Effects of sport withdrawal in the treatment of eating disorders in athletes1 Opinion
Many research studies have found how participation in sport can heighten an individual’s probability of developing an eating disorder or disordered eating problems. This is due to not only psychological, socio-cultural and genetic pre-dispositions to developing these issues but also additional risks unique to the sporting environment. Inadvertently, behaviours such as excessive exercise or training and a strict diet can be reinforced (Thompson & Sherman, 1999). Symptoms such as amenorrhea (Sherman, DeHass, Thompson & Wilfert, 2005) may be ignored as they may be considered normal, “good athlete” traits such completing extra training sessions and excessive physical activity (Shroff, Reba, Thornton, Tozzi, Klump & Berrettini 2006) may be rewarded by a coach and not seen as potentially problematic and finally, athletes may feel pressures to fit within a specific stereotypical body type associated with their sport (Thompson & Sherman, 1999).
Completing physical exercise is a common weight control method for many people who suffer from eating disorders. For athletes, not only does regular training improve performance, it can also act as stress relief for daily issues and also forms a very strong part of their identity (Klenk, 2006). The withdrawal of sport participation as a method of treating an athlete with potential disordered eating problems may, therefore, have both positive and negative effects upon their individual psychology and their chances of recovery.
Due to the amount of time they spend with their athletes, coaches are often in the best position to provide emotional support and also confront the athlete regarding their habits if necessary (Sherman et al. 2005). They are also the most influential in regards to management of the athlete’s condition (Currie, 2010). Results from a research study conducted by Arthur-Cameselle and Baltzell (2012) stated how participants thought coaches needed to know “when to draw the line” in terms of participating in sport and withdrawing athletes from physical activity if necessary was important to maintaining both physical and psychological health (Thompson & Sherman, 1999).
They also suggested that when there is an imminent health risk, the athlete should be removed from practises to ensure their safety and well-being. This is where an aspect of recovery from disordered eating behaviour, of benefit only to athletes, can become an advantage. With recovery and an increased intake of food, reintroduction into sporting practises and physical activity at a graded pace may be granted at the coaches’ discretion. A return to training and the sporting environment may act as an incentive to the athlete to continue with treatment and stay on track with their recovery and can serve as a powerful reward for making progress through their recovery (Currie, 2010). Furthermore, education into nutrition and the benefits of food integrated within the athletes recovery can help to teach them how continuing to recover could eventually lead to new improvements and personal bests in terms of athletic performance (Arthur-Cameselle & Baltzell, 2012).
When an athlete is removed from participating in physical activity, it is merely for the safety and welfare of the athlete, although it may seem like a punishment. The athlete should be informed of the specific changes and improvements they must make in their recovery from an eating disorder in order to regain sport participation (Sherman et al, 2005). These changes or improvements could include increasing their BMI, increasing their daily calorie intake to provide energy to meet the demands of physical activity or to keep up to date with treatment appointments (Yager & Powers, 2008). The sport withdrawal due to disordered eating problems may induce similar emotions and cognitive responses as experienced by an athlete upon the impact of injury. It has been found that the most severe mood disturbance and negative emotions will tend to occur immediately following sport withdrawal, with the athlete experiencing emotions such as anger, frustration and depression (Leddy, Lambert and Ogles, 1994). An athlete with a very strong sporting identity may perceive their removal from sporting activity threatening to their sense of self and well-being. These athletes have been found to experience loss of self-esteem and depression and this is exacerbated by being withdrawn from the sporting environment for a long period of time, or when the athlete feels a lack of progress in their recovery (Brewer, 2009)
Whether they occur within a sporting context or not, eating disorders can be severely damaging to an individual’s health; they have the highest mortality rate of any other mental illness (Walsh, Wheat, & Freund, 2000) and therefore must be treated with extreme caution and care. Attention, first and foremost should be directed on the individuals physiological and psychological health and well-being. For athletes, the possibility of regaining sport participation can act as a positive incentive to continue recovery, however, its removal must be stressed that it’s not a punishment and is simply to protect the athlete’s welfare. Whatever methods are chosen by the coach in order to help the athlete through their recovery, at all times, the athlete should be given input into any decisions made regarding sports participation (Petrie & Rogers, 2001) and understand the terms of their recovery of which they must meet in order to avoid its removal.
Thompson, R. A., & Sherman, R. T. (1999). Athletes, athletic performance, and eating disorders: Healthier alternatives. Journal of social issues, 55, 317-337
Sherman, R. T., Thompson, R. A., DeHass, D., & Wilfert, M. (2005). NCAA Coaches survey: The role of the coach in identifying and managing athletes with disordered eating. Eating disorders: The journal of treatment and prevention, 13, 447-466
Shroff, H., Reba, L., Thornton, L., Tozzi, F., Klump, K., Berrettini, W., & Bulik, C. (2006) Features associated with excessive exercise in women with eating disorders. International journal of eating disorders, 39, 454-461
Arthur-Cameselle, J. N., Baltzell, A. (2012) Learning from collegiate athletes who have recovered from eating disorders: Advice to coaches, parents and other athletes with eating disorders. Journal of Applied Sport Psychology, 24, 1-9
Currie, A. (2010) Sport and eating disorders – Understanding and managing the risks. Asian Journal of Sports Medicine, 1, 63-68
Yager, J., & Powers, P. S. (2008) Clinical manual of eating disorders. Arlington, VA: American Psychiatric Publishing.
Klenk, C. A. (2006). Psychological response to injury, recovery and social support: A survey of athletes at an NCAA division 1 university. Senior honours projects, paper 9.
Leddy, M. H., Lambert, M. J., & Ogles, B. M. (1994) Psychological consequences of athletic injury among high-level competitors. Research quarterly for exercise and sport, 64, 347-354
Brewer, B. W. (2009) Handbook of sports medicine and science, sport psychology. Wiley Blackwell. Retrieved 19th February 2014, from http://www.myilibrary.com?ID=200774
Petrie, T. A., Rogers, R. (2001) Extending the discussion of eating disorders to include men and athletes. The Counselling Psychologist, 29, 743-753
Walsh, J. M. E., Wheat, M. E., Freund, K. (2000) Detection, evaluation and treatment of eating disorders: The role of the primary care physician. Journal of General Internal Medicine, 15, 577-590
Buy and download up to 400 infographics!Buy infographics
About Lauren Clarkson
22 year old, Brunel University Sport Science Graduate. Currently working as a GCSE and A Level PE teaching assistant at the Duke of York's Royal Military School. Aspiring to be an Officer in the Army.