Eating/ Body Image Disorders

1. Eating/ Body Image Disorders

2. Who has Eating Disorders? • Do you know anyone that has an Eating Disorder? • 20 Professional Athletes with Eating Disorders

3. NATA Position Statement: • Preventing, Detecting, and Managing Disordered Eating in Athletes • Purpose: “To provide recommendations to better prepare ATC, other health care providers, sports management personnel, and coaches for the challenges of understanding and working with athletes who present with DE or who may be at risk.”

4. Anorexia Nervosia (AN) • A ED where an individual sees themselves overweight or not attractive and loses appetite and is unable to eat. • 0.9% of women=Anorexia Nervosa • 0%-2% women athletes= AN • Up to 50% of patients with AN develop bulimic symptoms but still carry the primary diagnosis of AN • Mortality rate= 10% with 10yrs. Of diagnosis.

5. Bulimia Nervosia (BN) • A ED where an individual disapproves of their body image and restricts food or fasts, followed by binging & purging. • 1.5% of women=Bulimia Nervosa • 1.1%-6% women athletes=BN • 1% patients die within 10 years of diagnosis • Self-induced vomiting is the most common form of purging.

6. Muscle Dysmorphia • Sometimes called Bigorexia. • A disorder in which a person becomes obsessed with the idea that he or she is not muscular enough • Opposite of Anorexia • Roots: obsessed with exercise- mostly weightlifting, use of steroids, and avoid removing clothes.

7. Body Image • Body image is a broad construct that refers to visual images of and attitudes toward the body • There are also demands to be thin for maximizing performance • Concerns for appearance, especially in aesthetic sports (gymnastics, diving, and figure skating) in which physical appearance may be a part of the judging process

8. Women Aren’t the Only Ones… • Equal attention should be paid to male athletes who exhibit signs and symptoms of EDs • Males have more of a problem talking about EDs because it is seen as a feminine disorder • Males usually don’t have signs of malnutrition

9. Prevention • Structured educational and behavioral programs for athletes, coaches, ATCs, administrators, and other support staff. • Athletes should feel comfortable talking about eating disorders with their athletic trainers. • Athletic trainers should stress the importance of a healthy diet and that it varies from sport to sport. • Female athletes-Menstrual cycle irregularities & importance of seeking medical attention at first signs.

10. Detecting • Be alert to the most common behavioral and psychological characteristics • Self-reporting EDs are rare among athletes due to secrecy, shame, denial, and embarrassment. • Early detection requires a screening program: PPE, questionnaires, interviews, and/or observations.

11. Managing • “Initial conversation should be straightforward, disclosing evidence of DE and balancing concerns for the athlete’s health and well being.” • Referral: supervising physician-for physical examination • If diagnosis was established- examination includes: past and present symptoms, past and present treatment, and the future care and treatment • Lab tests and/or electrocardiograph may be required.

12. Treatment Settings • Hospitalization, residential programs, partial hospitalization, or various outpatient care. • Working with athletes with an ED should include programs to help nutrition and mental health. • Nutrition: dietary counseling-maintain energy levels • Mental Health: counseling to help admit that an individual has an ED. • Support: Family, Teammates, Friends, Coaches, and ATC.

13. Psychological Factors for Athletes Who Fall Victim to EDs: • Having unrealistic standards, being overly self-critical, and doubting themselves, increases the individuals likelihood of negatively evaluating their bodies in comparison to the social beauty ideal • Key personality and psychological constructs: • Perfectionism • Psychological well-being • Reasons for exercising • Appearance orientation

14. Perfectionism: unrealistic standards, overly self-critical, and doubt about self would cause an individual to evaluate body critique in a negative way. • Psychological Well-Being: self-esteem issue coming from comments made by family, peers, co-workers, etc. • Reasons for Exercising: range from exercising to improve health, to exercising to appear to be more attractive. • Appearance Orientation: those who worry more about appearance are more likely to participate in an ED rather than those who are less worried about appearance.

15. Questions???