Anorexia athletica

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Anorexia athletica (sports anorexia), also referred to as hyper-gymnasia, is an eating disorder characterized by excessive and compulsive exercise. An athlete with sports anorexia tends to overexercise, to give themselves a sense of having control over their body. Most often, people with the disorder tend to feel they have no control over their lives, other than their control of food and exercise. In actuality, they have no control; they cannot stop exercising or regulating food intake without feeling guilty. [1] Generally, once the activity is started, it is difficult to stop, because the person is seen as being addicted to the method adopted.

Contents

Anorexia athletica is used to refer to "a disorder for athletes who engage in at least one unhealthy method of weight control". [2] Unlike anorexia nervosa, anorexia athletica does not have as much to do with body image as it does with performance. Athletes usually begin by eating more 'healthy' foods, as well as increasing their training. People feel like that is not enough and start working out excessively and cutting back their caloric intake, until it becomes a psychological disorder.

Hypergymnasia and anorexia athletica are not recognized as mental disorders in medical manuals such as the ICD-11 or the DSM-5. There are limited studies on the exact prevalence of anorexia athletica, but it has been found to be more common among elite athletes than the general population. [3]

Signs and symptoms

Someone with anorexia athletica can experience numerous signs and symptoms, a few of which are listed below. The seriousness of the symptoms is dependent on the individual, and more symptoms come with the length the athlete excessively exercises. If anorexia athletica persists for long enough, the individual can become malnourished, which eventually leads to further complications in major organs such as the liver, kidney, heart and brain. [4]

Causes

There is not one single cause of anorexia athletica, but many factors that are involved in the disorder. Research has shown that an area on chromosome 1 is linked to anorexia nervosa-sports anorexia. [5] Thus, a person is more likely to have anorexia athletica if someone in their immediate family has had the disorder. Besides genetics, the environment a person is in, has a major impact on the disorder. Coaches and parents often suggest to their athlete/child to lose weight in order to perform better. [6]

Sports such as figure skating, ballet, and gymnastics promote both male and female athletes to have a thin figure. There has been research into the prevalence in certain types of sports. For example, the pursuit of a certain body aesthetic in gymnastics, the need to be in a certain weight categorisation in order to compete in judo, or endurance sports such as running where weight and performance are closely linked. [7]

Females who partake in sports can develop a syndrome known as the triad. The female athlete triad was recognized in 1992 and is defined as a spectrum disorder of three interrelated components: (1) low energy availability due to disordered eating, eating disorder, or lack of nutrition relative to caloric expenditure; (2) menstrual dysfunction; and (3) low bone mineral density (BMD). [8] The media play a very significant role in pressuring athletes to have the perfect body and to be thin, which can also trigger sports anorexia. [1]

Treatment

According to the National Eating Disorder Information Centre (NEDIC), the first step for someone going through anorexia athletica is to realize their eating and exercise habits are hurting them. [9] Once an individual has realized they have a disorder, an appointment should be made with the family doctor. A family doctor can advise further medical attention if needed. With sports anorexia, it is important to go to a dietitian as well as a personal trainer. People with sports anorexia need to learn the balance between exercise and caloric intake.

See also

Related Research Articles

<span class="mw-page-title-main">Anorexia (symptom)</span> Loss of appetite

Anorexia is a medical term for a loss of appetite. While the term outside of the scientific literature is often used interchangeably with anorexia nervosa, many possible causes exist for a loss of appetite, some of which may be harmless, while others indicate a serious clinical condition or pose a significant risk.

An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health. These behaviors include eating either too much or too little. Types of eating disorders include binge eating disorder, where the patient keeps eating large amounts in a short period of time typically while not being hungry; anorexia nervosa, where the person has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD. It is estimated 20–60% of patients with an ED have a history of OCD.

<span class="mw-page-title-main">Bulimia nervosa</span> Type of eating disorder

Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. This activity aims to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives.

Orthorexia nervosa is a proposed eating disorder characterized by an excessive preoccupation with eating healthy food. The term was introduced in 1997 by American physician Steven Bratman, who suggested that some people's dietary restrictions intended to promote health may paradoxically lead to unhealthy consequences, such as social isolation, anxiety, loss of ability to eat in a natural, intuitive manner, reduced interest in the full range of other healthy human activities, and, in rare cases, severe malnutrition or even death.

