Dieting Has Become The Cultural Norm – Leading To Eating Disorders
Eating disorders have steadily increased over the years. Experts state that any behavior in society is generally reflected at about 10% in the sports world. Eating disorders were already evident before COVID-19 but seemed to have grown Post-pandemic, potentially to greater anxiety, stress, pressure, potential performance problems, expectations, etc.
Disordered eating has evolved into an epidemic in our culture. It is easy to develop an unhealthy relationship with food because food becomes feared, paving the way for disordered food behaviors. The National Eating Disorders Association reports that about 35 percent of “normal dieters” develop a pattern of pathological dieting and that 20-25% of those individuals develop eating disorders. Individuals with eating disorders exhibit disordered eating, but not all disordered eaters can be diagnosed with a full-blown eating disorder. The difference lies in the frequency and severity of behaviors and the distress they cause to the individual.
Similarity and Differences
Disordered eating indicates that the individual engages in abnormal eating patterns or food behaviors on a regular basis. Athletes who turn to disordered eating often do so to cope with uncomfortable emotions. They might begin focusing on weight and calorie intake to distract themselves from other areas in which they feel inadequate or with the idea that reaching their goal weight finally makes them happy. Once the goal weight is reached, a new lower one is set in a vicious cycle, and eating disorders develop.
Dieting has become “common and normalized” in our society. Even children are dieting at alarming rates. Nearly a third of children aged five to six choose an ideal body size thinner than their current perceived size. By age six, children are dieting and may have tried it, and by the time they are seven years old, one in four children has engaged in some kind of ⦁ dieting behavior, which can lead to Disordered Eating (ED). Therefore, dieting may not be the cause of ED, but it is often a precursor.
Disordered eating is present when a person regularly engages in abnormal eating patterns or food behaviors.
Emotional eating can also lead to binges, sometimes resulting in the development of binge eating disorder or bulimia nervosa.
Individuals with eating disorders exhibit disordered eating, but not all disordered eaters can be diagnosed with a full-blown eating disorder.
The difference lies in the frequency and severity of behaviors and the distress they cause to the individual. Focusing on dieting and weight loss can be a “perfect” escape from true emotions and issues.
Athletes turning to disordered eating often do so to cope with uncomfortable emotions.
They might begin focusing on weight and calorie intake to distract themselves from other areas of their lives in which they feel inadequate and with the idea of reaching their final set goal, which often leads to eating disorders.
Emotional eating can also lead to binges, sometimes resulting in the development of binge eating disorder or bulimia nervosa.
Those with disordered food behaviors, regardless of whether they fit the diagnostic criteria for an eating disorder, often feel extreme anxiety around food. They might track their daily food intake down to the calories, exercise obsessively at the gym, or avoid social situations in which food will be present. Once that goal weight is reached, a lower one is inevitably set.
Those with disordered food behaviors, regardless of whether they fit the diagnostic criteria for an eating disorder, often feel extreme anxiety around food. They might track their daily food intake down to the calories, exercise obsessively at the gym, or avoid social situations in which food is present.
Food shaming, which is negative food talk directed at other people or at oneself, breeds hostility toward food and a culture in which disordered eating is slowly becoming the norm. This is exacerbated by the recent rise in “healthy” or “clean” eating. Many disordered food behaviors have become mainstream as of late, such as the gluten-free diet, veganism, or the Paleo diet. This is not to say that anyone who follows these rigid food rules has an eating disorder, though they are at higher risk of developing one. The social acceptability of these diets also makes eating disorders more difficult to detect in those who struggle with them.
Orthorexia is an eating disorder characterized by an obsession with “clean” eating and the accompanying extreme diet restrictions.
Though not yet included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), orthorexia is generally recognized within the eating disorder community.
It is normal to get swept up in fads. However, this can be dangerous regarding diets and extreme exercise regimens. It is a slippery slope from going on cleanses to lose a few pounds to developing an all-consuming and life-threatening eating disorder.
Definitions:
Anorexia nervosa – Anorexia nervosa (athletics)– is a condition where people avoid food, severely restrict food, or eat very small quantities of only certain foods. Athletes have a distorted view of their body and an intense fear of weight gain. They also may weigh themselves repeatedly. Even when dangerously underweight, they may see themselves as overweight.
There are two subtypes of anorexia nervosa: a "restrictive" subtype and a "binge-purge" subtype:
In the restrictive subtype of anorexia nervosa, people severely limit the amount and type of food they consume.
In the binge-purge subtype of anorexia nervosa, people also greatly restrict the amount and type of food they consume. In addition, they may have binge-eating and purging episodes – eating large amounts of food in a short time, followed by vomiting or using laxatives or diuretics to get rid of what was consumed.
Over time, this behavior can lead to serious complications and can be fatal. It has an extremely high death (mortality) rate compared with other mental disorders. People with anorexia are at risk of dying from various medical complications associated with starvation. Suicide is the second leading cause of death for people diagnosed with anorexia nervosa.
