STUDENT-ATHLETES: EATING DISORDERS
Eating disorders, most commonly anorexia nervosa and bulimia nervosa, are relatively common health problems on for students on college campuses. Collegiate athletes are at the same risk for these disorders. It is a goal of the Sports Medicine Department at Kansas Athletics to work to prevent, identify, evaluate and treat these disorders in a such a way as to maximize the health and performance of those individuals affected.
Although the precise cause of eating disorders has not been agreed upon, the development of an eating disorder probably is related to a combination of psychological, geological, family, genetic, environmental and social factors. Kansas Athletics will minimize environmental factors by utilizing a science-based approach to weight management which emphasizes healthy, performance-enhancing eating and de-emphasizes body image (see 506 A Student-Athletes: Medical Policy ).
Sports medicine personnel will be familiar with the signs and symptoms of eating disorders. If there is concern about an eating disorder in an athlete, either from a coach, teammate or staff person, that athlete will be referred to a team physician for evaluation.
Diagnostic Criteria (DSM-IV)
- Refusal to maintain body weight at or above a minimally normal weight for age and height (<85% of=”” ideal=”” body=””>
- Morbid fear of becoming fat and a relentless drive for thinness
- Undue influence of weight or shape on self evaluation
- Absence of at least 3 consecutive menstrual cycles
- Pursuit and maintenance of low body weight is accompanied by increasingly rigid and ritualistic behaviors
- Food selection
- Eating behaviors
- Exercise regimens
- Foods are usually categorized as permissible and not permissible.
- Individuals may:
- Take an extremely long period of time to prepare and eat foods.
- Desire to eat meals alone.
- Have sole control over food preparation.
- Give away food.
- Compulsively exercise beyond normal training.
- Significant weight loss
- Loss of menstrual period
- Dry skin and hair
- Loss of hair
- Growth of fine body hair (face & arms)
- Cold hands and feet
- General weakness
- Inability to concentrate
- Constipation and digestive problems
- Wearing layers of baggy clothingBULIMIA NERVOSADiagnostic Criteria (DSM-IV)
- Recurrent episodes of binge-eating:
- Eating, in a discrete period of time, an amount that is definitely larger than most people would eat during a similar period of time or under similar circumstances
- A sense of lack of control over eating during the episode (ie, feeling that one cannot stop eating or control what or how much one is eating)
- Recurrent inappropriate compensatory behavior in order to prevent weight gain (Purging)
- Self-induced vomiting
- Misuse of laxatives, diuretics, enemas, etc.
- Excessive exercise
- Occurs at least twice a week for 3 monthsPhysical Symptoms
- Weakness, headaches, dizziness
- Frequent weight fluctuations
- Swollen glands (chipmunk-like appearance)
- Difficulty swallowing and retaining food
- Frequent vomiting
- Bloodshot eyes
- Damaged tooth enamel from exposure to gastric acid
- Disappearance after meals, often to the bathroom to “take a shower”
- Ability to eat enormous meals without weight gain
- Compulsive exercise beyond normal training
- DepressionEvaluationAn athlete suspected of having an eating disorder will be referred to a team physician for evaluation. This may consist of the following:
1. Physical exam
2. Laboratory evaluation
3. Nutritional evaluation
4. Psychological evaluation/testing
Once the diagnosis of an eating disorder is made, treatment will consist of a team approach to its management. This usually will consist of the following:
1. Team physician – coordinate caregivers, coaches, and administration. Although continued participation in athletics should be one of the goals of treatment, the Head Team Physician will make a decision if health issues mandate restriction of participation.
2. Psychologist/counselor – counseling
3. Eating Disorder Specialist/Psychiatrist (Physician) – Counseling, monitoring physical condition, and medication
4. Nutritionist – evaluate, educate, and monitor dietary intake
Involvement of the student-athlete’s family is dependent upon the consent of the student-athlete or upon the severity of the illness.
Continued participation in athletics will be balanced with the ongoing therapy. Although efforts will be made to keep the athlete involved with the team, the primary focus will be the health of the student athlete.