Anorexia athletica can best be translated as sports anorexia. Athletes starve themselves in order to perform better, but by doing so they put their health at risk.
What is anorexia athletica?
Sports anorexia most often occurs in those disciplines where thinness (rhythmic gymnastics, figure skating) or low weight (ski jumping, long-distance running, triathlon) give an advantage. Sports where weight class is crucial (boxing, judo, wrestling) are also affected. The desire to lose weight can degenerate into an eating disorder. Ski jumpers and girls and women who do rhythmic gymnastics are particularly at risk. Anorexia athletica is not only detrimental to health, but also reduces performance. The low food intake impairs concentration and causes problems with the circulation and low blood pressure. Anemia and immunodeficiency set in. The reduction in body weight leads to a decrease in bone density and this results in an increased risk of injury. If female athletes train hard and lose too much weight, then menstruation may stop (secondary amenorrhea).
Causes
Athletes are more prone to eating disorders than other people, and body weight plays a special role in some sports. Cyclists have advantages, as do long-distance runners, mountain runners, and ski jumpers, if they weigh less. In gymnastics, rhythmic gymnastics and figure skating, low weight promotes agility. In addition, evaluating the appearance of female athletes is crucial to success. Because thinness is equated with beauty and gracefulness, female athletes begin to starve themselves in order to conform to aesthetic ideals. Women, especially girls and young women, are more prone to anorexia athletica than men. In addition, a tendency to starve oneself must be present for female and male athletes to develop disordered eating behaviors. The causes are not only to be found in the described requirements of the respective sport, but also in individual personality traits (pronounced ambition, low self-esteem).
Symptoms, complaints, and signs
Weight fluctuations and severe weight loss represent clear symptoms. Conspicuous eating behavior and a compulsion to exercise should be taken seriously as clues, both in professional athletes and in ambitious recreational athletes. Often young people are affected by anorexia athletica: If their puberty does not occur or is delayed, then this may be a sign of anorexia. The often repeated affirmation of not wanting to become fat and the attempt to conceal or downplay the disturbed eating behavior are further alarm signals in adolescent athletes. It has already been mentioned that severe weight loss can lead to a decrease in bone density and osteoporosis, and in girls and women to menstrual disorders. The lack of nutrients also manifests itself in changes in skin structure, brittle nails, brittle hair and hair loss. Imbalance, susceptibility to illness and slumps in performance are also signs that the energy balance is disturbed.
Diagnosis and course
Sports anorexia begins inconspicuously and is hardly noticed by those around it, since low weight and low body fat are characteristic of the majority of athletes. A low BMI (body mass index) need not be a sign of anorexia athletica in every case, but can also be due to predisposition or other factors. However, if cravings occur, with meals of over 1500 calories, then the eating disorder is hard to deny. Questionnaires and tests of eating behavior, as well as continuous weight checks and attention to signs of osteoporosis, allow a reliable diagnosis.
Complications
Electrolyte disturbances may occur as a complication of anorexia athletica. The effects vary widely. Severe electrolyte disturbances can lead to quantitative disturbances of consciousness and even coma, and can also cause seizures and cardiac arrhythmias. In addition, functional disturbances of nerves, muscles and digestive tract are possible. To prevent these complications, adequate food intake and a reduction in sports activity are necessary.Excessive exercise increases the risk of injury. The concurrent restriction in food intake can lead to fatigue and impaired concentration, making injuries in sports even more likely. Other physical complications arise in anorexia athletica from behaviors that affect other aspects of the eating disorder. Abuse of laxatives can also cause electrolyte imbalances and cause long-term damage to the digestive system. Objective binge eating with large amounts of food and reactive eating can also cause cardiovascular symptoms. The so-called refeeding syndrome includes various cardiovascular complaints, which in rare cases can be life-threatening. In addition, many people who suffer from anorexia athletica suffer from nutrient deficiencies. Both physical and psychological problems can develop from this. A common long-term consequence is osteoporosis, which is due to calcium deficiency. Cognitive performance impairments are usually reversible. These include concentration and memory problems. Eating disorders often do not occur alone, but in many cases are accompanied by other psychological problems. These may be additional disorders (for example, a personality disorder, anxiety disorder, obsessive-compulsive disorder, or affective disorder) or individual syndromes and symptoms.
When should you see a doctor?
Anorexia athletica is a dangerous condition and should always be treated professionally. Although the slenderness of the body brings an advantage in certain sports, the athlete should not risk his health for it. If the low food intake is accompanied by symptoms such as poor concentration, circulatory problems and low blood pressure, the athlete should not shy away and seek contact with a doctor. Anorexia athletica is usually accompanied by a nutrient deficiency, which has negative effects on the health of the entire organism. Since the sole way out of an eating disorder is usually not easy, this difficult path should be accompanied by professionals. Since eating disorders often do not occur as a sole illness, but are usually accompanied by other mental disorders, a specialist in psychiatry is the right person to contact. The psychiatrist can get an overall picture of the disorder and initiate further treatment paths. The selection of the right therapy is carried out by the psychotherapist or psychiatrist and is always adapted to the personal characteristics of the person affected. In addition to psychotherapy, nutritional therapy by nutritional experts is also recommended in order to return the eating style and lifestyle to normal in the long term. Since in severe forms of anorexia athletica, competitive sports are no longer possible in the future, psychotherapy should prepare for a life without competitive sports.
Treatment and therapy
Initially, increasing caloric intake, weight gain, and compensating for the lack of calcium, vitamin D, and protein are central. This also involves improving bone density and, in women, rebalancing the menstrual cycle. In addition to a special diet, psychological counseling and support is common. The type of psychotherapy depends on the course of the disease as well as the personal preferences and idiosyncrasies of the affected individuals. An important part of the treatment is nutritional therapy, which serves to normalize and optimize the diet and lifestyle in the long term. In severe cases, competitive sports will no longer be possible in the future due to the damage to health. In this case, one focus of the therapy is to prepare the affected person for a life without competitive sports and to support them in reorienting their life. In this regard, attention is paid to addressing and correcting the relationship to sports and the relationship to one’s own body as well as the self-image associated with it. It is not uncommon for anorexia athletica to be maintained during an athlete’s career, not treated, and retained after the career ends. The health risk is maintained as self-worth continues to be fostered by the ability to self-control and mortify.
Outlook and prognosis
The prognosis for anorexia athletica depends on the progression of the disease and the age of the patient. The sooner diagnosis and treatment occur, the better the chances of recovery.In addition, young patients have a better prognosis for recovery. Nevertheless, the prospects of a complete cure for anorexia athletica are generally not very high. About one third of patients manage to lead a healthy life. In addition, the chances of recovery depend on the patient’s initial weight at the start of treatment. The lower the weight, the less likely recovery is. Experience shows that even patients with early treatment often remain eating disordered for life. In many cases, a secondary disorder develops in the further course. This is usually the eating disorder bulimia. Patients suffer attacks of ravenous hunger and then vomit up the food they have eaten. A mental illness is also possible as a secondary symptom. In addition, there is a risk that anorexia athletica will take a fatal course. Malnutrition combined with severe physical stress from athletic activities can lead to a collapse with multiple organ failure. The body gradually dries out and can no longer meet the daily demands. In chronically ill anorexics, the risk of mortality increases to over 15% after a decade.
Prevention
Anorexia athletica has long been tabooed and trivialized, but gradually a change in thinking is taking place and educational initiatives are being launched. Youth sports are where the most impact can be made. However, all campaigns are of little or no help if the standards in various sports remain unchanged and low weight gives a competitive advantage. Sanctions at least serve as a deterrent: In ski jumping, the problem of sports anorexia is combated by currently stipulating a BMI of 21 in order to be able to use the full ski length (145 percent of body height). Those who fall below the value must jump with shortened skis.
Aftercare
If anorexia athletica is present, the patient absolutely needs follow-up care after initial treatment. The point is to avoid falling back into the old behavior patterns. Anorexia is problematic and difficult to treat anyway. In anorexia athletica, the motives for the disorder lie in addictive athletic activity to achieve an athletic body. Sufferers follow false ideals. After acute treatment, anorexics need follow-up care to counter such distorted body ideals. In most cases, long-lasting psychological aftercare is essential for anorexia athletica. Self-help groups are also an option in order to correct false body images and a disturbed self-image in the long term. If aftercare falls flat, substitute behaviors and other addictions can take the place of anorexia athletica. Worse, the sufferer may fall back into his or her old patterns of behavior. Whenever sports and disordered eating behaviors take on an addictive character, there is something self-destructive about them. Acute treatment usually focuses on achieving a normal body weight. The task of aftercare is to treat the psychological component. The patient must learn not to exercise to the point of collapse, but to respect his limits. He must not confuse striving for success with being fully trained. An important aftercare goal is to establish a normal relationship with sports and one’s own body.
Here’s what you can do yourself
Since anorexia athletica is about the conscious reduction of body weight in an athlete, the athlete as well as his trainer should inform himself intensively and in detail about the natural conditions of the organism. The limits to permanent physical damage caused by the eating behavior should be strictly monitored. Weight reduction is often necessary before competition situations. Nevertheless, attention must be paid to the duration of the intentional change in eating behavior as well as the increase in training sessions. After a competition, the behavior should be discontinued immediately. In addition, close cooperation and consultation with a sports physician is always recommended in this approach. Together as a team, the natural needs of the body can be planned and worked out with those of achieving an athletic goal. To avoid a subjective view as well as possible misjudgement and thereby a permanently damaging behavior, one should not act alone. The knowledge of a trained coach and a doctor should be called upon.In addition, at the first complications, a visit to the doctor is necessary to make adjustments and changes to the eating as well as exercise plan. If warning signals from the body are overlooked, this can lead to functional disorders and lifelong organic damage. Therefore, special sensitivity to cues from one’s body is necessary and must be followed immediately.
