Body image and eating disturbances among adolescents 1

This is the first in a 3 part series on the subject of body image and eating disturbances which affects a number of young sports people.

Young people are constantly bombarded with messages and images of the ideal body. This ideal body is often portrayed as unrealistically thin or overly muscular. In contrast to this ideal body, our youth’s average weight is increasing. Adolescent athletes represent a group that strive towards an “ideal” of physical perfection. Not all athletes have a body that fits into the “ideal” body type which cause them to experience pressure to achieve the “ideal” body type for their sport. This contrast is a major contributing factor to a body image distortion and dissatisfaction. The dissatisfaction can lead to unhealthy eating patterns and dieting behaviour with health consequences and a possible eating disorder. The risk of disordered eating is likely to be present in athletes competing in sports that emphasize a thin body size or small body shape and in sports that utilise weight categories. Pressure from coaches to lose weight, frequent weight cycling, early start of sport-specific training, overtraining, injury and irresponsible coaching behaviour may be risk factors for the development of disordered eating.


Disordered Eating

Disordered eating is a general term used to describe a wide range of abnormal and harmful eating behaviours that sufferers use to try to lose weight or maintain an abnormally low body weight. Body dissatisfaction and body distortion are strong predictors of both mild and severe eating disturbances. Eating disturbances include a number of behaviours as follow:

  • Unhealthy eating behaviours including skipping of meals and consuming large amounts of foods high in fats
  • Unhealthy dieting including extreme energy restriction and the inappropriate use of meal supplements
  • Engagement in anorexic and/or bulimic behaviours including self-induced vomiting, the use of laxatives and diet pills and cycles of binge eating and dieting
  • Clinical eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder
  • Obesity which can increase the risk of a later eating disorder

Eating Disorders

Eating disorders reflect a combination of biological, psychological, social and environmental factors. It leads to chronic malnutrition, starvation and, in some cases, death. Immediate consequences of eating disorders are fatigue, decreased academic performance and impaired growth and development due to the low intake of important nutrients, e.g. calcium and iron.

Anorexia Nervosa

Adolescents and children with anorexia nervosa have a marked fear of gaining weight or becoming fat, even though they are below their normal weight. Their self-esteem is dependent on their weight and shape and they often describe themselves as fat. They often deny the seriousness of their current low body weight. Their eating behaviour often includes restriction of energy intake or episodes of binge eating and purging.




Weight 15% lower than minimum average for weight Excessive loss of weight
Self-starvation Feel fat even when thinner than other athletes
Obsessive fear of weight gain Often lie to family and friends about what they have eaten
Feeling fat when thin Constantly think about weight loss and food
Low self-esteem Periods have stopped, or never started
Social withdrawal Frequent weighing
Distorted body image Difficulty sleeping
Obsessive exercise Layer of soft hair over the body


Bulimia Nervosa

Individuals with bulimia nervosa also have a self-esteem closely tied to body weight and shape. Bulimia, although, is characterized by binge eating followed by compensatory behaviour including purging, self-induced vomiting, misuse of laxatives, diuretics and other medications or engaging in excessive exercise in order to prevent weight gain. Individuals feel a sense of loss of control over eating and recognize the behaviour as abnormal.




Bingeing on large amounts of food Regularly suffers from sore throats and experience infections
Guilt and remorse after bingeing Face appears puffy or swollen
Purging Periods are irregular
Starvation Obsessed with losing eight
Excessive exercise Self-induced vomiting after meals or taking laxatives to lose weight
Distorted body image Eating in secret, lying to family and friends about eating habits
Obsession with food and weight Emotional and depressed, mood swings


Binge-eating Disorder

Binge-eating disorder is characterized by compulsive eating with purging associated with bulimia nervosa. A binge-eating episode is characterized by eating a large amount of food in a short period of time. The episodes is often isolated and accompanied by a sense of lack of control during the episode of binge-eating. The disorder is associated with weight-related issues and obesity. Childhood obesity and negative comments about shape, weight and eating behaviour are more common amongst individuals with binge-eating disorders. Children with a personal or family history of obesity combined with adverse childhood experiences and risk factors for mood disorders or depression are at risk for developing binge-eating problems.


Next time we will focus on the causes and effects of eating disorders in young athletes

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