ABSTRACT
I. Introduction................................................................................... 62 II. Definitions and Diagnostic Criteria ............................................ 63
A. Anorexia Nervosa.................................................................... 64 B. Bulimia Nervosa ...................................................................... 65 C. Binge Eating Disorder............................................................. 65 D. Muscle Dysmorphia ................................................................ 66 E. Anorexia Athletica................................................................... 67 F. Exercise Dependence............................................................... 68 G. Eating Disorders Not Otherwise Specified ........................... 68
III. Prevalence of Eating Disorders in Athletes ................................ 69 IV. Etiology.......................................................................................... 70
A. Warning Signs.......................................................................... 72 V. Primary or Secondary Disorder? ................................................. 72
A. Separate Syndromes ................................................................ 73 B. Exercise Dependence Leads to Eating Disorders ................. 74 C. Another Disorder Underlies Both .......................................... 75 D. Exercise Dependence is a Variant of Eating Disorders ........ 76
VI. Nutritional Status ......................................................................... 76 A. Nutrient Intake ........................................................................ 76 B. Female Athlete Triad ............................................................... 77
VII. Identification and Assessment ..................................................... 78 A. Medical Nutritional Evaluation ............................................. 79
VIII. The Role of the Sports Nutritionist in Treating Eating Disorders ........................................................................... 81
IX. Summary........................................................................................ 83 References ............................................................................................... 84
In the past two decades, awareness of the importance of diet and exercise to health and well-being has grown. However, the use of dieting and exercise to extremes that can provoke injury and death has become a growing problem. Perhaps this is inevitable in cultures where the attitude, “If a little is good, a lot must be better,” prevails. Unlike chemical addictions or criminal behavior, eating and exercise behaviors are often viewed as positive choices. While a commitment to a healthy diet and regular exercise do not constitute disordered behavior, there are patterns within each of these choices that do appear to be dysfunctional. These patterns have been given a variety of names; some such as anorexia nervosa are bona fide medical diagnoses. Others, such as exercise dependence, have only recently appeared in the literature and have yet to be included in the
Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV).
