Female Athletes and the Risk of Disordered Eating

Can your daughter maintain a healthy body image when she is passionate about her sport?

I have been on a bit of a summer hiatus.. but vacation is over and I am back to my real life which includes full time counselling & group facilitation with clients who experience eating disorders, private consulting work in the area of girls and self-esteem, catching up with everything going on in the world and blogging about all of the above.

During my vacation, I did watch a lot of Olympic coverage.  I was inspired by so many athletes.  Like many of you, I will forever be moved by the incredible beauty,  grace and power of gymnast Gabby Douglas.  However, I always feel somewhat conflicted watching elite level sports because I am reminded of the more sinister side to this level of athleticism. I have written about the positive benefits of sports on girls and self-esteem here and here, but that is only one part of the story.

By the time they are competing for medals on the world stage, these young girls have been doing almost nothing but gymnastics for most of their life. There is no question they are strong, talented and incredibly fit. They are driven and perhaps single-minded in their pursuit of excellence and achievement. They have much to be proud of and much that I admire, yet I feel relief that my own daughter has not followed a similar path.

Gymnastics is a sport where a very thin body, low body weight and a shorter stature are seen as an aesthetic ideal and is considered significant in terms of presentation and performance. One way this is achieved is by delaying puberty through controlling nutritional intake and not allowing the body to acquire a normal amount of body fat or achieve appropriate bone growth. Girl's whose natural bodies most closely represent the aesthetic ideal are more likely to be able to remain in the sport throughout adolescence; yet many girls develop eating disorders as a logical outcome to the pressures they experience to succeed in their sport. Nadia Comăneci and Cathy Rigby, both famous gymnasts during my childhood, have spoken openly about the eating disorders they suffered during and after their time as Olympic athletes.

Gymnastics certainly aren't the only risky sport. Figure skating and long distance runners also experience higher incidence of eating disorders than in the general population. Girls who play sports that have revealing uniforms or must meet criteria for weight classes also experience undue pressure about their body shape and size.

Female Athlete Triad

Female athletes are at high risk for what is known as the Female Athlete Triad. The Triad refers to disordered eating, missed periods and osteoporosis. The International Olympic Commission reports in their 2009 Position Paper  that over 7% of collegiate athletes in 15 different sports and, shockingly, over 22% of athletes in the aesthetic sports of gymnastics, cheer leading and diving had not menstruated by age 16.   By contrast, the percentage of girls in the general population of the United States who have not menstruated by age 15 is less than 1%. The resulting medical complications are often permanent and irreversible. Bone loss starts as soon as six months from loss of menstruation. This can have immediate consequences on performance and health but also has long term consequences such as chronic joint problems and increased risk of fractures for the rest of their lives. Sometimes the resulting infertility is irreversible as well.

I am impressed that the IOC has begun to take these risks seriously and have invested in research, position papers, information brochures for athletes and even some moving videos to education athletes and their families. (See the link at the end of this post).But long before Olympic dreams are within reach, female athletes may be at risk. In fact many young girls who are extraordinarily passionate about the sport find that they are unable to continue to compete at higher levels as their bodies begin to change during adolescence. 

One woman I know was able to continue to compete nationally by switching to rhythmic gymnastics but it was made clear to her at the age of twelve that her growing breasts were a barrier to continuing in artistic gymnastics. By the age of fourteen she was skilled enough to coach others to athletic greatness but her own healthy, uninhibited puberty had eliminated her from competition. She told me that her parents wouldn’t let her sacrifice her health or her healthy body image in order to continue to compete. Today that young woman has achieved so many amazing things and has traveled the world in support of social justice issues. She also participates in sport for pleasure and fitness. I don’t know what she thinks now about that decision but I do know that she is someone I admire greatly and she doesn’t need a national medal to prove her achievements. 

Tips for supporting your daughter in her health and athletic pursuits:

• Help her have balance in her life. It is wonderful that she has a passion but also encourage her to develop interests and friendship groups outside of her sport.
• Teach your daughter to eat for energy and pleasure, not to restrict food in order to change her body shape.
• Know the warning signs and risk factors for disordered eating – and seek out professional help if you suspect your daughter is at risk.
• Speak up – if you hear a coach or sport club leader criticizing weight or encouraging dieting or use of diet pills, laxatives or steroids.
• Challenge the practice of public weigh ins or body fat analyses.
• Focus your own positive comments on her skills, attitude, and perseverance rather than her appearance or comparing her body to that of other girls in her sport.
• Support your daughter to set realistic goals that take in to account her natural body type and shape as well as her strengths and level of commitment to the sport.
• Encourage her club to host self-esteem workshops for girls, eating disorder prevention workshops for coaches and to promote a welcoming environment for girls of every shape and size.

For further information:

I recommend watching these four short videos provided on the Olympic website about promoting healthy body image in athletes and you can download a this brochure for athletes that further explains the risks, prevention and treatment for the Female Athlete Triad.

You may wish to share this information with your daughter's coach:  Tips for Coaches: Preventing Eating Disorders in Athletes.