Symptoms:
Extremely restricted eating
Extreme thinness (emaciation)
A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
Intense fear of gaining weight
Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight
Other Symptoms may develop over time, including:
Thinning of the bones (osteopenia or osteoporosis)
Mild anemia, muscle wasting, and weakness
Brittle hair and nails
Dry and yellowish skin
Growth of fine hair all over the body (lanugo)
Severe constipation
Low blood pressure
Slowed breathing and pulse
Damage to the structure and function of the heart
Brain damage
Multiorgan failure
Drop in internal body temperature, causing a person to feel cold all the time
Lethargy, sluggishness, or feeling tired all the time
Infertility
Eating disorders and disordered eating are increasing not only among females but also among males due to social pressure about the ideal body image and the influence of social media. Malnutrition occurs when not enough nutritious food is consumed to meet performance demands. Female athletes tend to be very clever, hiding their appearance and symptoms with baggy clothes, avoiding nudity, or showering in the locker rooms. Male coaches are disadvantaged because they can not observe female athletes in the locker room. Therefore, education to recognize behavioral changes, body language, mood changes, and unusual personal physical appearance is essential. There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.
Anorexia athletica – is a similar type of disordered eating that’s associated with athletes.
Bulimia nervosa – Bulimia nervosa (athletica)– is an extreme, pathologic exercise behavior and is a condition where athletes have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes.
Bulimia nervosa is an eating disorder that generally involves binge eating followed by purging. Purging means ridding your body of ingested food by self-induced vomiting or diarrhea.
This binge eating is followed by behavior that compensates for the overeating, such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or over overweight.
Binge-eating Disorder – is a condition where people lose control over their eating and have reoccurring episodes of eating unusually large amounts of food. Unlike bulimia nervosa, periods of binge eating are not followed by purging, excessive exercise, or fasting.
Many people who have binge-eating disorder feel negatively about themselves and their skills and accomplishments. Triggers for bingeing can include stress, poor body self-image, and certain foods. Certain situations also can be triggers, for example, being at a party or having downtime. People with a binge-eating disorder may be overweight or obese or at a healthy weight. They feel upset about their body size or shape no matter what the number on the scale is but often feel embarrassed or ashamed about their disordered behavior and often go through periods of trying to restrict or severely cut back on their eating as a result. But this may increase urges to eat and lead to ongoing binge eating. Symptoms of binge-eating disorder vary but can include. It is the most common eating disorder in the U.S. One of the common events on College and University campuses is to stage ‘Binge Parties’ in dormitory hallways! One may only guess the intent of such group behavior as these females ‘share a common disorder without being shamed for engaging in group-supported practices!
Behavior:
Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
Eating even when you're full or not hungry
Eating fast during binge episodes
Eating until you're uncomfortably full
Eating alone or in secret to avoid embarrassment
Feeling distressed, ashamed, or guilty about your eating
Frequently dieting, possibly without weight loss
Symptoms:
Chronically inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
Acid reflux disorder and other gastrointestinal problems
Intestinal distress and irritation from laxative abuse
Severe dehydration from purging of fluids
Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack
How to break Disordered Eating
Breaking disordered eating habits before they lead to an eating disorder can be done. Depending on the severity of an individual’s behaviors, professional help should be recommended. Treatment for binge-eating disorder can help people feel more in control and balanced with their eating. Christine Byrne (MD, RN) makes the following suggestions:
Know that just thinking you might have a problem with food is reason enough to seek help.
Get a clinical assessment.
No matter the assessment results, try to meet regularly with an eating disorder specialist (or a team of experts).
Consider joining a support group that connects you to people with similar identities and challenges.
Although recovery can be a long process, know it’s worth it.
What Can Coaches Do?
Coaching is an Art and a Science: the art of communication, reading the body language of athletes, observing and interpreting body language, and changing behavior or dress code. Coaching science requires knowledge and understanding of anatomy and exercise physiology, training effects and impact on recovery, and emotional and psychological impact on performance. The Coaching Profession should require the essential educational background and continual scientific updates as the modern sports scenario is far more complex than in the past.
Recommendations:
Upgrade personal education – read books or scientific research on essential content to improve your coaching delivery
Seminars, conferences, and courses related to eating disorders (ED)
Schedule meetings with parents and athletes at the start of the annual program for nutrition and ED
Invite an ED expert to present on the topic
Observe athletes’ behavior and body language, emotional and mood changes
Observe not only Female but also Male athletes’ behavioral changes as eating disorders have increased over the past years.
References:
Chavez, M.. & Insel, T.R. (2007). Eating disorders: National Institute of Mental Health’s Perspective. Am Psychol, 62(3), 159-166. April. National Library of Medicine (NIH). National Center for Biotechnology Information.
Encao, R. (2019, February 25). Types of eating disorders: Symptoms, causes and effects. Southern New Hampshire University. Retrieved March 15, 2024, from
https://www.snhu.ed./about-us/newsroom/health/types-of-eating-disorders
Mayo Clinic (n.d.). Eating disorders – Symptoms and causes. Retrieved March 15, 2024, from https://www.mayoclinic.org/diseases-conditions/eating disorder
Bryne, C. (2023). If you think you’re struggling with disordered eating, here’s how to get help. Retrieved March 15, 2024, from https://www. self.com/story/ disordered-eating-help
Schloder, M.E. (2020). The darker side of sports: the increase of eating disorders among athletes. Calgary, Alberta, Canada: Lecture Notes. Sociology of Sport.