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Jorunn Sundgot-Borgen

This study assessed the nutrient intake and eating behavior in Norwegian female elite athletes suffering from eating disorders (ED) who met the criteria for anorexia nervosa (AN), anorexia athletica (AA), or bulimia nervosa (BN). The subjects included 7 AN, 43 AA, 42 BN, and 30 controls. Three-day and 24-hr food records were used to assess energy and nutrient intake. Results revealed that a significant number of AN and AA athletes have diets too low in energy and nutrients, the mean intake for energy and CHO being lower than recommended for active females. A significant number did not reach the protein level recommended for athletes. In addition, there were low intakes of several micronutrients, most notably calcium, vitamin D, and iron. The energy and nutritional inadequacy, combined with the use of purging, are of major concern since the athletes in this study were relatively young. It is unknown whether the abnormal eating pattern is a consequence of ED or is typical of top level athletes.

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Katherine A. Beals and Melinda M. Manore

A growing body of evidence suggests that the prevalence of eating disorders and excessive concerns regarding body weight in certain subpopulations of female athletes are increasing. The pressure on female athletes to improve their performances and physiques, coupled with the general sociocultural demand placed on all women to be thin, often results in attempts to achieve unrealistic body size and body weight goals. For some female athletes the pressure to achieve and maintain a low body weight leads to potentially harmful patterns of restrictive eating or chronic dieting. This paper seeks to further delineate the characteristics of a recently identified subclinical eating disorder in female athletes: anorexia athletica. Research studies that support the existence of subclinical eating disorders will be reviewed. In addition, the possible physiological and psychological consequences of subclinical eating disorders will be explored.

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Jorunn Sundgot-Borgen

This study examined the prevalence of eating disorders (ED) and the possible difference between ED symptoms and true ED by using questionnaires as compared with an interview and clinical evaluation in Norwegian elite female athletes (n=522) from 35 sports and nonathletic controls (n=448). In addition to the 117 athletes classified as "at risk" to develop ED, 90 subjects were randomly chosen, comprising 30 athletic controls, 30 at-risk nonathletes, and 30 nonathletic controls. All weIe interviewed and clinically examined. A significantly higher number of athletes (18%) than controls (5%) were found to actually suffer from ED, particularly athletes competing in sports in which leanness or a specific weight were considered important. When results from the screening study were compared to those from the interviews and clinical examinations, a significant underreporting of ED among athletes was demonstrated. The athletes also reported the use of other pathogenic methods in the screening study compared to what they reported in the interview. Nonathletes more correctly reported the use of pathogenic methods but overreported the prevalence of ED. Thus the issue of using questionnaires alone or in combination with personal interview/clinical examination merits further investigation.

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Jorunn Sundgot-Borgen

This study examined clinical and subclinical eating disorders (EDs) in young Norwegian modern rhythmic gymnasts. Subjects were 12 members of the national team, age 13-20 years, and individually matched nonathletic controls. All subjects participated in a structured clinical interview for EDs, medical examination, and dietary analysis. Two of the gymnasts met the DSM-III-R criteria for anorexia nervosa, and 2 met the criteria for anorexia athletica (a subclinical ED). AH the gymnasts were dieting in spite of the fact that they were all extremely lean. The avoidance of maturity, menstrual irregularities, energy deficit, high training volume, and high frequency of injuries were common features among the gymnasts. There is a need to learn more about risk factors and the etiology of EDs in different sports. Coaches, parents, and athletes need more information about principles of proper nutrition and methods to achieve ideal body composition for optimal health and athletic performance.