight class, such as wrestling, horse racing, or sports where the emphasis is placed on physical appearance, as many as 33% of male athletes are affected. For female athletes in similar sports, the rate is closer to 62 percent. Athletes, regardless of gender identity, who participate in sports where thinness or the retention of a specific weight are highlighted are more likely to develop anorexia athletica. Some common examples include gymnastics, swimming and diving, dancing, cheerleading, figure skating, wrestling, running, and horseback riding. Although further research is needed, it is also believed that environmental factors and personal characteristics (such as genetics and personality) may elevate one’s risk for developing anorexia athletica.

Treating Anorexia Athletica

Currently, there is not a defied treatment model for anorexia athletica. However, like treatment for other forms of disordered eating, treatment generally involves several different elements. Depending on your teen’s specific treatment needs, their treatment program at Meadowglade will likely consist of a combination of behavioral therapies, nutritional and education, and medical care.

Behavioral therapies are used to treat many mental health conditions, including disordered eating. During treatment, a trained therapist will ask your teen to examine the behaviors, thoughts, and actions that are contributing to their illness. A better understanding of the root causes of disordered eating can help your teen develop and practice safe and healthy coping strategies to use as they recover.

For those who struggle with an eating disorder, nutritional care and education are a critical component of a comprehensive treatment plan. Negative and unhealthy eating behaviors are a central focus of anorexia athletica and other forms of disordered eating. To increase your teen’s opportunities for treatment success, it is critical to directly address harmful food-related behaviors. This process may involve working with dieticians, physicians, and personal trainers to help your teen develop a healthier and safer relationship with food. Nutritionally focused professionals can help your teen learn how to focus on healthy nutritional intake and restoring their weight to a healthy range that can be safely maintained. They will educate your teen about the dangers of extreme dieting and weight loss measures used to sustain unhealthy body weight. The recovery process may also involve alterations to your teen’s exercise habits depending on the type and amount of exercise they currently do.

When someone struggles with disordered eating, it can lead to a wide range of physical health difficulties. For this reason, medical care is often necessary before therapy can begin. Some teens require time to regain stamina, physical capability, and overall health before actively participating in a therapy program. The type and level of medical care necessary will depend on your teen’s unique situation, with particular attention given to their current physical and mental health and how long they have been struggling with disordered eating. As with any type of disordered eating, early intervention is essential to limiting the potential for long-term physical health consequences. In the case of anorexia athletica, this may include bone or muscle injuries, arthritis, osteoporosis, nutritional deficiencies, and electrolyte imbalances that can lead to potentially dangerous (and even fatal) cardiac irregularities.

While many are familiar with anorexia nervosa and its impacts, not as many are familiar with the effects of anorexia athletica. Because sports and athletic activities sometimes focus on a lean body type and maintaining a specific weight, many athletes who develop a pattern of disordered eating will go on to develop anorexia athletica. Some common examples include gymnastics, dancing, and other sports where body profile is heavily featured. A teen with anorexia athletica will actively restrict their calorie intake and participate in excess heavy physical activity to attain and maintain a particular body weight and shape. With anorexia athletica, these behaviors are often focused on performance over body image perceptions, as found in anorexia nervosa. Treatment for disordered eating (of any kind) is essential as ongoing patterns of poor nutrition and intense physical exercise can lead to harmful and sometimes fatal consequences. As many as four percent of those with any form of anorexia die from complications related to the illness-the highest fatality rate of any mental illness.

At Meadowglade, we understand how difficult it can be for your teen and family to seek mental health treatment. The fears associated with the ongoing stigma surrounding mental health can increase the desire to overlook critical mental health care. If you are concerned about your teens eating and exercise habits, don’t wait to reach out for help. Contact us at Meadowglade today. Let our caring and compassionate staff help you learn more about treatment for anorexia athletica.

Resources

https://www.nimh.nih.gov/index.shtml

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696614/

https://www.doe.in.gov/sites/default/files/standards/neda-toolkit-coaches07-20101.pdf

https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml