Athletes and Eating Disorders

Dr. Riley Nickols of the Victory Program at McCallum Place Discusses EDs and Athletes

Hosted by Dr. Riley Nickols of The Victory Program at McCallum Place
February 2015

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

Dr. Riley Nickols: 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 sport 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.

EDH: Please tell us about the treatment that is offered at the Victory Program? What kind of eating disorders do you treat?

Dr. Riley Nickols: The Victory Program treats all types of eating disorders. Treatment in the Victory Program is specialized to address issues that are unique to athletes such as sport nutrition, family therapy (family of origin and sport family), sport psychology, body image in the context in sport and outside of sport, and managing the exercise/energy demands of sport in a healthier manner.

EDH: What is the prevalence of EDs and athletes?

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

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

Dr. Riley Nickols: 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

EDH: What treatment methods are used particularly for EDs and athletes?

Dr. Riley Nickols: 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.

EDH: Which eating disorders do you see most commonly in athletes?

Dr. Riley Nickols: Anorexia nervosa and bulimia nervosa are the most common eating disorders that we see for 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.

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

Dr. Riley Nickols: 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

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

Dr. Riley Nickols: 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.

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

Dr. Riley Nickols: 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 where your sport 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.

If you are in need of resources for an eating disorder, visit our website at Eating Disorder Hope.