Essentials for Best Practice: Treatment Approaches for Athletes With Eating Disorders

in Journal of Clinical Sport Psychology

Click name to view affiliation

Jenny H. Conviser Northwestern University

Search for other papers by Jenny H. Conviser in
Current site
Google Scholar
PubMed
Close
*
,
Amanda Schlitzer Tierney The Victory Program at McCallum Place

Search for other papers by Amanda Schlitzer Tierney in
Current site
Google Scholar
PubMed
Close
*
, and
Riley Nickols The Victory Program at McCallum Place

Search for other papers by Riley Nickols in
Current site
Google Scholar
PubMed
Close
*
Restricted access

Eating disorders (EDs) and disordered-eating behaviors (DEBs), pose a high risk of morbidity and mortality, threatening physical health, emotional health, and overall quality of life. Unfortunately, among athletes, prevalence rates continue to increase. This document summarizes the challenges of establishing and navigating the multidisciplinary care needed to effectively treat EDs and DEBs among athletes. The benefits of timely and frequent communication within the multidisciplinary treatment team (MDTT) are emphasized and discussed. Authors advise who should be selected as members of the MDTT and suggest that all personnel, including athletic coaches, athletic trainers, physical therapists, and certified fitness professionals be ED-informed and ED-sensitive. Vital components of care are noted including use of a variety of evidence-based psychotherapeutic modalities, interventions which target emotional regulation, and prioritize values based compassionate care. Authors caution that performance decrements and medical/physiological changes are not always easily observable in individuals with EDs and DEBs and therefore, attuned, consistent, and ongoing monitoring is needed. Consensus regarding previously established parameters for return to play and careful titration of physical activity throughout the ED recovery process are suggested as important for preserving health, preventing re-injury, or relapse and facilitating successful return to sport participation.

Conviser is with Ascend Consultation in Health Care, LLC, Chicago, IL; and Northwestern University, Chicago, IL. Schlitzer Tierney and Nickols are with The Victory Program at McCallum Place, St. Louis, MO.

Address author correspondence to Jenny H. Conviser at Jenny.Conviser@ASCENDchc.com.
  • Collapse
  • Expand
  • Academy of Eating Disorders Report. (2016). Eating disorders: A guide to medical care (3rd ed.). Retrieved from https://www.aedweb.org/learn/publications/medical-care-standards

    • Search Google Scholar
    • Export Citation
  • Ackland, T., Maughan, R., Stewart, A., & Muller, W. (2013). How to minimize the health risks to athletes who compete in weight-sensitive sports. British Journal of Sports Medicine, 47, 10121022. doi:10.1136/bjsports-2013-092966

    • Search Google Scholar
    • Export Citation
  • American Academy of Pediatrics [AAP]. (2005). Promotion of healthy weight-control practices in young athletes. Pediatrics, 116, 15571564. doi:10.1542/peds.2005-2314

    • Search Google Scholar
    • Export Citation
  • American College of Sports Medicine. (2018). Guidelines for exercise testing and prescription (10th ed.). Philadelphia, PA: Wolters Kluwer.

    • Search Google Scholar
    • Export Citation
  • American Psychological Association. (2017). Discussing limits of confidentiality, ethics code 4.02 . Retrieved from https://www.apa.org/ethics/code/index.aspx

    • Search Google Scholar
    • Export Citation
  • Arcelus, J., Mitchell, A.J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders. Archives of General Psychiatry, 68, 724731. 21727255 doi:10.1001/archgenpsychiatry.2011.74

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chatterton, J.M., & Petrie, T.A. (2013). Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes. Eating Disorders, 21, 328341. 23767673 doi:10.1080/10640266.2013.797822

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coker-Cranney, A., & Reel, J.J. (2015). Coach pressure and disordered eating in female collegiate athletes: Is the coach-athlete relationship a mediating factor? Journal of Clinical Sport Psychology, 9, 213231. doi:10.1123/jcsp.2014-0052

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cook, B.J., Wonderlich, S.A., Mitchell, J.E., Thompson, R., Sherman, R., & McCallum, K. (2016). Exercise in eating disorders treatment: Systematic review and proposal of guidelines. Medicine & Science in Sports & Exercise, 48, 14081414. 26909533 doi:10.1249/MSS.0000000000000912

