Male Athletes and Eating Disorders

You may not think male athletes and eating disorders go hand in hand. Typically those who excel in sports take exceptional care of their bodies, eat the right foods to fuel their physical activity and train effectively to keep their bodies in top form. You may be surprised then to find that 33-35 percent of athletes report eating disorders. Another surprising statistic is that while 7 million women have an eating disorder in this country, so do one million men.

“What I can tell you is when we look at the male stats it does go across a broad spectrum–anorexia, bulimia nervosa, binge eating disorder and what’s also called eating disorder not otherwise specified (EDNOS), and what that means is, it’s not anorexia, not bulimia, not binge eating disorders, but has characteristics of all three. The ones we typically see predominantly in males is EDNOS and binge eating disorder,” says Jason Arnold, PhD., a psychologist on the inpatient psychiatric and eating disorder program at Walden Behavioral Care with locations around Massachusetts and Connecticut.

Arnold also points out that since eating disorders are viewed as women’s disorders, fewer males report them and/or find other excuses for them as opposed to what they really are.

Some are in denial. “If it’s a women’s disorder what does it say about them as young men,” says Arnold. Is there something wrong with them, does it mean they are girly? Is it a direct assault on their masculinity? Arnold tries to normalize it to eliminate any stigma surrounding being male with an eating disorder. “We do know men have eating disorders; they don’t discriminate.”

With athletes, the numbers are almost double the general population, and a lot of that is going to be due to the pressure that the athletes put on themselves and that coaches may be putting on them, explains Arnold. “What we see is there is a desire to be within a specific weight class, to monitor the fat in the body and to build muscle.”

WHO’S AT RISK FOR EATING DISORDERS?

Arnold says high school athletes are most at risk though athletes can develop an eating disorder at any age. There may be a lot of pressure to succeed, bulk up or play well from both parents, coaches and the athlete themselves.  “And one thing we see with eating disorders across the spectrum both male and female, is they have a very rigid perfectionistic quality about their character or temperament, and they think they have to be perfect,” says Arnold.

“I think we know now through research that there are biological and temperamental aspects that put people at risk for developing an eating disorder and that’s true for males and females,” says Jennifer Lombardi, an anorexia survivor and executive director at Eating Recovery Center of California.

Certain biochemistry aspects such as preexisting anxiety or depression, temperament factors such as struggling with self-directedness or knowing who you are, being sensitive to change or conflict, and having a very driven perfectionistic personality raises an athlete’s risk.

RED FLAG BEHAVIORS

“I’ve worked with a number of athletes and typically the warning signs you see is they don’t just do the practice that is required for their sport, they tend to go above and beyond and exercise even to the point of injury or illness, and also oftentimes they are not fueling their bodies properly for the activity they are engaging in,” says Lombardi.

Experts says athletes whose sport requires a weight class such as wrestling and rowing or sports that require weight maintenance, either keeping weight low like gymnasts or jockeys, or high like linebackers, may be more susceptible but all athletes are at risk. Newsweek reported that 40 percent of Cornell University football players surveyed engaged in binging and purging, which is associated with bulimia.

So even when athletes are at the top of their sport and engaged in high levels of coaching and training, you often see someone go outside of those practices and engage in even more exercise for extensive periods of time. They tend to over-train and not fuel or nourish their bodies appropriately.

“If I were a parent or a friend if I notice that somebody’s behavior around food has changed significantly or they are counting calories or weighing or measuring food that would be one potential red flag,” says Lombardi. Another would be a significant change in their exercise routine.

A lot of must do’s instead want to’s surround exercise and working out regardless of weather, injury or illness. There may be a compulsive quality to training and they are willing to sacrifice other things in their life in order to maintain their workout routine and/or their eating patterns.

Eating or exercise that has no flexibility whatsoever based on social events, illness, injury or even time constraints are also signs an athlete may be struggling with an eating disorder.

Has an athlete had undiagnosed anxiety or depression? In terms of their temperament, are they highly harm avoidant meaning they don’t like change or conflict? Are they people pleasing or perfectionistic? “Those are the genetics that load the gun, and when we look at environmental factors, the trip wire behaviors are dieting and intensive exercise, and if that has been introduced for some reason in that person’s life, they are much more at risk to fully develop an eating disorder,” says Lombardi. “Genetics loads the gun and environment pulls the trigger.”

WHAT CAN PARENTS DO?

If parents suspect their athlete may have behavioral changes surrounding food, exercise or overtraining, they should talk to their coaches sooner rather than later, and also get their primary care doctor and a nutritionist involved. Alerting their doctor to a potential problem may provide the necessary intervention as well as asking the help of a dietitian to put the athlete on the right kind of meal plan for his level of activity. Once experts get involved in the name of health, nutrition and proper training, athletes may listen more closely than if it’s perceived as mom or dad nagging to eat better or not workout so much.

Left untreated eating disorders are serious, life threatening illnesses that can cause devastating health, relationship and productivity problems. There’s no difference in success rates between males and females who get help but Arnold says people do have to be ready to get their eating disorder under control. The earlier and more aggressively and seriously you treat an athlete with an eating disorder, the better outcome they will have.