- disordered self-body image (mostly females)
- low self-esteem
- obsessive-compulsive behavior
- preoccupation with bodyweight
- excessive exercising
Anorexia athletica typically occurs in young female athletes (e.g., gymnasts, dancers, figure skaters, bodybuilders, wrestlers, divers, etc.) in which body image is very important. This disorder is characterized by fasting, vomiting, excessive use of diet pills, laxatives, diuretics, and/or compulsive over-exercise. Treatment options include group therapy, medical treatment, self-help programs, nutrition counseling, and/or exercise programs.
Anorexia nervosa occurs mostly in females and is primarily characterized by an underweight bodyweight (i.e., body mass index (BMI) less than 18.5 or a bodyweight less than 85% of a healthy bodyweight). Those with anorexia have a distorted view of their body and think of themselves as being overweight. Other characteristics include: amenorrhea (absence of three menstrual cycles); ritualistic diet regimen (eating extremely small food portions); obsessive body weighing; excessive exercising; laxative, diuretic or enema misuse; binging and purging; chronic restriction of food intake; and/or low self-esteem. Those with anorexia nervosa feel they have control of their behavior but in reality do not.
Bulimia nervosa also occurs mostly in females and is more common than anorexia nervosa. This eating disorder is primarily characterized by binging and purging behavior (twice per week for three months), tooth decay (worn away tooth enamel caused by the acidity of vomiting) and gum disease. Those with bulimia are usually not underweight (i.e., BMI greater than 18.5). Other characteristics include: oligomenorrhea (irregular mensus); excessive use of diet pills, laxatives, diuretics, and/or enemas; fasting; emotional eating; drug abuse; excessive exercise; malnutrition; low self-esteem; depression; and/or anxiety. Those with bulimia nervosa feel they lack control of their behavior.
Muscle dysmorphia typically occurs in males and is exhibited by what is referred to as "adonis complex" behavior. Characteristics include frequent body weighing, body obsession, wearing baggy clothes (to conceal the body out of insecurity), strict diet and exercise regimen, self-conscious behavior, supplement abuse (e.g., steroids), and/or low self-esteem.
Binge-eating disorder is the most common eating disorder and is characterized by binging behavior without purging. Other characteristics include emotional distress, rapid eating, and drug abuse. Those with this eating disorder are usually overweight (BMI greater than 25) or obese (BMI greater than 30) and feel they lack control of their behavior.
The health consequences of having an eating disorder include the following:
- electrolyte imbalances
- muscle cramping
- cardiac abnormalities
- impaired kidney function
- decreased bone mineral density (increased osteoporotic fracture risk)
- gastro-intestinal dysfunction
- reduced basal metabolic rate (BMR)
- dry, scaly skin
- thin, dry hair
- decreased blood pressure
- reduced resting heart rate
Fitness professionals need to be on the lookout for the following possible indicators in their clients that may be a sign of having an eating disorder:
- social isolation
- preoccupation with food
- higher incidence of sprains or fractures
- overly concerned about how their body appears
- light-headed or dizzy
- very impatient
- erratic mood swings
- little or excessive water intake
- increased sense of perfectionism
Wade, T.D., Keski-Rahkonen, A., and Hudson, J (2011). Epidemiology of Eating Disorders: Textbook in Psychiatric Epidemiology (3rd ed.). New York, N.Y.: Wiley.
Brian Danley, CFT
"Motivation is what gets you started. Habit is what keeps you going."