Athletes and Eating Disorders in Western Culture

In today’s society, many people feel self-conscious about their body types, and have a constant desire to be thinner. Research has found that “Eating disorders influence alterations of brain functions, significantly impair cognitive function, judgment, and emotional stability; and restrict the life activities of persons afflicted with these illnesses” (Klump, Bulik, Kaye, Treasure & Tyson, 2009). People are constantly influenced by others and consumed by the ideology of having a thin body shape, which essentially consumes the majority of their thoughts; thus negatively affecting the way they perceive their own bodies. When people have these negative connotations with the self, they tend to be more at risk for developing an eating disorder.

Anorexia nervosa is a prevailing eating disorder that is found amongst many athletes. This type of eating disorder is indicative of people who accomplish excessive weight loss through extreme dieting, fasting, or excessive exercise (Klump, Bulik, Kaye, Treasure & Tyson, 2009). These practices lead to the consequences of malnourishment in the body, leading to low energy levels and possible loss of bone mineral which is not completely reversible. People with anorexia nervosa are described to have a weight that is less than minimally normal, or minimally expected (Klump, Bulik, Kaye, Treasure & Tyson, 2009).

Eating disorders and characteristics of eating disorders are commonly adopted amongst many people today. In particular, competitive athletes are more prone to developing eating disorders due to their increased exposure to competitive environments that emphasize bodily factors such as leanness and thinness, bodily exposure from revealing uniforms, competitive thinness, unhealthy subcultural aspects, and the severity of the role that the coach plays in the athletes life, alongside the type of sport that the athlete participates in (Powers & Thompson, 2007).

Body Size Overestimation refers to the discrepancy between social cultural bodily pressures and the reality for many women, making it harder for them to accept their bodies. This can become a means of treatment to teach women about healthy weight management and accepting their body weight, despite societal pressures (Paxton & McLean, 2007).

Cognitive Dissonance is experienced when someone sets unrealistic expectations for themselves to attain a very thin body shape, while generating thoughts about the unreality of this goal (Paxton & McLean, 2007).

Justified Paternalism refers to the ethical and legal complications that arise when a patient is in denial of the treatment that they need. There are different interpretations about what plan to implement and the considerations regarding the patient’s consent or refusal of treatment that conflict the medico-legal advice gives by specialists (Silber, 2011).

Athletes and Eating Disorders Overview

In modern society, individuals are constantly influenced by bodily pressures that negatively affect the perception that they have of themselves. Athletes today are also impacted by these influences, in addition to the pressures experienced by their sports environments. These impacts can influence both the mental and physical health of athletes.

It is not the participation in the sport itself that triggers eating disorders, but rather the exposure to bodily influences in certain sport environments that can predispose athletes to develop an eating disorder (Powers & Thompson, 2007). As a result, these competitive environments emphasize a need for athletes to reduce their body fat percentage, and maintain a thin figure and low weight. Such expectations increase the risk of an athlete developing an eating disturbance. The notion of improving performance as a result of a thin body shape leads athletes to practice restricted eating habits, or excessive training outside of sport practices in the pursuit of maintaining the ideal body image for that sport. Although the pressure to optimize performance is not always a direct result of the influence to have a thin body shape, the association of having a thin figure is almost always a factor. Sports like distance running and ski jumping emphasize the need for a thin body shape to increase performance. This ideology is also relative to competitive athletes that participate in aesthetic sports, which involves being judged on performance; such as figure skating and gymnastics (Powers & Thompson, 2007).

Female athletes in particular, are more inclined to developing eating disorders, or adopting abnormal habits that lead to excessive weight loss. They are imposed with a challenge to deal with the pressures of balancing the influences that Western Culture has inhibited on body image. In addition, it emphasizes a thin bodily appearance in sport environments; by coaches, frequent weigh-ins, and comparison amongst teammates. These pressures directly influence female athletes to adopt symptoms of eating disorders at the very least, or on the other hand, be diagnosed with an eating disorder like Anorexia Nervosa or Bulimia Nervosa. According to Greenleaf, Petrie, Carter, and Reel, “Clinical and subclinical eating disorders involve the use of specific disordered eating and pathogenic weight-control behaviours to manage emotions, weight, and body size” (2009). It is evident that a higher rate of female college athletes experience symptoms of eating disorders when compared to female college students that are not athletes. It is believed that clinically diagnosed eating disorders adhere to approximately 8% of the elite female athletes population, in addition to 14-19% of elite female athletes that adopt characteristics of eating disorders, but are categorized as having non-clinical symptoms (Greenleaf, Petrie, Carter, & Reel, 2009). Binge eating is also a common factor found in female athletes. According to Johnson (1999), approximately 16.2% of female athletes engage in monthly binge eating, and 22.7% of this population continue these habits over the course of their lifetime. Additionally, these female athletes engage in various outlets of weight-loss. Another research study conducted stated that 14.7% engaged in fasted dieting, 7.3% practiced self-induced vomiting, and 4.2% used diuretics as a technique to enhance weight-control (Black & Burckes-Miller, 1998). Self-induced vomiting is a symptom of bulimia, that is noted to prevent weight gain (Klump, Bulik, Kaye, Treasure & Tyson, 2009). People who develop bulimia, however, do not lose weight as a result of their practices and therefore, acts as a recurring cycle of unhealthy habits. This is because they keep engaging in the same activities and do not see results in their weight, therefore acting as a motivator to keep doing so. This is one factor as to why 22.7% of 16.2% of female elite athletes engage in life-long eating disorder activities (Greenleaf, Petrie, Carter & Reel, 2009).

