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Understanding Eating Disorders

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Triathlete Hollie Avil recovered from an eating disorder to compete at the 2008 Olympic Games

  • Coaches should be mindful of the impact of criticism, indifference and provocation.
  • A study in 2001 revealed 16% of women distance runners had an eating disorder.
  • There is not usually one root cause that leads to someone trying to control their weight in a way that makes them ill.
  • Depression, lack of self-worth and emotional instability are just a few contributory factors.

‘I said I was looking forward to getting back to my swimming and that it would get me fit. He said, “swimming is not going to make you quicker Hollie; if you want to get quicker you should watch your weight”.’

That ill-advised, throwaway remark from a coach two years before triathlete Hollie Avil represented Great Britain at The Beijing 2008 Olympic Games triggered an eating disorder and sent her on a spiral of decline. In a footnote of cruel irony, the comment wasn’t even made by her coach.

The former world junior champion is one of a miniscule number of international sports stars to have confessed to having, or having had, an eating disorder.

It is a taboo subject, which is a crying shame, as there is strong and consistent evidence that eating disorders are prevalent in sport, and communication is one of the best medicines.

Research undertaken by UK Coaching Development Lead Officer  David Turner uncovered some alarming statistics, which illustrate in the starkest terms possible the malignant threat eating disorders pose to an athlete’s career and long-term health, as well as the vital role coaches have to play in helping combat this threat.

Perhaps the most troubling fact of them all is that eating disorders have the highest mortality rates of any mental illness, due to related medical conditions, such as depression – commonly referred to as ‘the silent killer’.

Here are a few more:

  • Admissions to hospital for eating disorders showed an 8% increase in 2014 (2,560 admissions).
  • One in 20 females exhibit concerning eating habits (MIND).
  • There are nine times as many females admitted to males.
  • For girls, the most common age of admission was 15.
  •  A 2001 study of distance runners in the UK found that of 184 female  athletes, 29 (16%) had an eating disorder.
  • 76% of admissions were for anorexia, 5% for bulimia,19% for other eating disorders.
  • Only one in 10 people who experience symptoms receive treatment.

 * Health and Social Care Information Centre statistics, 2014

Recognising the Signs

These figures are a real wake-up call for coaches, who should strive to create a supportive environment for their athletes and be mindful of the impact of criticism and, it should go without saying, bullying (particularly in relation to weight and body composition). Prevention, after all, is better than cure.

Specific coaching triggers and behaviour management principles to be aware of include:

  • authoritarian coaching behaviour
  • stimulating rivalry
  • verbal provocation
  • displaying indifference
  • entering into direct conflict
  • exhibiting favouritism.

While specific physical, psychological and behavioural signs to be on the look-out for include:

  • the use of at least one unhealthy method of weight control (vomiting, diet pills, laxatives or diuretics)
  • becoming more body conscious
  • weight loss
  • being increasingly self-critical about their body or performance
  • excessive exercise
  • an extreme/restrictive diet.

These signs do not always mean something is wrong, but it is always appropriate to raise any concerns you have with a club or governing body of sport welfare officer.

So what are the potential causes when it comes to eating disorders or disordered eating (the two terms are differentiated by the level of severity and frequency)?

Mild acts repeated over a long period of time can have a damaging outcome – the ‘drip, drip effect’. Depression, diminished feelings of self-worth, emotional instability, unbalanced power in the athlete-coach relationship, can all be contributory factors.

But there is not usually one single thing that can lead to an eating disorder, rather a cumulative effect of several concerns.

Coaches should consider how they can best safeguard against issues arising in the following situations:

  • Contributory environmental factors
  • Age-group international championships
  • Residential training centres
  • Possessive coaching/competitive coaching
  • Dietary/weight control programmes
  • Strength and conditioning coaching.

* Adapted from Gervis, M. 2010 in Brackenridge, C. and Rhind, D. (Eds) Elite Child Athlete Welfare: International Perspectives.

A Bright Spark

A coach should have a general awareness of all the issues detailed above and should not fall into the trap of believing eating disorders are simply a lifestyle choice that can be corrected with a little bit of self-discipline. This sort of attitude just serves to fuel the stigma surrounding them.

Let us finish where we began, with Hollie Avil, and how her coach Ben Bright helped her on the road to recovery and ultimate participation in the Olympic Games triathlon. 

Bright became Avil’s chief shoulder of support, discussing her emotional issues with her and her parents, and working closely with a nutritionist. 

He carried out his own research on the topic and used statistical evidence to show Avil that, the heavier she was, the faster her times. 

‘Ben told me that in triathlon it is about being strong rather than skinny,’ she says.

 It is fitting that she can remember the well-advised, carefully chosen remark that accelerated her revival, as well as that ill-advised, throwaway remark from a previous coach that sent her world spinning.

What do you think of this post? Let us know by leaving a comment below.

Next Steps

You might also find the 'Eating disorders – a coach’s guide' blog post useful, taken from an information sheet produced by Beat - the UK’s leading charity supporting anyone affected by eating disorders or difficulties with food, weight and shape.

The UK Coaching Research Team have also produced a research summary 'Strategies for Dealing with Eating Disorders Among Athletes and Players'.

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Comments (2)

   
KateO
Thanks for this. As a Tri coach I am super aware of these issues, it is a huge responsibility as a coach and this article captures it well.
15/09/15
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robertkmaaye
For anyone interested The Child Protection in Sport Unit has now produced a series of free webinars one of which is on Eating Disorders and Sport. It's available for free after sign up. More info here https://thecpsu.org.uk/news/2015/december/an-overview-of-eating-disorders-and-the-pertinent-issues-for-sport/
04/01/16
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