It has been recognized for some time that athletes are much more likely than other people to suffer from an eating disorder. Increasing amounts of research have been carried out into this area, and recently a term has been adopted to define one sub-group of athletes suffering from symptoms of an eating disorder but who have not been diagnosed with bulimia or anorexia. This term is Anorexia Athletica.

Although Anorexia Athletica may not yet be recognized formally as an eating disorder, it is widely known amongst the medical community and is now becoming better understood and treated. Yet, in the general population, the term is largely unheard of, and many people who display symptoms are unaware that their condition even has a name. 

What Do We Mean By Anorexia Athletica?

The Eating Disorder Foundation reports that almost half of all ten-year-old girls are currently dieting, binge-eating or have a fear of getting fat. Evidence shows that many more women entering their 30s, 40s or even 50s are now suffering from eating disorders too. Too many individuals today are exercising and dieting excessively to such a point that it takes over their whole lives, resulting in medical complications and poor self-esteem.

While most of us have heard of common eating disorders like anorexia and bulimia, most people have never heard of the subtype known as anorexia athletica. Otherwise known as sports anorexia or hypergymnasia, this eating disorder is characterized by obsessive exercising in order to shed weight or to guard against weight gain.

Anorexia Athletica has not yet been formally recognized as an eating disorder by the APA (American Psychiatric Association) however it is known to be a major problem that is linked to other recognized eating disorders like bulimia nervosa and anorexia. Experts have found that anorexia athletica is often seen accompanying cases of bulimia or anorexia, with sufferers using excessive exercise as a way of getting rid of excess calories following a binge. Rather than purging via laxative or diuretic abuse or self-induced vomiting, individuals exercise for an excessive amount of time or in extreme conditions to such a point that it is a compulsive obligation with no benefits or enjoyment. 

As an example, an 8-mile run followed up by an hour’s weight training and then an hour working out on an elliptical is an average workout for somebody suffering from this condition.

What Causes Anorexia Athletica?

Just like other eating disorders, there isn’t a single cause for developing anorexia athletica. There are, however, several underlying factors that are linked with this disordered eating behavior. The APA suggests that any of the following may be associated with the development of this condition:

• Past trauma or abuse
• Poor self-esteem
• Poor family relationships
• Bullying
• Borderline personality disorder
• NSSI (non-suicidal self-injury disorder)
• Substance abuse
• Perfectionistic personalities
• Problems in communicating negative emotions
• Difficulty in resolving conflict
• Genetics

A major risk factor appears to be dieting from a young age. Many people who start dieting at an early stage of their athletic career to improve their sporting performance have reported that it was their coach who first advised them to shed some pounds if they wanted to succeed. If that dieting is then unsupervised, the chances of developing an eating disorder increase substantially.

Many young athletes lack the essential knowledge they need about appropriate methods for weight loss. They then receive information from a number of unreliable sources like magazines, the internet, and friends. These diets they start on probably lack sufficient caloric intake to meet the higher energy requirements of an athlete in training. A crash diet often appears attractive to athletes who feel they need to lose weight rapidly to get onto their chosen team or to get first place in a competition. 

People who start training at an early age in their chosen sport are also more likely to have disordered patterns of eating. In athletes who participate in a range of sports before selecting the one in which they specialize, their body type is often a key factor in choosing their preferred sport. However, when athletes begin training in a particular sport before their body has matured, they may end up with a body type that is not well suited to the activity of their choice. This means that they may struggle to counteract the natural changes in their body through excessive diet and exercise.

It has even been suggested that extreme exercise along could potentially cause an eating disorder. When someone increases their training volume considerably, they may end up eating less, partially because they fail to recognize they need to increase their calorie intake to fuel their additional exercise level, and partially because endorphins can reduce their appetite.

Some athletes even put their development of anorexia athletica down to a traumatic event such as the loss of their coach or an illness or injury which prevented them from training at their previous high level. 

Why Are Athletes At Risk?

Although many people are at risk of developing anorexia, athletes are particularly at risk of developing anorexia athletica. This is because athletes are more likely to become obsessed about achieving a perfect body through the regulation of food and intensive workout routines. For an athlete, having a lower body weight gives them an advantage over their opponents, particularly in certain sports such as cycling, acrobatics, and gymnastics. Unlike other eating disorders such as bulimia or anorexia, anorexia athletica is primarily about athletic performance.

Athletes are under extra pressure relating to their performance, and some are also subject to aesthetic demands. Some sports which have weight categories also put participants at risk. Rowers, boxers, and wrestlers, for example, may go through cycles of weight loss then weight gain which eventually leads to disordered eating patterns. 

All too often, athletes also have a heightened awareness of their body, and this puts them more at risk of having body image issues. Also, compulsiveness, expectations of high achievement and perfectionism are all personality traits that are believed to be an advantage for competitive athletes. Unfortunately, all of these traits are also commonly associated with eating disorder development. 

Eating disorders amongst athletes are most commonly seen in females who compete in sports in which a specific bodyweight or leanness is seen as important for appearance or performance, although men suffer too at a lower rate, with around one male athlete to every ten females recognized as suffering from an eating disorder.

What Are The Symptoms And Signs Of Anorexia Athletica?

