It is well-established that playing sports, particularly team sports, have positive effects on a child or adolescent's self-image and self-esteem. Organized sports allow for participation in activities of cultural importance, achievement of goals, and recognition and respect from others for achievement of those goals. Sports participation also provide experiences for youth athletes that help develop positive attitudes and behaviors.
Sports participation emphasizes competitive success. There are often social expectations and pressure to achieve and to win. Likewise, those with eating disorders and body image disturbances are often subject to external pressures to achieve as well as pressures to appear a certain way.
Pressures to succeed can result in psychological symptoms that are characteristic of eating disorders. One 1999 study found that athletes who experience external pressure are more likely to exercise excessively and that such excessive exercise predicted increased levels of disordered eating patterns. In addition, there may be pressure for athletes who must adhere to weight restrictions (e.g. wrestler) or measuring up to a certain body type (gymnasts, female figure skaters). These issues are especially problematic for females.
In our research, we found that competitiveness was related to body dissatisfaction among female athletes, and that external pressures are related to symptoms of eating disorders. Furthermore, competitiveness among the female athletes we studied was related to body dissatisfaction.
Today's females receive mixed messages from society that recognize the importance of participation in athletics and reward them for maintaining a fit body and having physical power, but at the same time perpetuate a cultural ideal valuing thinness, bust size, waist size, even the kind of makeup they wear and their hairstyles. Often, such a focus promotes femininity and body dissatisfaction. Indeed, studies indicate that females often will not play sports until they are thin enough to wear the right clothes. Some combine athletics with unhealthy measures to manage their weight (laxatives, vomiting, starvation).
Criticism may lead to eating disorders
- Athletes who are subject to excessive criticism or are seldom praised may perceive themselves as not good enough or unworthy. External pressure may lead to self-critical thoughts, disordered eating, disordered exercise patterns, body dissatisfaction, and eating disorders. In fact, a major obstacle to successfully treating people driven by harsh, unconstructive, or unattainable external standards is the person who criticizes and pressures them.
- One 2000 study found, unfortunately, that some coaches view potential eating disorders symptoms such as excessive exercise, perfectionism, over-compliance, and competitiveness, as desirable.
- Another 2000 study found that some parents view a strong desire to please others, namely themselves, as a healthy trait in their children.
Absence of praise: just as harmful
- Children whose parents rarely approve or inconsistently approve of their accomplishments are more likely to obsess about perfection in order to assure that they receive parental approval. Therefore, the absence of praise may have as great an effect on disordered eating as does the presence of criticism.
- Athletes whose parents expect them to perform at a high level may learn to do well in order just to receive more praise or avoid excessive criticism.
- Individuals with symptoms of eating disorders are more likely to seek approval from others, even if such approval is unattainable or must be obtained through harmful means.
- Because individuals with symptoms of eating disorders often strive for success in order to please others, they are more likely to worry about social acceptance, feel inadequate, spend time thinking about personal inadequacies, and be dependent on others.
External pressure to succeed linked to eating disorders
- Athletes playing sports in less competitive environments and thus subject to less competitive pressure are less likely to have disturbed eating patterns and body dissatisfaction.
- Pressure to compete with peers in terms of appearance has been linked to eating patterns in adolescents..
- College females who compare themselves to peers or celebrities are more likely to experience increased body dissatisfaction, especially if their focus is on weight and body size.
Parents and coaches: criticize less and praise more
To reduce the chances that an athlete will engage in disordered eating or develop a full-blown eating disorder, parents, coaches and athletic trainers need to:
- Reduce the amount of pressure on athletes to succeed or to appear attractive;
- Help athletes avoid the mindset that they have to be the best at everything or appear the most attractive;
- Offer athletes consistent praise so they know you approve of their accomplishments;
- Avoid excessive criticism because it sends the message that you do not approve of them;
- Help athletes to strive for goals set by internal standards rather than external sources.
- Help athletes to experience satisfaction and approval from knowing that they have done a good job and tried their best. This is better than looking for and relying on external sources of approval;
- Identify, if possible, what is driving a child's feelings of inadequacy;
- Pay attention to the messages children see on television and in magazines, which are often unhealthy and unnatural and set standards that are impossible to obtain; and
- Help athletes stay healthy by educating them about eating disorders, nutrition, and healthy eating habits.