Female dancers, in particular, experience significant bodily influences, ones that primarily contribute to the development of their negative perceptions of themselves. Compared to non-dancers, dancers have significantly more intense motivation to have a thin body shape. Statistical data showed that children who participated in dance classes from a young age were more inclined to perfectionism than those who were nondancers. In turn, these factors are carried with the individual throughout their life, and continues to influence them into their adulthood. The desire to have a thin body shape affects the eating habits of an individual; which can impact the eating habits of a women in adulthood (Ackard, 2004). Dancers often participate in harmful eating behaviours to lose weight and maintain a thin body shape. Doing so portrays a common belief among dancers that a thinner body will enhance their performance and be favourable to judges. Therefore, the relation between dancers and eating disorders can be described by their motivation to perform well, and be successful in competition with other dancers that also have a thin physique (Bruin, 2009). They typically have a smaller than the ideal BMI from a young age, and this ideology is carried with them throughout their lives as they may feel a sense of dissatisfaction if they do not meet the expectation of their ideal BMI that they have set for themselves from a young age (Ackard, 2004). Alongside their increased anxiety of constantly feeling judged for their body shape and size (Thompson & Chad, 2002).

Research Results

Athletes are constantly predisposed to competitive environments that determine a body-image standard that has a direct correlation with their performance in the sport. Particularly, for judged sports such as dance, athletes are vulnerable to increased pressure on body-image. The stress of maintaining a thin body shape are emphasized primarily by two factors–coaching behaviours, and specific interactions with other athletes that suffer from unhealthy eating behaviours (Cameselle & Baltzell, 2011). A study was conducted with 16 female participants who ranged from the ages of 18 to 28. The recruiting specs mandatory for participants to partake in the study included the criteria of being a former or current collegiate athlete, and having been diagnosed with an eating disorder, such as anorexia nervosa or bulimia nervosa. The study found that the coach, being the leader of the sports team, needed to be more educated on eating disorders to increase the awareness of eating disorders amongst athletes. There is a fine line between being healthy and obtaining a diligent diet plan, versus developing an unhealthy, malnouritional diet. The study emphasized the coach’s power to influence the athlete’s eating behaviours and bodily influence. One participant in the study stated “do not criticize her food or food choices or eating habits. Drawing negative attention to her habits and situation could cause the reverse of what the coach is trying to accomplish”. The female athletes preferred for the coach to show genuine care for the athlete’s well-being and show support to the athletes, as opposed to emphasizing their eating behaviours. This is more of a comforting approach that would motivate the athletes to eat healthy, instead of being self-conscious of their eating habits. The athletes would be more inclined to develop eating-disorders because emphasizing negative aspects of their eating patterns would make them feel uncomfortable with their eating habits, and feel the need to alter them to get approval from the coaches (Cameselle & Baltzell, 2011).

Another study involved female athletes, 198 of them were aerobic exercisers, and 204 of them were female college athletes. These athletes were undergraduate and graduate students, ranging from 17-24 years of age. The study’s objective was to measure the eating behaviours of college female athletes related to body shape. The results indicated that 16.7% of these athletes were dissatisfied with their bodies, 0.7% had been diagnosed with bulimia, and 4.9% have a drive for thinness (Krane, Waldron, Shipley, Michalenok, 2001). These findings also indicate that these athletes participate in excessive exercise in addition to these results regarding eating-behaviours.

Another study was conducted to examine the relationship of eating pathology to body image concerns, weight pressures, sociocultural internalization, and mood state of female collegiate athletes. They were, on average, 19.68 years old. The study was amongst three various NCAA Division institutions in the Southwest regions of the United States. A total number of 442 female collegiate athletes were recruited from these institutions and participated in 20 different sports overall. These recruitees were required to complete a 7-item appearance evaluation regarding the athletes’ demographics and weight, menstrual history, eating disorders, weight pressures, mood, internalization, and body attitudes. The results from the study indicated that 18.3% of this sample were symptomatic to eating disorders, alongside the 5.7% of female athletes who had eating disorders. In addition, 54% reported that they were satisfied with their current body weight, while 93.6% of the athletes that were unsatisfied with their body weights and indicated that they perceived themselves to be overweight, although they had a healthy body weight (Greenleaf, Petrie, Carter, and Reel, 2009). These findings are relative to the body size overestimation concept because these athletes perceive themselves to be overweight as a result of the sport environment that they are constantly exposed to. These statistics emphasize the bodily pressures of female athletes that are present in various sport environments, and the risk factors that increase an athlete’s vulnerability to adopting an eating disorder.

