By Stuart Koman, PhD  and Gail Hanson-Mayer, APRN

Among athletes in general, bulimia is the most common eating disorder.

Of course, it depends on the sport.  Gymnasts, jockeys, runners, rowers, dancers and others who can perform at their best at a low weight are more likely to develop anorexia nervosa, in which individuals take extreme measures to avoid eating.  Athletes with anorexia have a distorted image of their body and continue to diet, even when they are severely underweight.  Other signs include social withdrawal and emotional changes.

Many athletes, though, could not survive training or competing for long without eating properly.

A football lineman would never have anorexia, but could have binge-eating disorder, which is characterized by uncontrollable, excessive eating, followed by feelings of shame and guilt.  It is the most common eating disorder, but is rare among athletes.

The most likely eating disorder for most professional athletes to develop is bulimia nervosa.  Those with bulimia typically “binge and purge.”  Purging is forced vomiting, but some with bulimia may compensate for binging in other ways, such as excessive exercise, or use of laxatives or diet pills.  Those who have bulimia can often hide the disorder for years.

Athletes may also be susceptible to muscle dysmorphia, also known as bigorexia, or orthorexia, an obsession with healthy eating.

Those with eating disorders are more apt to have other psychiatric disorders and they have a higher incidence of substance abuse than the general population.

Eating disorders are life threatening; in fact, they have the highest mortality rate of any psychiatric disorder.  At the very least, they can hamper an athlete’s performance and make the athlete more susceptible to injuries, such as bone fractures.  Many athletes have ruined their careers by developing eating disorders and not treating them.

Athletes, their physicians, their coaches, their trainers and their families should all be aware of the symptoms and dangers of eating disorders, and should take action if an eating disorder is suspected.