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Warning Signs of Anorexia and Bulimia

Disordered Eating May Indicate Presence of Female Athlete Triad

Athletes at Risk

Though seen in all sports, those at greatest risk of anorexia, bulimia and other eating disorders are those:

  • Playing single sport on a year-round basis;
  • Playing endurance sports (long distance running, swimming, cross-country skiing);
  • Engaged in sports demanding a thin physical appearance (gymnastics, ice skating, ballet dancing, diving);
  • Participating in sports with weight classifications (martial arts, rowing, wrestling);
  • Whose parents are perfectionists and put too much pressure on their athletic daughters to succeed no matter what the cost.


  1. Balanced Diet. First, and foremost, a proper balance of exercise, body weight, calcium intake, Vitamin D (400 IU's daily) and estrogen is critical. If necessary, you should take your daughter to a dietician or nutritionist who works with adolescent athletes.
  2. Screening. To screen for anorexia and bulemia, make sure your daughter undergo a pre-participation physical evaluation. It is essential that, in taking the medical history, your daughter's pediatrician asks questions about nutrition, menstruation, evidence of bone mineral loss (stress fractures; Dual Energy X-Ray Absorptiometry scan), and body image . Because athletes tend to be more honest about menstrual history and are typically dishonest about eating patterns, an abnormal menstrual history is a red flag for eating disorders and psychological issues (this is why your daughter should keep track of her periods).
  3. No Pressure. As a parent you should avoid pressuring your daughter to achieve an unrealistically low body weight, such as by comments about appearance, good or bad foods, dieting and nutrition (this advice holds true for your sons as well, particularly swimmers and wrestlers) You should be wary of coaches who conduct out-of-competition weigh ins or measurement of body fat, especially public ones which can highlight for teenage girls the already sensitive issue of their weight (one prominent Southern California swim club that counts among its alumni numerous Olympic gold medal winners labeled members with what it deemed too high a body fat ratio as members of the "Blub Club"). One eating disorder specialist theorizes that a relationship exists between eating disorders and girls going through the natural separation in adolescence of girls from their fathers because they are particularly vulnerable during this time to viewing their coach as a substitute father figure. Because girls tend to internalize criticism more than boys, if the coach is critical of her weight, he or she can have a negative effect on a female athlete's self-esteem.
  4. No Secrets. If you suspect that your daughter exhibits symptoms of an eating disorder such as anorexia, let her know that you want to help but that you can't keep the matter a secret, nor can you solve the problem on your own. If she is found to have disordered eating, experts recommend a multidisciplinary treatment approach (doctor, nutritionist, mental health professional).

Above all, be patient. Don't engage your daughter in a test of wills.

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