    • Crossref
    • Search Google Scholar
    • Export Citation
  • De Souza, M.J., Nattiv, A., Joey, E., Misra, M., Williams, N., Mallinson, R.J., … Matheson, G. (2014). Female athlete triad coalition consensus statement on treatment and return to play of female athlete triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013. British Journal of Sports Medicine, 48, 289289. 24463911 doi:10.1136/bjsports-2013-093218

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Eisenberg, D., Golberstein, E., & Gollust, S.E. (2007). Help-seeking and access to mental health care in a university student population. Medical Care, 45, 594601. 17571007 doi:10.1097/MLR.0b013e31803bb4c1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Galli, N., Petrie, T.A., Reel, J.J., Chatterton, J.M., & Baghurst, T.M. (2013). Assessing the validity of the weight pressures in sport scale for male athletes. Psychology of Men & Masculinity, 15, 170180. doi:10.1037/a0031762

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Glazer, J. (2008). Eating disorders among male athletes. Current Sports Medicine Reports, 7, 332337. doi:10.1249/JSR.0b013e31818f03c5

  • Hay, P.J., Touyz, S., & Sud, R. (2012). Treatment for severe and enduring anorexia nervosa: A review. Australian & New Zealand Journal of Psychiatry, 46, 11361144. doi:10.1177/0004867412450469

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jacobson, C.M., & Luik, C. (2014). Epidemiology and socio-cultural aspects of non-suicidal self- injury and eating disorders. In L. Claes& J. Muehlenkamp (Eds.), Non-suicidal self-injury in eating disorders: Advancements in etiology and treatment (pp. 1934). New York, NY: Springer Heidelberg. doi:10.1007/978-3-642-40107-7_2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Markser, V.Z. (2011). Sport psychiatry and psychotherapy. Mental strains and disorders in professional sports. Challenge and answer to societal changes. European Archives of Psychiatry and Clinical Neuroscience, 261, 182185. 21901268 doi:10.1007/s00406-011-0239-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McArdle, S., Meade, M.M., & Moore, P. (2016). Exploring attitudes toward eating disorders among elite athlete support personnel. Scandinavian Journal of Medicine & Science in Sports, 26, 11171127. 26134346 doi:10.1111/sms.12515

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Petrie, T., Galli, N., Greenleaf, C., Reel, J., & Carter, J. (2013). Psychosocial correlates of bulimic symptomatology among male athletes. Journal of Psychology and Sport Excellence, 15, 680687. doi:10.1016/j.psychsport.2013.09.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Plateau, C.R., Arcelus, J., McDermott, H.J., & Meyer, C. (2015). Responses of track and field coaches to athletes with eating problems. Scandinavian Journal of Medicine & Science in Sport, 25, 240250. doi:10.1111/sms.12286

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosendahl, J., Bormann, B., Aschenbrenner, K., Aschenbrenner, F., & Strauss, B. (2009). Dieting and disordered eating in German high school athletes and non-athletes. Scandinavian Journal of Medicine Science and Sports, 19, 731739. doi:10.1111/j.1600-0838.2008.00821.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Styer, D.M., Conviser, J.H., Washburn, J.J., & Aldridge, D. (2014, March). Gender differences in quality of life and functional impairment associated with binge eating disorders: A clinical population study. Paper presented at the International Conference on Eating Disorders, New York City, NY.

    • Search Google Scholar
    • Export Citation
  • Sundgot-Borgen, J., & Torstveit, M.K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14, 2532. 14712163 doi:10.1097/00042752-200401000-00005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thompson, A., Petrie, T., & Anderson, C. (2017). Eating disorders and weight control behaviors change over a collegiate sport season. Journal of Science and Medicine in Sport, [Published online ahead of print]. http://www.sciencedirect.com/science/article/pii/S1440244017303341

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Touyz, S., & Hay, P. (2015). Severe and enduring anorexia nervosa (SE-AN): In search of a new paradigm. Journal of Eating Disorders, 3, 26. 26236477 doi:10.1186/s40337-015-0065-z

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 49 0 0
Full Text Views 6491 1772 275
PDF Downloads 3710 1732 643