Athletes and Eating Disorders

Transcript from our February 18, 2015 TweetChat with Dr. Riley Nickols of the Victory Program at McCallum Place.

“Athletes and Eating Disorders”

Please tell us a little bit about yourself and your background. What is your role at the Victory Program?

Sports have always been an integral part of my life, and I feel very fortunate to work with athletes every day in the Victory Program. I played baseball in college and was introduced to sports psychology after I struggled with a career-ending shoulder injury.

Shortly thereafter, I obtained an M.S. in Sport Psychology. I then earned an M.A. in Counseling Psychology and a Ph.D. in Counseling Psychology as I wanted to help athletes address both performance and clinical issues. I have participated in endurance events over the last 15 years and have coached triathletes and runners for the last 10 years.

I oversee the daily operations within the Victory Program, prescribe and monitor exercise plans for athletes who are receiving treatment with Victory, facilitate group and individual therapy sessions, consult with colleges about student-athletes who are struggling with disordered eating, and speak to coaches and athletes about athletes and eating disorders.

What is the prevalence of eating disorders among athletes?

The prevalence rates for athletes with a diagnosed eating disorder are difficult to obtain as, similar to some other psychiatric illnesses, they are largely under-reported. However, Sundgot-Borgen & Torstveit (2004) found that 8% of Norwegian elite male athletes had clinical or subclinical eating disorders. Torstveit, Rosenvinge, & Sundgot-Borgen (2008) found that 32.8% of elite female athletes had eating disorders (46.7% of lean sport participants and 19.8 % of non-lean sport participants).

What special needs do athletes with eating disorders have? How could a parent or coach determine if their child or athlete is struggling with an eating disorder?

Excessive training, exceeding coaches’ recommendations; Poor body image, preoccupation/focus on weight and shape; Body checking, inspection, critical self-evaluation; Changes in body shape/weight/mood; Injuries; Isolation from teammates; Performance decrements in sport/school; Rigid food rules, eating beliefs, rituals around eating.

What treatment methods are used particularly for athletes with eating disorders?

Similar treatment methods are used for treating athletes as they would be for non-athletes with eating disorders. Sport is often a tremendous motivator for athletes so we continually attempt to leverage this in an athlete’s treatment with The Victory Program.

Which eating disorders do you see most commonly in athletes? 

Dr. Menzel: Picky eating is a relatively normal phenomenon in children. Many children outgrow their picky eating habits or are able to meet their nutritional needs on a picky diet.

A child may have ARFID if he or she fails to gain weight or grow as expected, or begins to lose weight. Parents should also suspect ARFID if a child’s range of foods becomes severely restricted or a child has a great deal of distress or fear surrounding eating.

What evidence-based methods are used to treat ARFID?

Anorexia nervosa and bulimia nervosa are the most common eating disorders that we see in athletes receiving treatment in the Victory Program. However, in my interactions with college athletes and coaches, orthorexia, or having an unhealthy obsession with food and healthy eating, is the most common form of disordered eating among athletes.

As an athlete, what are red flags to look for that may indicate an eating disorder has developed?

Excessive training, exceeding coaches’ recommendations; Poor body image, preoccupation/focus on weight and shape; Body checking, inspection, critical self-evaluation; Changes in body shape/weight/mood; Injuries; Isolation from teammates; Performance decrements in sport/school; Rigid food rules, eating beliefs, rituals around eating.

What can an athlete do to return to competition and training after being diagnosed with an ED?

Seeking treatment and adhering to treatment parameters from eating disorder professionals who understand the complexities of integrating exercise/training into treatment is of utmost importance if an athlete desires to return to competition after an eating disorder diagnosis.

What encouragement would you offer to an athlete with an eating disorder?

An eating disorder does not mean that you need to permanently give up your sport. Obviously, there might need to be a period of time when your sports participation is limited due to complications of an eating disorder. However, with treatment, not only can you return to your sport when appropriate, but you will likely return as a stronger, healthier athlete.

Please stay tuned for future Twitter Chats from EDH!

If you are in need of resources for an eating disorder, visit our website at EatingDisorderHope.com