If the athlete is ready to get over her disorder,
allowing her to continue with her sport with
minimal risk when she really wants to continue
can enhance the motivation for and the effect of
treatment.
It is the author’s experience that a total suspen-
sion is not a good solution. Therefore, if she
wants to compete after treatment and no medical
complications are present, she should be allowed
to train, but usually at a lower volume and at a
decreased intensity.
The athlete’s family may be involved in the
process of getting the athlete into treatment.
One factor affecting this involvement is the
athlete’s age—the younger the athlete, the more
the family’s involvement is recommended.
Health maintenance standards
If the athlete meets the criteria just mentioned,
the ‘bottom-line standards’ regarding health
maintenance must be imposed to protect the
athlete. The treatment staff determine these
and individually tailor them according to the
athlete’s particular condition. These standards
may vary between individual athletes or by
sport.
According to Thomson and Trattner-
Shermann (1993), athletes should maintain at a
minimum a weight of no less than 90% of ‘ideal’
weight. This is not sport-related, but health-
related body weight. The athlete should eat at
least three balanced meals a day, consisting of
enough energy to sustain the pre-established
weight standard the dietitian has proposed.
Athletes who have been amenorrhoeic for 6
months or more should undergo a gynaecologi-
cal examination to consider hormone replace-
ment therapy. In addition, bone-mineral density
should be assessed and results should be within
the normal range.
Prevention of eating disorders
in athletes
Since the exact causes of eating disorders are
unknown, it is difficult to draw up preventive
strategies. Coaches should realize that they can
strongly influence their athletes. Coaches or
others involved with young athletes should not
comment on an individual’s body size, or require
weight loss in young and still-growing athletes.
Without offering further guidance, dieting may
result in unhealthy eating behaviour or eating
disorders in highly motivated and uninformed
athletes (Eisenman et al. 1990). Early intervention
is also important, since eating disorders are
more difficult to treat the longer they progress.
However, most important of all is the prevention
of circumstances or factors which could lead to
an eating disorder. Therefore, professionals
working with athletes should be informed about
the possible risk factors for the development of
eating disorders, the early signs and symptoms,
the medical, psychological and social conse-
quences of these disorders, how to approach the
problem if it occurs, and what treatment options
are available.Weight-loss recommendation
A change in body composition and weight loss
can be achieved safely if the weight goal is realis-
tic and based on body composition rather than
weight-for-height standards.
1 The weight-loss programme should start well
before the season begins. Athletes must consume
regular meals, sufficient energy and nutrients to
avoid menstrual irregularities, loss of bone mass,
loss of muscle tissue and the experience of com-
promised performance.
2 The health care personnel should set realistic
goals that address methods of dieting, rate of
weight change, and a reasonable target range of
weight and body fat.
3 Change in body composition should be moni-
tored on a regular basis to detect any continued
or unwarranted losses or weight fluctuations.
4 Measurements of body composition should be
done in private to reduce the stress, anxiety, and
embarrassment of public assessment.
5 A registered dietitian who knows the demands
of the specific sport should be involved to
plan individual nutritionally adequate diets.