Eating disorders are complex mental health conditions, including anorexia nervosa, bulimia nervosa, binge-eating disorder, and others, characterized by abnormal eating behaviors and distorted body image. These disorders can have serious physical and psychological consequences, requiring a multidisciplinary approach for treatment, which includes mental health professionals, nutritionists, and support systems, especially in the context of sports. Early intervention and comprehensive care are crucial for the recovery and well-being of individuals, particularly athletes, who may face unique pressures related to performance and body image.

2.  Eating disorders are complex mental health
conditions characterized by abnormal eating
behaviors, distorted body image, and obsessive
thoughts about food, weight, and shape.
 There are several types of eating disorders, each with
its own unique features and diagnostic criteria. The
main types of eating disorders include:

3. TYPES

4. • Anorexia Nervosa:
i. Anorexia nervosa is characterized by an extreme
fear of gaining weight and a distorted perception of
body weight and shape.
ii. Individuals with anorexia often restrict their food
intake severely, leading to significant weight loss and
malnutrition.
iii. Other symptoms may include excessive exercise,
obsessive calorie counting, and a preoccupation with
food and body image.

5. • Bulimia Nervosa:
i. Bulimia nervosa involves recurrent episodes of binge
eating followed by compensatory behaviors to
prevent weight gain, such as self-induced vomiting,
laxative or diuretic abuse, fasting, or excessive
exercise.
ii. Individuals with bulimia may experience feelings of
guilt, shame, and loss of control during binge-eating
episodes, followed by relief or satisfaction after
purging.

6. • Binge-Eating Disorder (BED):
i. Binge-eating disorder is characterized by recurrent
episodes of binge eating without the use of
compensatory behaviors.
ii. Individuals with BED may consume large amounts of
food in a short period, often feeling a loss of control
during binge-eating episodes.
iii. Binge eating may be triggered by emotional distress,
boredom, or negative body image.
iv. Unlike bulimia, individuals with BED do not engage
in regular purging behaviors.

7. • Other Specified Feeding or Eating Disorder
(OSFED):
i. OSFED, formerly known as Eating Disorder Not
Otherwise Specified (EDNOS), encompasses a
range of eating disorder symptoms that do not meet
the full criteria for anorexia nervosa, bulimia nervosa,
or binge-eating disorder.
ii. Examples of OSFED include atypical anorexia
nervosa (where individuals meet all criteria for
anorexia nervosa except for low body weight),
purging disorder (regular use of purging behaviors
without binge eating), and night eating syndrome
(consuming a large portion of daily food intake during
nighttime hours).

8. • Avoidant/Restrictive Food Intake Disorder
(ARFID):
i. ARFID is characterized by a persistent avoidance or
restriction of food intake, leading to inadequate
nutrition and weight loss or failure to gain weight in
children.
ii. Unlike anorexia nervosa, individuals with ARFID do
not necessarily have body image concerns or a
desire to lose weight.
iii. ARFID may be associated with sensory sensitivities,
fear of choking or vomiting, or other psychological
factors that impair eating.

9.  These are the main types of eating disorders
recognized in the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5).
 It's important to note that eating disorders can have
serious physical and psychological consequences
and require professional evaluation and treatment by
mental health professionals, including therapists,
psychiatrists, and registered dietitians, to address
both the underlying psychological factors and the
physical health implications of the disorder.
 Early intervention and comprehensive,
multidisciplinary care are essential for supporting
individuals with eating disorders on their journey to
recovery.

10. TYPES (Sports
related)

11. • Anorexia Athletica (Excessive Exercise Bulimia):
i. Anorexia athletica, also known as excessive exercise
bulimia, involves an obsessive focus on exercise and
physical activity, often coupled with restrictive eating
habits.
ii. Athletes with anorexia athletica may engage in
compulsive exercise routines, excessive training,
and calorie restriction to achieve or maintain a low
body weight or specific body composition for their
sport.

12. • Muscle Dysmorphia (Bigorexia):
i. Muscle dysmorphia, sometimes referred to as
bigorexia or reverse anorexia, is a subtype of body
dysmorphic disorder characterized by an obsession
with muscularity and a distorted perception of one's
body size and shape.
ii. Athletes, particularly those involved in sports
emphasizing strength and physique, such as
bodybuilding, weightlifting, and certain combat
sports, may develop muscle dysmorphia and engage
in excessive exercise and dietary practices to
increase muscle mass and achieve an idealized
muscular physique.

13. • Weight-Cutting Practices:
i. In sports with weight classes or aesthetic ideals,
such as wrestling, boxing, martial arts, gymnastics,
and bodybuilding, athletes may engage in extreme
weight-cutting practices to meet weight requirements
or achieve a desired appearance for competition.
ii. These practices may include rapid weight loss
through dehydration, starvation, excessive exercise,
or the use of diuretics and laxatives, which can have
detrimental effects on both physical and mental
health.

