NEDA TOOLKIT for Coaches and Trainers
The physiological impact of eating disorders on athletic
performance The physiological impact of an eating disorder is related to its severity and duration, as well as to the athlete’s
overall health, age, body stature and genetics.
Athletes are often not taught that ideal body fat levels are not a one-size-fits-all formula. The athlete’s own body
type, genetics and fitness level should all be considered. It is important to convey to athletes that a thin athlete is
not necessarily a strong athlete. In fact, too much weight loss can result in the athlete’s loss of power and strength.
An athlete suffering from an eating disorder may suffer
from the following physiological conditions:
• Fatigue
• Malnutrition
• Dehydration
• Low heart rate (bradycardia)
• Low blood pressure (orthostatic hypotension)
• Electrolyte imbalance
• Osteoporosis
• Loss of endurance
• Loss of coordination
• Loss of speed
• Muscle cramps
• Overheating
Many female athletes suffer from the Female Athlete
Triad, which is a combination of disordered eating,
absent or irregular menstrual periods and low bone
density. Inadequate food intake to fuel workouts, as
well as low body fat, is thought to be the driver of
menstrual issues. Regular menstrual periods are crucial
to the development and maintenance of adequate
bone density.
Even short-term weight loss can hurt
performance Some athletes may only engage in eating-disordered
behaviors during their competitive seasons. Even
a short period of weight loss will often result in a
decrease in water weight, and this can leave the athlete
dehydrated. When athletes in weight-class sports
restrict carbohydrate intake to make weight goals, they
may suffer a decline in strength, speed or stamina. Tell
your athletes that restricting fluid or food intake to
make weight does not optimize performance, and may
in fact hurt it.
Medical problems that can arise from specific
eating disorders
Although the following medical complaints may not all
affect athletic performance, they are further signs that
an athlete may be suffering from an eating disorder and
is in a compromised medical state.
Low resting heart rate is a frequent sign of many eating
disorders, and is frequently missed in young athletes
because physicians and other clinicians assume that the
low pulse is due to fitness rather than cardiac issues. If
a resting heart rate is less than 60 beats per minute and
there are ANY signs of an eating disorder, the athlete
could be at high risk for cardiac arrest and an eating
disorder evaluation by a qualified provider should occur
before the athlete returns to practice or competition.
Anorexia Nervosa
• Heart failure. This can be caused by slow heart rate
and low blood pressure. Those who use drugs to
stimulate vomiting, bowel movements or urination
are also at high risk for heart failure. Starvation can
also lead to heart failure, as well as brain damage.
• Brittle hair and nails; dry skin. Skin may dry out
and become yellow, and the affected person can
develop a covering of soft hair called lanugo.
• Mild anemia
• Swollen joints
• Reduced muscle mass
• Osteoporosis
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