<span class="mw-page-title-main">Appetite</span> Desire to eat food

Appetite is the desire to eat food items, usually due to hunger. Appealing foods can stimulate appetite even when hunger is absent, although appetite can be greatly reduced by satiety. Appetite exists in all higher life-forms, and serves to regulate adequate energy intake to maintain metabolic needs. It is regulated by a close interplay between the digestive tract, adipose tissue and the brain. Appetite has a relationship with every individual's behavior. Appetitive behaviour also known as approach behaviour, and consummatory behaviour, are the only processes that involve energy intake, whereas all other behaviours affect the release of energy. When stressed, appetite levels may increase and result in an increase of food intake. Decreased desire to eat is termed anorexia, while polyphagia is increased eating. Dysregulation of appetite contributes to ARFID, anorexia nervosa, bulimia nervosa, cachexia, overeating, and binge eating disorder.

Promotion of anorexia is the promotion of behaviors related to the eating disorder anorexia nervosa. It is often referred to simply as pro-ana or ana. The lesser-used term pro-mia refers likewise to bulimia nervosa and is sometimes used interchangeably with pro-ana. Pro-ana groups differ widely in their stances. Most claim that they exist mainly as a non-judgmental environment for anorexics; a place to turn to, to discuss their illness, and to support those who choose to enter recovery. Others deny anorexia nervosa is a mental illness and claim instead that it is a lifestyle choice that should be respected by doctors and family.

<span class="mw-page-title-main">Obsessive–compulsive personality disorder</span> Personality disorder involving orderliness

Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by a spectrum of obsessions with rules, lists, schedules, and order, among other things. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

<span class="mw-page-title-main">Stress fracture</span> Medical condition

A stress fracture is a fatigue-induced bone fracture caused by repeated stress over time. Instead of resulting from a single severe impact, stress fractures are the result of accumulated injury from repeated submaximal loading, such as running or jumping. Because of this mechanism, stress fractures are common overuse injuries in athletes.

<span class="mw-page-title-main">Oligomenorrhea</span> Less frequent menstruation

Oligomenorrhea is infrequent menstrual periods. Generally the menstrual periods occur at intervals of greater than 35 days, with less than 9 periods in a year, where previously there had been a regularly established pattern. The period may be light or short in duration, and irregular.

<span class="mw-page-title-main">Underweight</span> Below a weight considered healthy

An underweight person is a person whose body weight is considered too low to be healthy. A person who is underweight is malnourished.

<span class="mw-page-title-main">Sociology of the body</span> Branch of sociology studying the human body

Sociology of the body is a branch of sociology studying the representations and social uses of the human body in modern societies.

<span class="mw-page-title-main">Relative energy deficiency in sport</span> Syndrome of disordered eating, oligomenorrhoea and osteopenia

Relative energy deficiency in sport (RED-S) is a syndrome in which disordered eating, amenorrhoea/oligomenorrhoea, and decreased bone mineral density are present. It is caused by eating too little food to support the amount of energy being expended by an athlete, often at the urging of a coach or other authority figure who believes that athletes are more likely to win competitions when they have an extremely lean body type. RED-S is a serious illness with lifelong health consequences and can potentially be fatal.

<span class="mw-page-title-main">Athletic heart syndrome</span> Medical condition

Athletic heart syndrome (AHS) is a non-pathological condition commonly seen in sports medicine in which the human heart is enlarged, and the resting heart rate is lower than normal.

Functional hypothalamic amenorrhea (FHA) is a form of amenorrhea and chronic anovulation and is one of the most common types of secondary amenorrhea. It is classified as hypogonadotropic hypogonadism. It was previously known as "juvenile hypothalamosis syndrome," prior to the discovery that sexually mature females are equally affected. FHA has multiple risk factors, with links to stress-related, weight-related, and exercise-related factors. FHA is caused by stress-induced suppression of the hypothalamic-pituitary-ovarian (HPO) axis, which results in inhibition of gonadotropin-releasing hormone (GnRH) secretion, and gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Severe and potentially prolonged hypoestrogenism is perhaps the most dangerous hormonal pathology associated with the disease, because consequences of this disturbance can influence bone health, cardiovascular health, mental health, and metabolic functioning in both the short and long-term. Because many of the symptoms overlap with those of organic hypothalamic, pituitary, or gonadal disease and therefore must be ruled out, FHA is a diagnosis of exclusion; "functional" is used to indicate a behavioral cause, in which no anatomical or organic disease is identified, and is reversible with correction of the underlying cause. Diagnostic workup includes a detailed history and physical, laboratory studies, such as a pregnancy test, and serum levels of FSH and LH, prolactin, and thyroid-stimulating hormone (TSH), and imaging. Additional tests may be indicated in order to distinguish FHA from organic hypothalamic or pituitary disorders. Patients present with a broad range of symptoms related to severe hypoestrogenism as well as hypercortisolemia, low serum insulin levels, low serum insulin-like growth factor 1 (IGF-1), and low total triiodothyronine (T3). Treatment is primarily managing the primary cause of the FHA with behavioral modifications. While hormonal-based therapies are potential treatment to restore menses, weight gain and behavioral modifications can have an even more potent impact on reversing neuroendocrine abnormalities, preventing further bone loss, and re-establishing menses, making this the recommended line of treatment. If this fails to work, secondary treatment is aimed at treating the effects of hypoestrogenism, hypercortisolism, and hypothyroidism.

