Athletes and Eating Disorders: Risk Factors, Identification, Treatment, and Prevention

Thompson, Ron A.

Thursday, March 22, 2012: 8:30 AM-10:30 AM

Opal Two (The Charleston Marriott)

This workshop will focus on specific factors in the sport environment that increase the risk of eating disorders to athletes, as well as on sport-related factors that complicate identification and strategies to facilitate treatment. Regarding prevention, four educational DVDs related to disordered eating in athletes will be viewed and discussed.

I. Introduction

A. Special subpopulation

B. Literature review

1. Prevalence

2. Lean vs. non-lean athletes

3. Female Athlete Triad

II. Sport-Related Risk Factors

A. Emphasis on leanness/thinness and performance

1. Thinness and performance research

2. What coaches /athletes believe

B. Coaches

1. Power/influence

2. Role of coaches in promotion/prevention of eating disorders

C. Competitive thinness

1. Competitive thinness and some sports

2. Competitive thinness in disordered eating in athletes

D. Revealing uniforms

1. Revealing uniforms and risk

2. Revealing uniforms and competitive thinness

3. Women’s uniforms are often more revealing than those of men in same sport

III. Identification

A. Sport body stereotypes

1. Definition

2. Stereotypes affect the perception of athletes by sport personnel

B. “Good athlete” traits and characteristics of anorexia nervosa

1. Traits that enhance performance may increase the athlete’s risk

2. An athlete with eating disorder may look like the “ideal” athlete to a coach

C. Presumption of good health with good performance

1. Athletes with good performance in lean sports are less apt to be identified

2. How some athletes with eating disorders perform well

IV. Treatment

A. Athlete with an eating disorder must be in treatment

1. The disorder will eventually negatively affect performance

2. “Good” athletes respond to a decrease in performance with an increase in training

and/or a decrease in body fat/weight

B. Resistance to treatment

1. Fears loss of playing time

2. Fears displeasing others

3. Fears weight gain

4. Fears therapist won’t value importance of sport

C. Coaches’ concerns about treatment

D. Decisions regarding training and competition

1. Training/competition don’t increase risk

2. BMI of at least 18.5-19.0

3. Treatment progress

4. Desire to train/compete

5. Health maintenance criteria

E. Rationales for training/competing

1. Attachment

2. Identity, self-esteem, etc.

3. Monitoring

4. Facilitates eating

5. Motivation

F. Enhancing treatment

1. Treatment staff variables

2. Using “sport family”

3. Using sport to motivate

4. Using “good athlete” traits

V. Prevention

A. Brief review

B. Educational DVDs

This workshop will begin with a discussion related to why athletes with eating disorders constitute a special subpopulation in need of specialized approaches to identification, management, treatment, and prevention. A brief review of the literature regarding special issues will follow. The crux of the workshop will focus on sport-specific risk factors, as well as factors that can complicate or facilitate identification and treatment of eating disorders in athletes. Sport-specific risk factors to be discussed include the purported relationship between leanness/thinness and sport performance, weight pressures from coaches, competitive thinness, and revealing sport attire. Issues that can complicate or interfere with identification of eating disorders in athletes will be examined from the perspective of the athlete and the sport personnel who manage them. These issues will include sport body stereotypes, similarity of “good athlete” traits and eating disorder characteristics, and the presumption of good health with good performance. Topics to be discussed with respect to the facilitation of treatment will include recommendations regarding treatment staff training, experience and expertise, determining when a symptomatic athlete can train and compete, and motivating the resistant athlete-patient. The prevention portion of the workshop involves the Healthy Body Image (HBI) Project developed by the presenters for the Youth Olympic Games as a health initiative sponsored by the Medical Commission of the International Olympic Committee to educate young athletes regarding the Female Athlete Triad. Four educational DVDs developed as part of the HBI project will be viewed and discussed.

Primary Presenter:

Ron A. Thompson, PhD, FAED

Ron Thompson is a psychologist in private practice in Bloomington, Indiana. He is a consultant on eating disorders to the NCAA, where he coauthored the "NCAA Coaches Handbook: Managing the Female Athlete Triad." He also coauthored the Disordered Eating section of the IOC Medical Commission’s Position Stand on the Female Athlete Triad. His publications include "Bulimia: A Guide for Family and Friends," "Helping Athletes with Eating Disorders," "The Exercise Balance," and "Eating Disorders in Sport." He is a Fellow in the Academy for Eating Disorders (AED). Dr. Thompson and Dr. Roberta Sherman jointly received the AED’s 2008 Leadership Award.

Co-Presenter:

Roberta Trattner Sherman, PhD, FAED

Roberta Sherman is a psychologist in private practice in Bloomington, Indiana. She has served as a consultant on eating disorders to the NCAA, where she coauthored the NCAA Coaches Handbook: Managing the Female Athlete Triad. She also coauthored the Disordered Eating section of the IOC Medical Commission’s Position Stand on the Female Athlete Triad. Her publications include Bulimia: A Guide for Family and Friends, Helping Athletes with Eating Disorders, and Eating Disorders in Sport. She is a Fellow in the Academy for Eating Disorders (AED). Dr. Sherman and Dr. Ron Thompson jointly received the AED’s 2008 Leadership Award.

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