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Athletes and anorexia: counting the cost of life in the fast lane

   

The Times, February 21, 2012

Peta Bee

With the London Olympics less than six months away, you might expect British team hopefuls to be honing their bodies like finely tuned machines, replenishing them with fuel and rest when they have pushed them to the limit. Yet, for many, the veneer of supreme athleticism belies a struggle to subsist on a calorie intake that is barely enough to keep them alive. Such is the concern that the UK’s first clinic dedicated to treating athletes with anorexia and bulimia, the National Centre for Eating Disorders in Sport, has opened at Loughborough University.


Dr Huw Goodwin, the clinic’s co-ordinator, says that it will provide crucial day care and residential support for athletes whose careers are threatened by a spiral into the binge, purge and starvation cycles of anorexia and bulimia. Once referred to non-specialist centres within the NHS, they will now get specialist treatment at Loughborough that will take into account the demands and requirements of their training. “Often we find that it is those who have not reached their full potential who get these problems,” Goodwin says. “It’s the athletes who might become tomorrow’s medallists, those trying to make the team, who are most likely to suffer. But it can also become a problem when athletes get injured. It can happen at all levels and in all sports.”


Liz McColgan, a former British track star who now coaches a group of young female athletes, says that the Loughborough centre is overdue. “It’s an issue that has really needed addressing for a long time,” she says.


“So many athletes — and I’m talking men and women — think that they need to be a certain weight and look a certain way to get to the top. They lose perspective.”


About 1 to 2 per cent of people are thought to suffer from an eating disorder, but the prevalence is much higher within the bubble of elite sport. Research suggests that up to 50 per cent of top sportspeople could be suffering from either anorexia or bulimia, and are bingeing, purging or avoiding calories while pushing themselves to exhaustion in intense training programmes.


One study by psychologists at the University of Leeds, published in Psychology of Sport and Exercise three years ago, claimed that one athlete in five of Britain’s leading female runners had an eating disorder at the time of the study or had suffered from one in the past. The authors suggested that the true number might be higher because most sufferers are notoriously secretive about their difficulties.


Male athletes suffer too. In his autobiography, Colin Jackson, the former hurdler, admitted that he starved himself before the 1993 World Championships — although he took the gold medal (and broke the world record) in the 110m hurdles. “I was really frail,” he says. “I was definitely bordering on anorexia.”


Even Carl Lewis, the American Olympian who won ten medals (nine of them gold), has said that he was “hardly eating” at the high point of his career. “Technically speaking I had an eating disorder,” he said in an interview. “I created this disorder because I thought I needed to do that to keep my weight down.”


Dr Jon Arcleus, the clinical director at the Loughborough centre, says that no one sport triggers an eating disorder. However, few are immune. Boxers, rowers and jockeys often go to extreme lengths to meet required weights for competition. Tennis players, cyclists and swimmers are also known to suffer from eating disorders, possibly because of the pressure for top competitors to look good to gain the sponsorship and advertising deals that fund their careers.


Others eat less because being lean can help their performance. “There will always be a higher prevalence in distance running and gymnastics where, to a point, low body weight aids performance,” Goodwin says.


“Being overweight is a limiting factor as the body is forced to supply oxygen to fuel surplus fatty tissue.”


Lose some weight and oxygen goes instead to the working muscles, allowing the athlete to move faster and more efficiently.


But it is easy to overstep the mark. “They get into the mindset where they believe that more weight loss means even better performances,” Goodwin says. “But there is a fine line between being an optimum weight and dropping to a level where it begins to affect performance adversely.”


Athletes have spoken of a shocking culture of dietary practices, such as the use of laxatives and of eating paper or cotton-wool balls to promote satiety without ingesting calories.


Horror stories have included an athletics coach who allegedly insisted on weekly group weigh-ins for his young charges before forcing the heaviest to wear a pig mask during training, and a top sports club that charted players’ body fat percentages and weight on a whiteboard in the canteen to serve as a deterrent to overeating.


Often, though, it is comments by coaches that tip the balance. The Loughborough team recently looked at the effect of critical comments on a group of dancers. Those who had been criticised most about the way that they looked or performed were more likely to be suffering from an eating disorder.


Naomi Cavaday, one of Britain’s most promising young tennis players, retired last year aged 22 after a long-term battle with bulimia. She has said that critical comments about her weight and body shape began when she was just 11.


And while McColgan says that she never suffered a full-blown eating disorder, she “touched the base of anorexia” in 1988 after her coach at the time told her that she needed to lose a few pounds to run faster.


“I cut down on what I ate and went into the Seoul Olympics way too light and undernourished,” she says. “My performance suffered because I didn’t have the energy to sprint for the line. I should have won gold in the 10,000m, but I got the silver medal instead.”


But how are athletes able to continue training and performing in extreme calorie debt? Dr Arcleus says that the body is “amazingly adept at coping with short-term food deprivation” even when coupled with intense activity levels, but that it will eventually break down in some way.


“Over time, an inadequate dietary intake will take its toll,” he says. “Lose too much weight and you start to lose muscle mass, which leaves you too weak to train. All body systems are compromised, leaving the athletes prone to fractures, infections and other problems.”


In female athletes whose body fat drops below the level needed to support an unborn child, amenorrhoea, (the cessation of periods) is common. “This causes a drop in levels of oestrogen, the hormone that protects bones,” Arcleus says. “As a result, they become vulnerable to stress fractures and, the longer it goes on, to osteoporosis.”


Disturbingly, many female athletes view their periods as a sign that they are not training hard enough. “They start to eat less and train harder,” he says. “That is when they need guidance.” But eating disorders will always exist within sport to some extent. “Athletes exhibit a lot of traits that are associated with eating disorders,” Goodwin says.


“They are high achievers, they exercise excessively and they control what they eat. That’s fine when it’s within healthy limits, but a concern when it’s not.”


The team at the Loughborough centre hopes to help athletes before they fall too far into the abyss.





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