This lecture resonated with me as my niece was diagnosed with anorexia. This lecture educated me on disordered eating (DE), a phenomenon I had never heard off before and whilst not everyone who has disordered eating develops an eating disorder (ED), those with eating disorders would have had DE.  There are many signs and symptoms for various eating disorders to look out for but knowing the difference as to whether it is DE/ED or a committed athlete is a tricky road to traverse down.

This piqued my interest as the more I learnt in this lecture is that I suffered from DE as did my friend, whom I spoke to about this lecture. I started to wonder, how many people in the general population have DE but rationalise the normalcy of this because they were trying to lose weight or tone up and do not recognise that, in fact, they have an unhealthy relationship with food and/or exercise.  Apply that thought process to the athletic population and actually is this affiliation with food or exercise a sign of a committed athlete to their sport or actually a start of an unhealthy relationship with food/exercise that could worsen to become an ED?  The research shows there is a prevalence of ED/DE in the athletic population and therefore it is reasonable to assume that, as a practitioner, I will have clients on this spectrum.

There are studies that show there is more ED in athletes versus the general population (Bashforth, 2022) with 13.5% prevalence of ED in elite athletes (El Goch, 2013) with female athletes suffering more than male athletes (20.1% vs 7.7%) (Bashforth, 2022). According to UK sport cited by Bashforth (2022) the sports that have high risks of ED are swimming, running, gymnastics, diving, synchronised swimming, wrestling and judo.  However, there are other sports, that some may not associate with DE/ED such as rugby, netball and hockey (Bashforth, 2022). Worryingly and disappointingly, as we are trying to have a more inclusive society, there is very little information on ED/DE for disabled athletes (Bashforth, 2022). There is an increase in DE in lean sport types and that behaviours displayed depend on athlete type and it is crucial to recognise the risk for DE in athletes as early as possible so that treatment options can be prioritised in order to stop the development of an eating disorder, lessen the negative effects on an athlete’s performance, and avoid other harmful health implications (Mancine et al., 2020). There is a complex triangulation of societal expectations, social comparisons and sport pressure that provide a cacophonic environment for the contribution and development of ED/DE (Stoyel, 2021).

Disordered eating behaviours (DEB) may include features such as binge eating, purging, laxative abuse, excessive exercise and fasting for weight loss, but are not sufficiently severe or frequent to meet full ED diagnostic criteria. 70% of athletes who participate in sports having weight classes, are engaging in one or more disordered eating behaviours (DEBs) in order to meet weight requirements (Sundgot-Borgen & Torstveit, 2010).  In fact, the exercise addiction (EA)/ED dyad is not fully understood and more research on this dyadic relationship needs to be completed to help identify, prevent and manage athletes with these conditions (Godoy-Izquierdo, 2021). With the pressure on athletes to perform and excel there will always be pressure for athletes to internalise how they can enhance their performance leading to an unhealthy relationship with food and exercise, so recognising pathopsychological signs of ED/DE is essential.  This is a problem that will not just cease to exist but I imagine athletes will find creative ways to hide the problem and usually to detriment of their performance, of which, all sport is about performance.

What the above research has shown is that the prevalence of ED/DE is high in elite athletes.  The pressure to perform and be the best will drive athletes to take whatever path they need to, to be the best. Without sounding crass or distasteful, this means as a practitioner at least 1/5 of my potential client base could be suffering from ED/DE which is a significant amount for one issue.  Therefore, it makes sense, practically and commercially to take on extra training to become an expert in this field, especially as EA/ED dyadic relationship has not been fully explored and that the figures mentioned above could be an under-representation of the real numbers of elite athletes suffering from ED/DE.  Studying for a doctorate in counselling psychology would also allow me to work with athletes suffering from this issue whereas if I complete the sports and exercise psychology doctorate, I would have to refer the individual on; which will effect the therapeutic alliance but also a loss of revenue.

References

Bashforth, E. (2022, June 15). We Need to Stop Romanticising Eating Disorders. Inspire the Mind. https://medium.com/inspire-the-mind/we-need-to-stop-romanticising-eating-disorders-6d1806f7de11

El Ghoch, M., Soave, F., Calugi, S., & Dalle Grave, R. (2013). Eating Disorders, Physical Fitness and Sport Performance: A Systematic Review. Nutrients, 5(12), 5140–5160. https://doi.org/10.3390/nu5125140

Godoy-Izquierdo, D., Ramírez, M. J., Díaz, I., & López-Mora, C. (2021). A Systematic Review on Exercise Addiction and the Disordered Eating-Eating Disorders Continuum in the Competitive Sport Context. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-021-00610-2

Mancine, R. P., Gusfa, D. W., Moshrefi, A., & Kennedy, S. F. (2020). Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type – a systematic review. Journal of Eating Disorders, 8(1). https://doi.org/10.1186/s40337-020-00323-2

read, D. S. J. M.-M.-2. · 9 mins. (2022, March 21). Eating disorders in athletes: how can we tackle them? Patient.info. https://patient.info/news-and-features/eating-disorders-in-sport-why-are-they-so-common-and-how-can-we-tackle-them

Stoyel, H. (2021). Eating Disorders and Disordered Eating in Athletes [Thesis]. https://discovery.ucl.ac.uk/id/eprint/10125987/

Sundgot-Borgen, J., & Torstveit, M. K. (2010). Aspects of disordered eating continuum in elite high-intensity sports. Scandinavian Journal of Medicine & Science in Sports, 20(s2), 112–121. https://doi.org/10.1111/j.1600-0838.2010.01190.x