To continue on the theme of athletics and eating disorders for just one more post, I [Nancy] want to mention a new book out, Eating Disorder in Sport, by Ron A. Thompson and Roberta Trattner Sherman (Routledge, 2010). This is the most authoritative book in the field you will find, covering a review of the extant literature on the subject, a look at risk factors and misconceptions that keep eating disorders hidden, management of eating disorders in sport, and treatment issues.
The authors have been consultants to the NCAA, the International Olympic Committee and other sport organizations, and have provided therapy to many elite athletes. Both are psychologists in private practice in Bloomington, Indiana and, along with contributor Pauline Powers (who wrote the chapter on medical considerations in eating disorders), spend more time than just about anyone else thinking about the relationship between athletes and eating disorders. Drs. Thompson, Sherman and Powers also served on the National Eating Disorders Association Coach and Trainer Toolkit advisory committee.
In their review of the literature, Thompson and Sherman tackle the question of whether sports participants experience more eating and body image problems than nonparticipants. The conclusion: yes, most likely, especially among women in “lean,” sports (where leanness is considered an advantage) such as distance running, diving, figure skating and gymnastics.
On the issue of “competitive thinness,” the literature tells us that it exists among women both without and within the sport environment. In sport, however, it is not just about attractiveness, but about athletic performance as well. Athletes are naturally competitive to begin with, so it is no surprise that they attack this particular competition with as much vigor as any other. The mistaken belief that leaner athletes are always more competitive also provides eating-disordered athletes with a rationale for their behaviors.
Eating Disorders in Sport is a wise book. One important point the authors make is that (despite the obvious competitive aspect of these disorders in athletics) it is wrong to assume that the primary or only cause of athletic eating disorders is to enhance performance. They write, “Eating disorders serve multiple functions and purposes in the patients’ life. In our clinical practice, sport participation plays little if any role in the disorders of many of our sport-participant patients.” They go on to say that these patients’ eating disorders would have developed without participating in sport. It follows that it would be equally wrong for professionals or parents to decide that quitting the sport in which the eating disorder is being played out will solve the problem. Thompson and Sherman emphasize “it is not sport participation per se that is the problem, but rather the risks that are sometimes found in the sport environment.”
The authors also point out that an eating-disordered athlete is far from “weak.” In fact, those who suffer are often those with the steeliest will to succeed and the most maniacal work ethic. The problem is that “as their eating becomes more disordered they will have less and less control over their symptoms,” Thompson and Sherman write. This runaway train aspect of eating disorders is something that those who have watched one unfold close up understand; it is this feature of eating disorders that makes them so agonizingly difficult to overcome. As we have seen in many high-achieving eating disorder patients, however, the strength that serves them so well in athletics and other areas of their life can be put to work to overcome even the most entrenched disorder.
Marcia Herrin and Nancy Matsumoto, co-authors The Parent’s Guide to Eating Disorders, Gūrze Books, (www.childhoodeatingdisorders.com).
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