This is a wake-up call to all adults who take on the responsibility of coaching and training young athletes. When 15-year-old Kerry came to me for a routine physical I was informed that her high school cross-country track coach was encouraging her to lose weight. She was told that by losing ten pounds she would be a faster runner. And Kerry wanted information on how to lose the weight rapidly.
How unfortunate that this coach is giving such a message to his athletes. It is a known fact that females are more likely at risk for developing certain abnormal eating habits. Some sports emphasize a lean appearance, such as gymnastics, dance, figure skating, and synchronized swimming. Others emphasize body leanness for best performance, such as swimming, long distance running, and cross-country skiing. Still other sports utilize weight classifications, such as rowing, judo, and tae kwon do.
Not all athletes with disordered eating meet the full criteria for anorexia or bulimia, but their eating habits are usually considered unhealthy. Approximately 32 percent of competitive female athletes overall have disordered eating; 15 percent of female adolescent competitive swimmer fall into this category. We are including the onset of vomiting, fasting, use of diet pills, diuretics or laxatives. Over 70 percent of those young ladies who engage in dangerous eating practices do not believe they are harmful. The truth is that disordered eating in female athletes leads to reproductive dysfunction, irreversible bone loss, psychological disorders, heart and circulatory problems, intestinal problems, trouble maintaining body temperature, and in severe cases, death in 10 – 15 percent of those with actual anorexia. Besides affecting the body, disordered eating in female athletes adversely affects athletic performance by causing decreased strength, endurance, speed and coordination, slower reaction times, an inability to concentrate, electrolyte imbalances, dehydration, an increased susceptibility to injuries, as well as menstrual problems, loss of bone density, and stress fractures.
It is important that Kerry’s coach becomes aware of her activities. Very likely others on her team are practicing disordered eating, as well. Athletes, parents, coaches, and trainers should all be aware that good nutrition leads to optimal athletic performance. A frank discussion with all of the athletes should be initiated, and a warm, supportive environment should be encouraged.
If Kerry has not developed any of the medical consequences of disordered eating, she should be able to continue in her sport, as long as she receives proper nutritional and psychological support. In general, physicians are knowledgeable in the area of adolescent athletes and their possible medical and social consequences. The medical textbook, Care of the Young Athlete, is an excellent resource that pediatricians use to care for their athletes.