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Surveys suggest that 8 to 41% of athletes may struggle with binge/purge and bulimic eating behaviors. Many of these athletes with bulimia struggle alone, receiving no professional help for recovery. This article offers effective counseling strategies for nutrition professionals who want to help bulimic athletes. Through a case study of a triathlete who binges, and then purges through compulsive exercise, a nutrition care plan is discussed that addresses the food and weight concerns commonly expressed by athletes with bulimia. The priorities of the care plan are to reduce preoccupation with weight, establish a pattern of regular eating, and address the underlying causes of the binges. The case demonstrates that nutrition counseling is only one part of the treatment program, and emphasizes the importance of developing a team of health professionals to assist athletes with bulimia.

The purpose of this study was to characterize recovery experiences of female collegiate athletes who have suffered from eating disorders. Participants were 16 collegiate female athletes who experienced recovery from an eating disorder. Participants told their recovery stories in semistructured interviews regarding factors that initiated, assisted, and hindered recovery. The most common turning point to initiate recovery was experiencing negative consequences from the eating disorder. Factors that most frequently assisted recovery included making cognitive and behavioral changes, supportive relationships, and seeking professional care. Hindering factors most commonly included lack of support from others, professional care complaints, and spending time with others with eating disorders. Results suggested that unique features of the sport environment, including coaches’ behavior and team norms, introduce either positive or negative influences on athletes as they work to recover from an eating disorder. Based on these findings, specific treatment and prevention recommendations for athletes are discussed.

Some have claimed that the similarities between athletes with eating problems and women with eating disorders (ED) include only symptoms such as dieting and fear of weight gain, and do not extend to the psychopathological characteristics associated with these disorders. However, studies used to support this viewpoint have relied on comparisons between “eating-disturbed” athletes and clinically diagnosed ED patients, a method that confounds diagnostic classification with athlete status. The present study held ED classification constant by comparing ED patients who had been involved in high-level competitive athletics with nonathlete ED. No significant differences were found between the groups on any measures of psychopathology or eating-related symptoms; this suggests that if an athlete develops an eating disorder, her psychological profile is no different from others with this disorder.

Research shows inconclusive results pertaining to the comparison of eating disorder indices between athletes and nonathletes and among different subgroups of athletes. The purpose of this study was to meta-analytically review the literature on (a) bulimia nervosa indices, (b) anorexia nervosa indices, and (c) drive for thinness (a cardinal feature of both anorexia and bulimia) in male and female athletes. Results of 92 studies with 560 effect sizes (ES) revealed small ESs (range: −.01 to .30) in relation to group membership characteristics. Results for female athletes revealed small ESs for bulimia and anorexia indices, suggesting that female athletes self-reported more bulimic and anorexic symptomatology than control groups; nonsignificant group differences were evidenced for drive for thinness. Results for male athletes revealed small ESs on all three indices, suggesting that male athletes self-reported more eating disorder symptomatology than control groups. Moderator variables that might contribute to understanding the results are examined, and future research directions are presented.

While college women in general are at risk for anorexia nervosa and bulimia, these disorders may present more of a problem for the student-athlete due to her weight/body consciousness and the pressure associated with athletic competition at the college or university level. This paper discusses the physical and psychological characteristics of each disorder, their etiology, and how each affects the life and performance of the athlete. Recommendations are offered regarding the role of the sport management team (i.e., sport psychologist, team physician, coach, athletic trainer, exercise physiologist) in assisting the eating-disordered athlete.