Identifying and Overcoming Eating Disorders

A shocking one-fourth of young women (<20 years) who suffer from anorexia have early osteoporosis. Some end up in severe pain for their lifetime, others in wheelchairs. Teens need to be fully aware they are not only losing bone density but also are not gaining it, as should happen during teenage years. Surprisingly, men with anorexia end up with worse osteoporosis than women.

More: Athletes and Eating Disorders: How to Find Peace with Food

Any female athlete with amenorrhea (loss of her menstrual period for more than 3 months) should get her bone density measured for a baseline. Taking a birth control pill can force the return of menses, but current research suggests the athlete should not resort to this.  The pill offers a false sense of recovery, plus does not enhance bone density. The better path is to eat enough food to restore the body to an appropriate weight.

People with eating disorders commonly have high cholesterol levels. The solution is not to limit red meat and eggs; rather, the athletes need to normalize their entire diet.

More: The Diet Detective: Understand Your Food Labels

Medical symptoms that raise red flags include: heart rate less than 40 beats per minute, body temperature less than 95°F (35°C), blood pressure less than 70/40, and low blood glucose (<60 mg/dL) between meals. These numbers are sometimes seen in highly-trained athletes; hence to identify those with eating disorders can be tricky.

Other red flags include noticeable "fur" on arms and face (lanugo hair, for warmth), brittle fingernails, blue fingertips, itchy dry skin, and a yellow skin tone due to overindulging in carrots and orange vegetables.

More: Improve Your Relationship with Food

Do People Recover?

Athletes suffering from eating disorders can recover, usually with help from a therapist, registered dietitian (RD), and medical team. Some people get tired of the eating disorder and learn to accept their perceived body flaws. Others get scared when they vomit blood. Some find hope in a new personal relationship —Maybe I am good enough to be loved!—or choose to eat better so they can get pregnant.

One pathway for recovery is to see the eating disorder as being just one part of you. It is the part that tries to protect your other parts that don't like feeling lonely, rejected, or imperfect. For example, perhaps you had traumatic experiences in middle school. Your eating-disordered part can distract and numb feelings of pain, terror, and fear. It keeps you feeling more in control of life.

More: Nutrition Tips for Women with Amenorrhea

Try talking to your eating disorder and ask, "Please tell me why you are here? What are you trying to do for me?" The ED part might answer "I'm trying to distract you and protect you from painful feelings—you know, the shame you felt as a kid in middle school..." Yet, we all know that starving one's body does not solve any problems. Hence, a probing question is, "How effective on a scale of 1 to 10 (with 10 being 100% effective) is the eating disorder in making you happy in your core?" Most athletes with eating disorders are miserable.

Using a model of recovery such as Internal Family Systems (, athletes can discover their core that is centered, competent, secure, self-assured, relaxed, and able to both listen to and respond to feedback. These core values can displace the eating disordered voices and lead to a happier, healthier life and improved performance. Is it time for you to stop struggling and start living and performing better?

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