N202-801 King Edward Avenue, Ottawa Ontario Canada K1N 6N5 Tel: (613) 562-5667 Fax: (613) 562-5668Email: caaws@caaws.ca Web: www.caaws.ca

FOR FURTHERINFORMATION

National Eating DisordersInformation Centre (NEDIC)Toronto General Hospital200 Elizabeth St. Room 2-882Toronto, ON M5G 2C4416-840-4156

Bulimia and Anorexia NervosaAssociation (BANA)Faculty of Human Kinetics,University of WindsorWindsor, ON N9B 8P4519-258-4282 ext. 249 or519-258-7421 or 519-258-7545

RESOURCES

Athletes@Risk Program, SportC.A.R.ESunnybrook &Women’s CollegeHealth Sciences Centre1-800-363-9353Canadian Academy of SportMedicine1-877-585-2394Position Paper: AbandoningRoutine Body CompositionAssessment: A Strategy toReduce Disordered Eating amongFemale Athletes and Dancers(August, 2001)

Quick facts! Over 60,000 Canadians have some

form of an eating disorder.

! Concern over body shape andweight are heightened duringperiods of transition (i.e. growth, newcompetitive class, retirement fromsport)

! Some groups are at higher riskbecause their activities orprofessions emphasize a particularsize, shape or weight. Athletesconstitute one such group. (HelpingAthletes with Eating Disorders,Thompson, Sherman, 1998)

! While no sport is immune from theproblem, athletes involved inendurance, esthetic and weightdependent sports are particularlyvulnerable.

! Eating disorders are common amongfitness instructors and athletes whoparticipate in gymnastics, figureskating, marathon running, rowing,synchronized swimming, equestriansports, boxing and wrestling.(Desperate Measures, SportMedicine Council of Canada, 1992)

Signs and symptoms*Many of these symptoms on their owndo not indicate an eating disorder.The likelihood increases with thenumber of symptoms an individualdisplays and may include:

Emotional:

! Excessive concern and frequentthoughts about weight

! Guilt or shame about eating

! Frequent and inappropriate use ofweight scales

! Imbalance between food intakeand physical activity output

! Frenzied, compulsive approach toexercising

! Avoiding social occasions andcommunal meals in order to eat

! Low self-esteem

! Absolute thinking; an “all ornothing” attitude

! Associated depression, socialwithdrawal and/or anxieties

Disordered Eating in Sport:Taking a new direction

Food is fuel for an active body. In order to allow women to nourish and not deprivetheir bodies, we must strive to balance our energy output (activity) with our energyinput (nourishment) and therefore avoid an energy deficit that can rob us of our health.

There is a continuum of poor eating habits that include on one end of Disorderedeating and on the other end of Eating Disorders. Disordered eating consists of poornutrition habits, improper balance of food groups, lack of appropriate servings of foodand food avoidances. Eating Disorders consist of behaviour changes (binging,purging, restricting) with the intent of controlling food intake in order to produce weightloss accompanied by a distorted self body image. Many active girls and women fallinto disordered eating habits due to lack of education and many women with eatingdisorders delay effective treatment due to myths and fears that hold them back fromrecovering a healthy weight.

Fluctuating weight levels with either weight loss or weight gain can be a cardinal signthat the body is unable to find a correct “set point” for optimal health. Weight changeshave not been proven to correlate with performance levels and the emphasis weightas a number is a false measure of body composition, muscle tone and athletic ability.

Disordered Eating in Sport

N A i ti

Signs and symptoms(continued)*

Physical:

! Noticeable and frequent weightchanges as either a gain or loss

! Irregular or total absence ofmenstruation

! Scabs on knuckles from repeatedvomiting

! Dizziness from low blood pressure

! Constipation, diarrhea, bloating

! Bloodshot eyes

! Headaches

! Muscle weakness

! Muscle weakness

! Poor sleep patterns

! Dry skin and hair

! Stress fractures and overuse injuries

! Cold intolerance

*Adapted from information available fromthe Bulimia and Anorexia NervosaAssociation.

Guidelines for safeweight reductionIf an individual could benefit fromreducing her weight in order to optimizeher health, it is important that she:

! Consult a Medical Doctor orDietician before beginning to loseweight and be monitored throughoutthe period of weight loss

! Establish realistic goals

! Follow Canada’s Food Guide

! Avoid weight reduction during thecompetitive season and otherstressful periods

! Establish a training regime thatmeets your strength and endurancegoals while toning your bodycontours

A checklist for parentsParents can be indispensable inpreventing eating disorders as wellas in their early detection and promptreferral for treatment. Encourage,nurture and listen carefully to yourchildren. Demonstrate that youlove and value them as they are –regardless of their size or shape.Act quickly if you suspect an eatingdisorder. The shorter the time periodbetween the onset of the disorder andthe start of treatment, the better thelikelihood of recovery.

! Emphasize healthy activity andhealthy nutrition, not weight goals.

! Avoid specialization in one sport atan early age and expose children toa number of activities, particularlythose that emphasize friendship, fairplay and fitness rather than a winning-at-all-costs approach.

! Advocate a well-rounded approach tolife

! Teach stress management and copingskills

! Follow Canada’s Food Guide ToHealthy Eating in your home

! Provide unconditional love andsupport for your children regardless oftheir shape, size and sportingaccomplishments

! Discourage family members frommaking teasing remarks about weight

! Before enrolling children in a sportingactivity, talk to the instructor/coach todetermine if she/he has a balancedapproach to sport and a healthyattitude towards body size

! Expose young children to toys anddolls of various sizes

! Write letters of complaint tomanufacturers who use emaciatedmodels to promote their products

! Teach children that fasting is adangerous practice and should not beallowed or rewarded.