No diagnostic criteria exists to determine whether someone is suffering from anorexia athletica or not. However, there are a number of symptoms and signs to be aware of, all of which center around an obsession with body image and weight and excessive amounts of exercise. As the disorder is usually linked with bulimia nervosa or anorexia nervosa, the symptoms and signs usually correlate with those conditions. Some general symptoms to look out for include:

• Excessive amounts of exercise
• Obsessive behaviors and thoughts surrounding calories, weight, body image and fat
• Basing self-worth solely on physical performance
• Non-existent or diminished enjoyment of activities and sports
• Denial of excessive exercise as a problem
• The repeated expression of worries about feeling or being fat even if the individual’s body weight is below average or completely normal
• Stealing food or eating secretly 
• Eating a large meal before disappearing 
• Making regular bathroom trips
• Bloodshot eyes particularly after using the bathroom 
• Eating excessive amounts of food which aren’t consistent with bodyweight 
• Swollen glands under the jaw 
• Vomit or the odor of vomit in the bathroom
• Large weight fluctuations over a short period of time 
• Unwillingness to eat food in front of other people 
• Wearing layers or very baggy clothes
• Mood swings
• Preoccupation with others’ eating behavior
• Continuously drinking water or diet soda

Do I Have Anorexia Athletica?

If you are an athlete who is keen to optimize your sporting performance, it’s clear that there are lots of benefits in taking care of your diet and working out regularly. However, if this has developed into an overwhelming and unhealthy obsession with body weight, calories, and food, there’s a chance that you may have tipped over into anorexia athletica. 

There are a few questions you can ask yourself to see if you are suffering from this condition:

• Do you continuously worry about what you’ll eat, where you’ll eat and when?
• Do you have fears about putting on weight if you eat out with friends or have a takeaway?
• Do you think about the amount of time you’ll need to work out to burn off calories?
• Do you have banned foods that you feel you need to avoid at all costs?

If the answer to any or all of these questions is yes, you may be suffering from anorexia athletica. Both men and women can be sufferers, and people of all ages can be affected. Some of the signs you should be looking out for in yourself include:

• Counting calories obsessively and weighing yourself frequently
• A preoccupation with body weight, calories, and food
• Dissatisfaction with your appearance
• Poor self-esteem if you fail to lose weight and higher self-esteem if you shed some pounds 
• Fear of weight gain 
• Using several different methods to stay at as low a bodyweight as possible including restricting your intake of calories, limiting food groups or food choices, carrying out vigorous, intense and long exercise routines, abuse of laxatives or diuretics or inducing vomiting
• A feeling of guilt if you break the diet rules that you’ve set for yourself
• Many female athletes exhibiting signs of anorexia athletica have an irregular menstrual cycle or no periods at all 

If these signs and symptoms sound familiar to you, or you recognize this pattern of thoughts and behavior in yourself, you should seek medical advice immediately to address the problem.

Can Anorexia Athletica Cause Any Complications?

If you exercise excessively, this can result in physical trauma being caused to your body. If your muscles are continually overused without sufficient caloric and nutritional intake, you can cause damage to your muscles, ligaments, and bones. Fractures and torn ligaments are commonly seen in people suffering from this disorder. Some other complications include cardiovascular complications as well as liver and kidney failure due to malnourishment. There’s also a risk of arthritis caused by joint damage from excessive exercise. 

Diagnosing Anorexia Athletica

There are certain criteria which medical professionals can use to diagnose whether an individual is suffering from anorexia athletica. Although it isn’t a formally recognized eating disorder, it can be treated by professionals. The criteria include:

• Weight loss without any affective disorder or medical illness to explain it
• Unexplained gastrointestinal problems
• Excessive fears of obesity even when underweight or excessively underweight
• Restricted calorie intake 
• Maintenance of a below-normal body weight for their height and age for at least a year

Along with one or several of the following criteria:

• Menstrual irregularities
• Delayed puberty
• Disturbed body image
• Purging for a minimum of 1 month via vomiting, diuretics or laxative abuse
• Compulsive exercising
• Binge eating (a minimum of 8 episodes per month for a minimum of 3 months) 

How Is Anorexia Athletica Treated?

Depending on how severe the disorder is, the treatment will consist of either inpatient or outpatient psychotherapy with CBT (cognitive behavioral therapy), IPT (interpersonal psychotherapy) and counseling about nutrition. These approaches can help individuals to recognize their triggers while developing new, healthier coping mechanisms to combat the eating disorder.

Of course, prevention is a better solution than treating an eating disorder which has already got out of hand. Athletes, coaches, training staff and parents as well as medical professionals all need to be better educated about the various warning signs and risks of disordered patterns of exercise and eating. By spotting a potential problem quickly and getting help for the individual concerned, it’s possible to nip the problem in the bud before a full-blown eating disorder can develop. If you’re worried that you or someone you know is suffering from anorexia athletica, it’s important to share your worries. 

Help is out there, and a physician or nutritionist like the trained staff at The Meadowglade can offer valuable advice that can get someone suffering from an eating disorder on the road to recovery. Contact us today in order to find out how our facility can help you flip the switch and start recovering from anorexia athletica.