You would think that professional athletes, who need to be in near-perfect shape to compete, would be the last people to have an eating disorder. Yet athletes, both men and women, may be two to three times more likely to have an eating disorder than the average person, according to a 1999 study of college athletes by the National Collegiate Athletic Association. A 2004 study of top athletes in Norway reached a similar conclusion, finding that 13.5% of athletes surveyed had an eating disorder, compared with 4.6% of the control group.
As a professional athlete, you may not think these studies apply to you. While additional research is needed, the same characteristics that make college athletes vulnerable to eating disorders may be even more prevalent in professional athletes. At the professional level, the stakes are higher, and the characteristics that help athletes at the highest levels to excel may also be found in those with eating disorders.
A study comparing the psychological profiles of athletes with those of anorexics found many common traits, including high self-expectations, perfectionism, competitiveness, hyperactivity, repetitive exercise routines, compulsiveness, drive, a distorted body image, preoccupation with weight and dieting, and a tendency toward depression.
Professional athletes typically begin training at an early age and are prone to over-exercise. Their parents are sometimes demanding and controlling. Depending on the sport, training may take place in near social isolation.
Athletes are also sometimes obsessive about their weight, because in some sports, being a few pounds lighter or a few pounds heavier can make athletes more competitive. In some cases, they need to stay within a certain weight range to stay in their current weight class.
All of these factors can contribute to the development of an eating disorder. There have been few reports of professional athletes with eating disorders, but that’s understandable. For an athlete to admit that he or she has an eating disorder would be about as helpful to a career as admitting to taking anabolic steroids.
There have, however, been plenty of stories about Olympic athletes with eating disorders. Bahne Rabe, a male rower who won eight gold medals, and gymnasts Helga Brathen and Christy Henrich are among those who died from complications related to anorexia. Cathy Rigby, the first American woman to win a medal in World Gymnastics, and Nadia Comaneci, who won nine gold medals, both suffered from bulimia. Comaneci also overcame anorexia.
All athletes are at risk
Women are more likely to develop eating disorders than men, and athletes in sports where body aesthetics or weight are important are more likely to develop eating disorders than those in other sports. Two studies of college athletes, one in 1999 by Craig Johnson of the Laureate Psychiatric Clinic and Hospital in Tulsa and another in 2002 by Katherine Beals of the University of Utah in Salt Lake City, separately found that at least one-third of female college athletes have some type of disordered eating.
However, there are also plenty of male athletes with eating disorders. The National Eating Disorders Association estimates that 33% of male athletes in aesthetic sports (bodybuilding, gymnastics, swimming) and weight-class sports (wrestling, rowing) are affected by eating disorders.
Writing about eating disorders in male athletes in Sports Medicine in 2006, Antonia Baum, M.D., of Fairfax Hospital in Falls Church, VA, detailed the extremes that male athletes sometimes go to when weight is a factor in performance. Jockeys may sit in a heated car wearing a rubber suit, use hot-box saunas, self-induce vomiting, or take cocaine and amphetamines to suppress their appetite. Wrestlers abuse diuretics, binge and purge, and take laxatives to make their weight requirements before a match, and then they routinely binge following a match. Crew athletes wear many layers of clothing during runs on hot days to lose weight.
What about male athletes in major sports like baseball, football, and basketball? Anyone can have an eating disorder. Newsweek reported that 40% of Cornell University football players surveyed engaged in binging and purging, which is associated with bulimia.
Writing about eating disorders in male athletes, Dr. Baum made a connection between eating disorders and the use of anabolic steroids in football, baseball, and body building. The use of steroids is a sign of “muscle dysmorphia,” where the athlete becomes preoccupied with increasing muscle mass to the exclusion of almost everything else. In addition, athletes who take steroids to improve performance eat more as a result and then try to control their weight, which can result in an eating disorder.
While bans on the use of performance-enhancing drugs are being increasingly enforced, the personality traits that lead to their use will still be there, even if steroid use is eliminated from professional sports.
Types of eating disorders
To determine whether you have, or are in danger of developing, an eating disorder, it helps to have an understanding of the different types of disorders.
The most well-known eating disorder is anorexia nervosa, in which individuals take extreme measures to avoid eating. They have a distorted image of their body and continue to diet, even when they are severely underweight. Other signs include social withdrawal and emotional changes. Few athletes, other than gymnasts, jockeys, runners, and rowers, are likely to develop anorexia. They could not survive training or competing for long without eating properly. A football lineman would never have anorexia, but could have binge-eating disorder, which is characterized by uncontrollable, excessive eating, followed by feelings of shame and guilt. It is the most common eating disorder, but it is rare among athletes.
The most likely eating disorder for most professional athletes to develop is bulimia nervosa. Those with bulimia typically “binge and purge.” Purging is forced vomiting, but some with bulimia may compensate for binging in other ways, such as excessive exercise, or use of laxatives or diet pills. Those who have bulimia can often hide the disorder for years.
Those with eating disorders are more apt to have other psychiatric disorders and they have a higher incidence of substance abuse than the general population.
Eating disorders are life-threatening; in fact, they have the highest mortality rate of any psychiatric disorder. At the very least, they can hamper an athlete’s performance and make the athlete more susceptible to injuries, like bone fractures. Many athletes have ruined their careers by developing eating disorders and not treating them.
What to do
If you are binging and purging, or showing other signs of having an eating disorder, you should seek medical help immediately. Especially in the early stages, most people who have an eating disorder are in denial about it. The typical rationalization is, “I’m just doing this to get myself in better shape to play.” Failure to accept the problem and do something about it will only lead to bigger problems in the future.
The earlier an eating disorder is treated, the more likely you will be to make a full recovery. You will miss playing time, as your body will need time to heal and your pattern of exercise will need to be disrupted, but failure to act quickly can end your career and can even be a fatal mistake.