! Encourage daughters to declarepersonal boundaries and teach themto say “no” to coaches whenappropriate

! Be aware of the signs and symptomsof eating disorders.

“The best treatment

for

an eating disorder

is prevention.”

Dr. Dick Moriarty, founder

of the Bulimia and Anorexia

2

Disordered Eating in Sport

!

Nadwspsube

AoSredeppdpp

!

!

!

!

!

!

A woman is often

measured by the things

she cannot control.

She is measured by the

way her body curves or

doesn’t curve, by

where she is flat or

straight or round.

She is measured by 36-

24-36 and inches and

ages and numbers, by

all the outside things

that don’t ever add up

to who she is on the

inside. And so, if a

woman is to be

measured, let her be

measured by the things

she can control, by

who she is and how she

is trying to become.

Because as every woman

knows, measurements

are only statistics.

And statistics lie.

--Nike, Inc.

A checklist for coachesCoaches exert great influence overathletes. An encouraging commentcan produce a lasting, positive effect onan athlete; one that is inappropriate orthoughtless can lead to devastatingconsequences. Develop a game planfor handling eating disorders andinclude information about referrals tocounsellors, nutritionists, social workersand doctors. Act quickly if yoususpect an eating disorder. Theshorter the time period between theonset of the disorder and the start oftreatment, the better the likelihood ofrecovery.

! Praise girls for their skills andsuccesses, not for their appearanceor weight loss

! Provide ample opportunity foreducation regarding healthynutrition, physical activity and bodyimage as young ages andthroughout the high risk time ofadolesence

! Discontinue any public weigh-ins orpresence of scales in a training area

! Body fat percentage has not beenproven to be an accurate indicator ofathletic ability and it should not bemonitored without a dietician’s ormedical doctor’s input

! Provide positive feedback based onathletes abilities andaccomplishments.

! Do not criticize for weight gain norpraise for weight loss

! Do not make an athlete’s position onthe team conditional upon weightloss

! Do not use weight loss as a meansto enhance athletic performance

! Emphasize a well-balancedapproach to performance andwinning

! Emphasize individual training plansso that comparisons betweenathletes does not affect body image.

! Refer to athletes by their names, notby their body sizes

! Be aware of the signs and symptomsof eating disorders

Make it as easy as possible for theathlete with an eating disorder tocomply with treatment by excusingher from a practice if it conflicts withtreatment time.

ote: Individual circumstances and thevice of the treatment team will dictate

hether or not an athlete continues herorting activity during treatment. Moderate,pervised activity, with no competition, may the best course of action.

checklist for sportrganizationsport organizations can be proactive inducing the incidence of eating

isorders among athletes. Begin byxamining and confronting policies,rograms and practices which mayrecipitate the onset of an eatingisorder, then create a culture whichermits athletes to realize theirotential, regardless of shape or size.

Educate coaches and leaders abouteating disorders and gender-sensitive teaching strategies.

Because links have been madebetween harassment and the onsetof eating disorders, adopt andimplement a harassment policywhich clearly describes harassment,the complaint process, disciplinaryactions, and appeal procedures

Include visual images of active girlsand women of all shapes and sizesin promotional and educationalmaterials

In esthetic sports, encourage theinternational federation to adoptrules and practices which ensurethat athletes are judged on athleticperformance alone, and not onappearance.

In sports with weight classifications,encourage the internationalfederation to update theclassifications to reflect the stronger,healthier and heavier weights ofathletes of the 1990s

Eliminate any weight loss or weightmaintenance clauses in contractswith athletes.

3

Disordered Eating in Sport

WEB SITE RESOURCES:

Dieticians of Canada:www.dieticitians.caBodysense Project:www.bodysense.caNational Eating DisorderScreening Program:www.mentalhealthscreening.org

A checklist for fitnessinstructorsIt is ironic that fitness instructors – whoare generally regarded as ‘healthy’ andwho instruct others about fitness andexercise – appear to be a high riskgroup for eating disorders. Being fitand getting in shape may have becomesynonymous with restrictive dieting andcompulsive exercising. It’s time toreplace the current concern with‘thinness’ and put ‘health’ back intoexercise programs. (Helping Athleteswith Eating Disorders, Thompson,Sherman, 1998)

! Emphasize getting fit, making friendsand having fun rather than losingweight. Participants are more likelyto join classes linked to health ratherthan thinness

! Encourage participants to wearcomfortable clothing

! Because participants will notice whatyou are wearing, be aware of whatyour fashions represent to others.During the course, make a point ofwearing baggy clothing from time totime, and not just tight-fitting outfits.Thongs, for example, accentuate theimage of thinness and may suggestto potential participants that theyhave to be thin in order to join theclass.

! Avoid references such as ‘butts ofsteel’ and ‘thunder thighs’.

If you suspect an eatingdisorder

! Approach the individual in a caring,sensitive, assertive, and no-judgmental manner that respects herprivacy and right to confidentiality.

! Mention the symptoms you haveobserved and suggest a consultationwith medical doctor, dietician orsocial worker.

! Provide the telephone number

! Offer to discuss your observationswith the parents or guardians forathletes who are living with theirfamilies

! Expect denial, rejection and a bumpyroad to recovery, don’t take thatpersonally.

! Let the individual know that theyhave many strengths and abilities toovercome this disorder.

Adapted from information available throughthe Bulimia and Anorexia NervosaAssociation

4