Beverly L. Stiles is an associate professor of sociology at Midwestern State University where she focuses on gender, social psychology, and medical sociology. She can be reached at Beverly.Stiles@mwsu.edu. She is particularly interested in hearing from female athletes who have had problems with eating disorders.Adapted from Peden, J., Stiles, B., et. al. "The Effects of External Pressures and Competitiveness on Characteristics of Eating Diorders and Body Dissatisfaction." Journal of Sport & Social Issues (November 2008). To order a copy of the complete article, go to http://jmm.sagepub.com. Dr. Stiles gratefuly acknowledges the contribution of Jamie D. Peden to this article.
Eating disorders commonly exist among athletes, especially those involved in sports that place great emphasis on the athlete to be thin. Sports such as gymnastics, figure skating, dancing, and synchronized swimming have a higher percentage of athletes with eating disorders, than sports such as basketball, skiing and volleyball. According to a 1992 American College of Sports Medicine study, eating disorders affected 62 percent of females in sports like figure skating and gymnastics. Famous gymnasts Kathy Johnson, Nadia Comaneci and Cathy Rigby have all admitted to fighting eating disorders. Cathy Rigby, a 1972 Olympian, battled anorexia and bulimia for 12 years. She went into cardiac arrest on two occasions as a result of it.
Female athletes with a genetic predisposition to eating disorders may develop them as a result of restricting calories in an attempt to be thin. They may do so in order to please coaches and judges, or because they believe that it allows them a competitive advantage. Comments from coaches pertaining to body weight can potentially cause an athlete to resort to dangerous methods of weight control. Such practices also can cause serious emotional damage to the athlete.
In sports where athletes are judged by technical and artistic merit, they can feel enormous pressure to be thin. Many judges consider thinness to be an important factor when deciding the artistic score. In 1988, at a meet in Budapest, a US judge told Christy Henrich, one of the world’s top gymnasts, that she was too fat and needed to lose weight if she hoped to make the Olympic squad. Christy resorted to anorexia and bulimia as a way to control her weight, and her eating disorders eventually took her life. Christy Henrich died at the age of 22 of multiple organ failure.
Athletes with eating disorders can be at a higher risk for medical complications such as electrolyte imbalances and cardiac arrhythmias. They are already engaging in strenuous physical activity and putting a lot of pressure on their bodies. Having an eating disorder increases the risk of sudden death due to cardiac arrest. It is usually difficult to convince athletes that they are in need of help because they usually believe that they will become a better athlete, and perform better, if they lose more weight. Gymnastics is one sport where the size of the gymnast has gotten drastically smaller over the years.
For Coaches and Trainers
Coaches and trainers should educate themselves on the dangers and on the signs to look for in an athlete who may be suffering from an eating disorder. They must be able to recognize when healthy training routines turn into an obsession where the athlete turns to drastic measures to become thin and succeed in their sport. Coaches should also bring in nutrition experts to educate the athletes on healthy eating and to make them aware of how important it is to eat properly, especially when involved in such intense training. Counseling should also be made available to athletes that are suffering from eating disorders and they should be encouraged and supported to accept the help available to them. They need to be assured that they will not be criticized or looked down on if they do come forward with their problem.
Here is more on how to recognize the signs and symptoms of an eating disorder.
For parents who are putting their child into a competitive sport, it is important to find a coach who is aware of the dangers of eating disorders and will not put too much pressure on the child. Coaches should encourage and help the athlete to maintain a healthy routine that will not put them at risk of harming themselves. Resorting to dangerous methods of weight control to try and succeed and win competitions can be a great risk to long term health. No gold medal is worth dying for.
The Female Athlete Triad
The female athlete triad refers to three distinct and interrelated health concerns sometimes seen in women driven to excel in athletics. Those health concerns include disordered eating of some sort (such as eating far too little or binging and purging), amenorrhea (irregular menstrual periods or lack of menstruation) and osteoporosis (low bone density due to excessive exercise and lack of nutrients like calcium and vitamin D). Women that participate in activities like gymnastics, ballet and figuring skating are at increased risk for the female athlete triad, just as they are at increased risk for eating disorders like anorexia nervosa. Early recognition and treatment is imperative to prevent life-threatening complications.
Follow this link to learn more about NCAA athletes with anorexia.
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A good resource for athletes and coaches alike is the NEDA Coach and Trainer toolkit.
American College of Sports Medicine
Updated by Tabitha Farrar – 2014
Written by Colleen Thompson – 1997