Eating Disorders in Female College Athletes: Risk Factors, Prevention, and Treatment

Article excerpt

Female athletes are at risk for developing eating disorders because of the pressures that are placed on them by society, their peers, their coaches, and the sports culture itself. This paper reviews the literature on the risk factors involved and various methods of prevention and treatment. The authors conclude that individual and group approaches are most effective when they utilize the sports culture to change attitudes and behaviors.

Eating disorders have become a problem on many college campuses (Holston & Cashwell, 2000), with as many as one-third of college women engaging in some kind of disordered eating behavior (Grigg, Bowman & Redman, 1996; Joiner & Kashubeck, 1996). Eating disorders are usually associated with a fear of gaining weight and excessive emphasis on body shape and weight. One of the most common eating disorders is anorexia nervosa, which is characterized by self-starvation and a distorted perception of body size and/or shape. Individuals affected by anorexia nervosa are generally secretive and exhibit a steady decline in body weight. Physical symptoms include fatigue, low blood sugar, thinning hair, slowed metabolic rate, and in severe cases, an absence of regular menstruation, bone loss, a weakened heart, and even death. Depressive symptoms such as withdrawal, irritability, and insomnia are also exhibited. Individuals with anorexia nervosa are often in denial about their condition or lack insight into the problem. Another common eating disorder is bulimia nervosa in which individuals consume a large amount of food and then compensate by vomiting, using laxatives or diuretics, fasting, or exercising excessively. The physical symptoms include dehydration, vitamin and mineral deficiencies, bad breath, damage to vital organs, and blisters in the throat. There are rare, but potentially fatal complications, such as esophageal tears, gastric rupture, and cardiac arrhythmias. Depressive symptoms or mood disorders are common, as well as anxiety and substance abuse (American Psychiatric Association, 1994).

Those who are most at risk of developing eating disorders are Caucasian, middle-to-upper class educated populations in developed countries (LoBuono, 2001). They may exhibit perfectionism, obsessive compulsive behavior, social withdrawal, depression, and high achievement (Seidenfeld & Rickert, 2001). Although anorexia nervosa can occur in men, nearly 90% of the cases have occurred in women (DSM-IV, 1994). Likewise, Bulimia is less common in men, but occurs in 1% - 3% of young women (DSM-IV, 1994). One study of female college students showed that 14% had hinged and purged at least once in their lives (Kashubeck, Marchand-Martella, Neal, & Larsen, 1997). Another study showed 61% of college women reported behaviors characteristic of eating disorders and 20% acknowledged some type of eating disorder (Levitt, 2004).

There is some evidence that participation in athletics, especially weightdependent and competitive sports, increases an individual's likelihood of developing an eating disorder (Beals, Brey, & Gonyou, 1999; DiBartolo & Shaffer, 2002; Kirk, Singh, & Getz, 2001; Picard, 1999). Some researchers (e.g. Berry & Howe, 2000; Kirk et al, 2001) have argued that female athletes are at particular risk for eating disorders because of the sports culture and the pressures they place on themselves, but the results of empirical studies comparing female athletes and non-athletes have been inconclusive (Kirk et al, 2001). Kirk et al. found no differences between female athletes and non-athletes, however two other studies showed female athletes to have lower incidences of eating disorders than non-athletes (Reiking & Alexander, 2005; Sanford-Martens, Davidson, Yakushko, Martens, Hinton, & Beck, 2005). A study by Hopkins & Lock (2004) demonstrated higher perfectionism and eating disorders among athletes than non-athletes. Similarly, Johnson et al. (2004) showed that female athletes scored lower than other groups on self-esteem and higher on measures of disordered eating. …