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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 Page  | 18