In 1992, the American College of Sports Medicine first recognized that girls and women in sports were particularly susceptible to three interrelated conditions - disordered eating, menstrual irregularity, and osteoporosis - that have come to be known as the "female athlete triad."
While reliable statistics on the number of gymnasts affected by disordered eating or Triad related problems are not available, the stories of how such celebrated gymnasts as Nadia Comaneci, Cathy Rigby and Kathy Johnson struggled with disordered eating suggests, as a 1995 article in Sports Illustrated put, that women gymnasts are "designed for the disease."
What statistics there are suggest that a significant percentage of gymnasts, particularly at the elite levels, are affected:
- 28 percent of elite gymnasts and their mothers had disordered eating problems according to one survey
A Canadian study of youth gymnasts (average age 13.4 years) reported that 10.5% saw themselves as overweight, 27% reported worrying about the way they looked, and 39% reported dieting behaviors; those who perceived pressures by coaches to be thin were more likely to report poorer body image and disturbed eating behaviors.
- The number of college gymnasts who have engaged in disordered eating practices ranges from 51% to 62% according to the NCAA, a far higher percentage than in any other sport.
A 1996 study reported disordered eating in 100% of elite female gymnasts, and osteoporosis in more than half, although another preliminary study suggests that gymnasts do not appear to suffer from osteoporosis and that gymnasts actually experience a gain in bone mass and density.
- On average, gymnasts begin menstruation at 15.5 years, just prior to the 16-year age at which the failure to menstruate is deemed to constitute primary amenorrhea.
There are a number of reasons why female gymnasts are particularly vulnerable to disordered eating, including the fact that:
- Evidence suggests that they are more preoccupied with weight than both non-athletes and other athletes.
Because they need to maintain a thin and girlish figure to be competitive at the highest levels (the average size of the U.S. team declined from 5'3", 105 pounds in 1976 to 4'9", 88 pounds in 1992), gymnasts are more inclined to view starving themselves (i.e. becoming anorexic) as a way to avoid developing hips or breasts that could negatively impact on performance
- Gymnastic judging is subjective: how a gymnast looks may affect their score. A tragic example: a U.S. judge once told gymnast Christy Heinrich - an elite gymnast in the late 1980's who weighed less than 60 pounds when she died in 1994 from complications of bulimia and anorexia - that she would have to lose weight to make the national team.
The sport is full of controlling, authoritarian coaches whose recommendations to lose weight are taken very seriously by the young, impressionable athletes they instruct.