14. • Disordered Eating in Endurance Sports:
i. Athletes participating in endurance sports, such as
running, cycling, swimming, and triathlon, may be at
increased risk of developing disordered eating
patterns due to the high energy demands of training
and competition.
ii. Endurance athletes may experience pressure to
achieve a lean physique or optimize performance by
restricting food intake, manipulating macronutrient
ratios, or engaging in purging behaviors, such as
self-induced vomiting or excessive exercise.

15. • Performance-Enhancing Substance Use:
i. In addition to disordered eating behaviors, some
athletes may resort to using performance-enhancing
substances, such as anabolic steroids, stimulants, or
appetite suppressants, to enhance athletic
performance, control weight, or alter body
composition.
ii. Substance use can exacerbate the risk of developing
eating disorders and have serious health
consequences.

16.  It's important to recognize that eating disorders in
sports are often driven by a combination of factors,
including societal pressures, sport-specific demands,
perfectionism, and psychological stressors.
 Addressing eating disorders in athletes requires a
comprehensive approach that involves collaboration
between sports medicine professionals, coaches,
sports psychologists, and other members of the
athlete's support team.

17.  Early identification, education, supportive
interventions, and access to specialized treatment are
essential for promoting the health and well-being of
athletes and preventing the onset or progression of
eating disorders in the sporting population.

18. ADRESSING
DISORDERS

19.  Eating disorders are serious mental health conditions
that can affect athletes in various sports.
 In sports psychology and sports physiotherapy,
addressing eating disorders requires a
multidisciplinary approach involving collaboration
between mental health professionals, sports medicine
practitioners, coaches, and other members of the
athlete's support team.
 Here's how eating disorders are addressed in sports
psychology and sports physiotherapy:

20. • Education and Awareness:
i. Sports physiotherapists and sports psychologists
play a crucial role in raising awareness about the
prevalence, signs, and consequences of eating
disorders among athletes.
ii. Education sessions and workshops can help
athletes, coaches, and support staff recognize the
warning signs of disordered eating behaviors and
understand the importance of early intervention.

21. • Screening and Assessment:
i. Sports physiotherapists may conduct screenings or
assessments to identify athletes at risk for or
experiencing eating disorders.
ii. This may involve asking athletes about their eating
habits, body image concerns, weight fluctuations,
and history of disordered eating behaviors.
iii. Referrals to mental health professionals or
specialized eating disorder treatment centers may be
necessary for comprehensive assessment and
diagnosis.

22. • Psychoeducation and Counseling:
i. Sports psychologists and mental health
professionals can provide psychoeducation to
athletes about the psychological factors underlying
eating disorders, such as body image dissatisfaction,
perfectionism, and low self-esteem.
ii. Counseling sessions may focus on exploring the
emotional triggers and maintaining factors
contributing to disordered eating behaviors, as well
as developing coping strategies and healthier ways
of managing stress and emotions.

23. • Nutritional Counseling:
i. Registered dietitians or nutritionists may collaborate
with sports physiotherapists and sports psychologists
to provide individualized nutritional counseling to
athletes with eating disorders.
ii. This may involve addressing myths and
misconceptions about nutrition, establishing
balanced meal plans, and promoting intuitive eating
practices to restore a healthy relationship with food
and nourish the body for optimal performance and
recovery.

24. • Behavior Modification and Cognitive
Restructuring:
i. Cognitive-behavioral techniques, such as cognitive
restructuring and behavior modification, may be used
to challenge distorted thoughts and beliefs about
food, weight, and body image.
ii. Sports psychologists can help athletes develop more
adaptive coping strategies, challenge negative self-
talk, and build self-esteem and resilience to
counteract the psychological effects of eating
disorders.

25. • Collaborative Care and Support:
i. Collaboration between sports physiotherapists,
sports psychologists, coaches, and other members
of the athlete's support team is essential for
providing comprehensive care and support to
athletes with eating disorders.
ii. Regular communication and coordination of care
ensure that athletes receive holistic treatment
addressing both the physical and psychological
aspects of their condition.

26. • Long-Term Monitoring and Follow-Up:
i. Eating disorder recovery is often a long-term process
requiring ongoing monitoring, support, and follow-up
care.
ii. Sports physiotherapists and sports psychologists can
work together to develop relapse prevention
strategies, monitor athletes' progress, and provide
continued support as they navigate their recovery
journey and return to sport.

27.  By addressing eating disorders in sports psychology
and sports physiotherapy, practitioners can help
athletes overcome their struggles with disordered
eating, restore their physical and psychological
health, and cultivate a positive and balanced
relationship with food, body, and sport.
 Early intervention, comprehensive assessment, and
multidisciplinary collaboration are key to supporting
athletes' recovery and promoting their overall well-
being.

28. THANK YOU!