Research Discussion

Further research is needed to analyze the complications in the research conducted, and eliminate any existing information gaps. I have conducted further research to assess the next steps necessary in conducting research.

Many of the students previously studied had conducted self-evaluations; regarding the way that they perceive themselves relative to sport environments, predisposition to eating disorders, risk factors and coach’s influences on these athletes. These assessments should also be completed through a professional lens. For example, they can perform clinical assessments, interviews, and close eating behaviour examination provided by specialized doctors and certified eating-disorder therapists. The clinically proven accuracy of these results will allow specialists to analyse the trends of eating disorders in athletes over the course of their lives (Cameselle & Baltzell, 2011). However, the conflict arises for therapists if the patient is unwilling to accept treatment. The therapist is conflicted between their duty to prevent nutritional injury and respecting the patient’s rights to refuse treatment. In severe cases, however, the theory of Justified Paternalism is adopted (Silber, 2011); this involves paternal figures making a treatment decision for the patient, and disobeying their right to refuse treatment. Justified Paternalism is acceptable when the decision is well thought-out and is in the best interest of the patient.

Another gap found in the research is present through the examination of the external factors in addition to the environmental factors that these athletes face. These pressures can include influences like familial perception on body image, or influences from the Western Culture–such as, social media and the desire to be thin. It would be beneficial to study these athlete’s family history of eating disorders to determine if this is a prevailing influence on the eating behaviours of these individuals. These athletes may also experience body dissatisfaction and cognitive dissonance as a result of their exposure to familial pressures. For example, if a parent experiences anorexia nervosa, and their child is slightly heavier, the child might experience psychological discomfort that affects the way they perceive themselves. Since this self-perception is formed at a young age, it is often carried with the person throughout their lives. If an athlete experiences this in their household, and is also exposed to bodily pressures in their sport environments, they may become inclined to developing an eating disorder.

In the treatment process of people who have eating disorders, it would also be beneficial to treat negative self-schemas through the use of Cognitive Reconstructing. This would encourage patients to be happy for others who have their desired body shape, rather than comparing themselves to the other person. This can also be accompanied by short and frequent cognitive exercises. Eventually, these exercises become habits and the person starts to develop more positive interpretations of the self.

Although there are prevalent risk factors that are examined in female collegiate athletes, it is also important to examine diverse sample sizes, including an equal ratio of males and females. Sport environments are dynamic for both female sports and male sports, and therefore conducting research on only one gender may develop bias in the data. Since risk factors are experienced by both genders, it may simply be a measure of severity that differentiates the two. It may also be beneficial to study reasons why there is an emphasis on eating disturbances in female athletes. Whether it is because these sport environments add to the pressures that the Western Culture puts on female athletes, or because female athletes might be more willing to speak about their disturbances than males, or any other risk factors that may influence eating behaviours for female athletes (Petrie, Greenleaf, Reel & Carter, 2008). However, both male and female athletes experience bodily pressures in their sports environments and equal attention should be given to both genders. Conducting such research may generate new data that would improve the development of better treatments for athletes.

It is common for people with psychological disturbances to adopt eating disturbance behaviours as well. This is another important risk factor to be considered when conducting research on athletes and eating disorders. The principles of mind, thought, and consciousness can help guide positive psychology and gain a clearer understanding of the cognitive thinking process (Kelley, 2004). These three principles can also be interrelated with spiritual beliefs and religious values that play a significant role in the psychological well-being of an individual. Further research of these three dimensions will help to gain a greater understanding of why each individual athlete develops different eating behaviours. For example, a sport like wrestling emphasizes the need for heavy-weight individuals with a large muscle mass (Heggan, 2011). However, these athletes may be conflicted if they have spiritual and religious beliefs regarding a restriction from eating meat. Since meat contains protein, it helps to build muscle mass, which may also negatively affect the athlete’s cognitive process; making them feel as if they cannot achieve the ideal body image for wrestlers.

The research conducted also failed to address the socio-economic factors that the athletes face. This implication can critically affect the amount of training that the athlete is able to attend, and therefore affects their performance in the sport (Huffman & Cooper, 2012). Their socioeconomic status may also restrict them from purchasing healthier and fresh food because it is generally more expensive, therefore directly affecting their body size. Perhaps, resulting in the absence of eating due to the pressures of their sport’s environment to be thin, or in contrast, developing symptoms of bulimia; like self-induced vomiting.

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