Detecting and Managing Disordered Eating in Athletes

Detecting and Managing Disordered Eating in Athletes

Clinical Features

           Athletes that suffer from disordered eating rarely self-report their symptoms because they are ashamed, in denial, or have fear of reprisal. Early detection and treatment of DE should be one of an athletic programs highest priority. Mild cases that increase in frequency and severity can develop into a clinically diagnosable condition. Pre-participation physical exams and questionnaires can give clinicians to screen for signs and symptoms of DE1.

Signs, Symptoms, and Physical Complications

           Signs and symptoms can be seen in even the earliest stages of DE. “Medical complications associated with malnutrition and purging can affect multiple organ systems and progress to serious health consequences, including, but not limited to, cardiovascular, reproductive, and skeletal dysfunction and, in some cases, death”.  Some of the most common signs of DE are constant dieting, secretive eating, excessive weighing or exercising, social withdrawal, and depression. Being able to recognize these signs and symptoms will help with a quicker diagnoses and management of the condition1.

Management

        When an eating disorder is suspected in an athlete it is best to have a superior that the athlete trust to confront them. The confrontation should be in private where the superior is straightforward, explaining the reasons why they believe the athlete suffers from a disorder, and expressing concern for the athletes mental and physical health.  Once the disorder is confirmed immediate referral to a physician is necessary.  A physician will complete a detailed medical history and a physical exam. Once a diagnosis has been made an action plan must be designed.  The proper treatment setting must be determined, can the athlete be treated by: an athletic trainer, hospitalization, outpatient care, or counseling sessions. In counseling sessions the following is desired for treatment; acceptance of the problem, changing unhealthy thoughts and body image, identifying triggers, stabilizing medical conditions caused from an eating disorder, reestablishing healthy eating patterns, and building a reliable support system.  Dietary counseling is designed to educate athletes on the proper caloric intake based on their metabolic status. Dietary management helps athletes maintain adequate energy availability and establish a healthy target weight1.  

Disordered eating in athletes is becoming more and more common. Proper education is the best way to prevent athletes from suffering from an DE. Athletic trainers and athletic staff must be able to identify signs and symptoms of DE. Immediate referral to a physician who can determine the proper course of action is the most important step.  Once a treatment path has been chosen a trustworthy support system needs to be put in place to insure the athlete stays healthy.

References

Bonci, C., Bonci, L., Granger, L., Johnson, C., Malina, R., Milne, L., Ryan, R., Vanderbunt, E. (2008). National Athletic Trainers' Association Position Statement: Preventing, Detecting, and Managing Disordered Eating in Athletes. Journal of Athletic Training, 43(1), 80-108.