NUTRITION IN SPORT

type of drugs most commonly abused by athletes
while eating-disordered dancers also report the
use of marijuana, cocaine, tranquillizers and
amphetamines (Holderness et al.1994). Eight per
cent of the Norwegian elite athletes suffering
from eating disorders reported a regular use of
diuretics and a significantly higher number
reported the use of laxatives, vomiting, and diet
pills (Sundgot-Borgen & Larsen 1993b). It should
be noted that diet pills often contain drugs in the
stimulant class, and that both these and diuretics
are banned by the IOC.

Identifying athletes with eating disorders

anorexia nervosa and
anorexia athletica

Most individuals with anorexia athletica do not
realize that they have a problem, and therefore
do not seek treatment on their own. Only if these
athletes see that their performance level is level-
ling off might they consider seeking help. The
following physical and psychological character-
istics may indicate the presence of anorexia
nervosa or anorexia athletica.
The physical symptoms of athletes with
anorexia nervosa or anorexia athletica (Thomp-
son & Trattner-Sherman 1993) include:
1 significant weight loss beyond that necessary
for adequate sport performance;
2 amenorrhoea or menstrual dysfunction;

514 practical issues

3 dehydration;

4 fatigue beyond that normally expected in

training or competition;

5 gastrointestinal problems (i.e. constipation,

diarrhoea, bloating, postprandial distress);

6 hyperactivity;

7 hypothermia;

8 bradycardia;

9 lanugo;

10 muscle weakness;

11 overuse injuries;

12 reduce bone mineral density;

13 stress fractures.

The psychological and behavioral charac-

teristics of athletes with anorexia nervosa and

anorexia athletica (Thompson & Trattner-

Sherman 1993; Sundgot-Borgen 1994b) include:

1 anxiety, both related and unrelated to sport

performance;

2 avoidance of eating and eating situations;

3 claims of ‘feeling fat’ despite being thin;

4 resistance to weight gain or maintenance

recommended by sport support staff;

5 unusual weighing behavior (i.e. excessive

weighing, refusal to weigh, negative reaction to

being weighed);

6 compulsiveness and rigidity, especially

regarding eating and exercise;

7 excessive or obligatory exercise beyond that

required for a particular sport;

8 exercising while injured despite prohibitions

by medical and training staff;

Restrictive eating

Weight loss and

improved performance

Positive feedback from

'important others'

Athlete has feeling of total control

Intensified behaviour

Loss of control, reduced

performance

Eating disorders

Fig. 39.2Aetiological model for

the development of eating

disorders in athletes.