<span class="mw-page-title-main">Anorexia nervosa</span> Type of eating disorder

Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin.

The differential diagnoses of anorexia nervosa (AN) includes various types of medical and psychological conditions, which may be misdiagnosed as AN. In some cases, these conditions may be comorbid with AN because the misdiagnosis of AN is not uncommon. For example, a case of achalasia was misdiagnosed as AN and the patient spent two months confined to a psychiatric hospital. A reason for the differential diagnoses that surround AN arise mainly because, like other disorders, it is primarily, albeit defensively and adaptive for, the individual concerned. Anorexia Nervosa is a psychological disorder characterized by extremely reduced intake of food. People with anorexia nervosa tend to have a low self-image and an inaccurate perception of their body.

Jorunn Kaiander Sundgot-Borgen is a Norwegian professor of sports medicine.

Exercise addiction is a state characterized by a compulsive engagement in any form of physical exercise, despite negative consequences. While regular exercise is generally a healthy activity, exercise addiction generally involves performing excessive amounts of exercise to the detriment of physical health, spending too much time exercising to the detriment of personal and professional life, and exercising regardless of physical injury. It may also involve a state of dependence upon regular exercise which involves the occurrence of severe withdrawal symptoms when the individual is unable to exercise. Differentiating between addictive and healthy exercise behaviors is difficult but there are key factors in determining which category a person may fall into. Exercise addiction shows a high comorbidity with eating disorders.

Drunkorexia is a colloquialism for anorexia or bulimia combined with an alcohol use disorder. The term is generally used to denote the utilization of extreme weight control methods to compensate for planned binge drinking. Research on the combination of an eating disorder and binge drinking has primarily focused on college-aged women, though the phenomenon has also been noted among young men. Studies suggest that individuals engage in this combination of self-imposed malnutrition and binge drinking to avoid weight gain from alcohol, to save money for purchasing alcohol, and to facilitate alcohol intoxication.

Atypical anorexia nervosa is an eating disorder in which individuals meet all the qualifications for anorexia nervosa, including a body image disturbance and a history of restrictive eating and weight loss, except that they are not currently underweight. Atypical anorexia qualifies as a mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), under the category Other Specified Feeding and Eating Disorders (OSFED). The characteristics of people with atypical anorexia generally do not differ significantly from anorexia nervosa patients except for their current weight.

References

  1. 1 2 "National Eating Disorder Information Centre". Archived from the original on January 21, 2012. Retrieved November 10, 2011.
  2. ↑ "Activity Disorder: Too Much Little Of A Good Thing" from WebMD
  3. ↑ Vasiliu, Octavian (17 Jul 2023). "Current trends and perspectives in the exploration of anorexia athletica-clinical challenges and therapeutic considerations". Frontiers in Nutrition. 10.
  4. ↑ "mayo-clinic research" . Retrieved November 10, 2011.
  5. ↑ "Eating Disorder Research in Sweden" (PDF). Retrieved November 10, 2011.
  6. ↑ SUNDGOT-BORGEN, JORUNN (April 1994). "Risk and trigger factors for the development of eating disorders in female elite athletes". Medicine & Science in Sports & Exercise. 26 (4): 414–419. doi: 10.1249/00005768-199404000-00003 . PMID   8201895.
  7. ↑ SUNDGOT-BORGEN, JORUNN (April 1994). "Risk and trigger factors for the development of eating disorders in female elite athletes". Medicine & Science in Sports & Exercise. 26 (4): 414–419. doi: 10.1249/00005768-199404000-00003 . PMID   8201895.
  8. ↑ Chamberlain, Rachel (2018-04-15). "The Female Athlete Triad: Recommendations for Management". American Family Physician. 97 (8): 499–502. PMID   29671493.
  9. ↑ "National Eating Disorder Information Centre" . Retrieved November 10, 2011.
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