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Learn more about the results we get at Within

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What is anorexia athletica?

Many people have heard of eating disorders like bulimia nervosa (BN) or anorexia nervosa (AN), but these conditions don't always present in the same way. And sometimes, when specific symptoms manifest, it can be considered its own subset of a mental health disorder.

Anorexia athletica (AA) is one of these types of conditions. The disorder resembles many aspects of AN and is developed and driven by similar environmental, psychological, and physical factors. Still, anorexia athletica involves additional symptoms, including excessive exercising behavior to control weight or achieve a specific body shape.

Left untreated, AA can be a dangerous condition. However, learning more about the signs and symptoms of anorexia athletica can help you better recognize the condition and seek out the appropriate treatment.

5
 minutes read
Last updated on 
February 22, 2024
February 22, 2024
Anorexia athletica
In this article

Anorexia athletica definition

Unlike anorexia nervosa, there is no specific anorexia athletica definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This can make spotting—and diagnosing—the condition a tricky prospect, but, in general, AA is considered a subset of anorexia nervosa that specifically impacts athletes.1

In these cases, people utilize a severely limited food intake to lose weight, as with AN. However, people with AA also use excessive exercise to achieve a low body weight or specific lean body shape.1

On top of often struggling with factors like low self-esteem or poor body image, people struggling with AA usually believe that achieving these certain weights, shapes, or sizes will offer them an athletic advantage in their sport.1

What causes anorexia athletica?

Anorexia athletica remains a largely understudied mental illness. As such, it's difficult to pinpoint the exact causes of the condition. It's likely, as with nearly all eating disorders, that a combination of mental, physical, and environmental factors combine to create this pattern of disordered thoughts and behaviors.

Some sports pressure athletes to achieve certain body weights, shapes, or sizes more than others.2 Wrestling, ballet, and gymnastics, among others, have all been tied to these expectations.1 Some studies have found that athletes in these types of "lean body" sports had higher body shape concern scores than those in "non-lean" sports.3

Athletes struggling with AA have also been found to experience:1
  • Intense body dissatisfaction
  • An obsession about being thin for their athletic performance
  • Guilt around eating
  • Body shame

These thoughts may be learned or be connected to other conditions that commonly co-occur with many eating disorders, including anxiety and depression.4 But once someone begins utilizing excessive exercise and extreme food restriction to deal with these thoughts, it can be difficult to stop.

Unfortunately, in some cases, coaches or fellow players may encourage athletes to participate in unhealthy levels of exercise or food restriction due to cultural norms or competitive nature. Spotting excessive exercising behaviors in an athlete can also be very difficult, making it easy for someone to develop AA or struggle with the unrecognized condition for a long time.

What is anorexia athletica? Signs and symptoms

Again, there are no official criteria to define anorexia athletica, so what doctors and researchers consider signs and symptoms of the condition may vary.

Some warning signs that may indicate an issue include:5

  • Lack of energy
  • Dizziness or lightheadedness
  • Fatigue
  • Irritability
  • Increased recovery time between workouts
  • Difficulty concentrating
A fixation on exercising often leads to injury and to exercising despite injury, illness, fatigue, or prioritizing working out over other social obligations.

Anorexia athletica is also often marked by low body weight, which can result in:6

  • Menstrual cycle disruption or absence of a period
  • Osteoporosis
  • Weakened immune system
  • Dizziness
  • Anemia
  • Depression

Medical complications of anorexia athletica

Anorexia athletica can have several effects on physical and mental health.

Excessive exercise can put undue strain on the body, leading to frequent injuries. These can then bring on extreme distress if someone has to stop competing or is unable to workout in the way they prefer.

The extreme food restriction involved can also lead to malnourishment, which can bring on a host of problems, such as:7

  • Low body temperature
  • Low heart rate
  • Low blood pressure
  • Digestive system issues
  • Vitamin deficiencies
  • Soft bones

Prevalence of anorexia athletica

Again, AA has not been studied as extensively as other eating disorders, so estimates of anorexia athletica prevalence vary.

One study, which looked at pre-professional teenage ballet dancers, found that 6% of participants struggled with AA, compared to 2% of high school students. Anorexia athletica was diagnosed in 6% of the dancers compared to 2% of regular high school students.8

Another study looked at the presence of eating disorders in various sports and found that athletes participating in "aesthetic sports," such as dance, cheerleading, aerobics, gymnastics, and figure skating, had the highest rate of eating disorders overall, at 42% of participants.9

Remote treatment for anorexia athletica is available.
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Treatment for anorexia athletica

There's no eating disorder treatment specifically recommended to help with anorexia athletica. But, as with nearly all eating disorders, it's likely that a combination of mental health care, nutritional counseling, and possibly medication will be needed to overcome the condition.

Therapy

Some form of psychotherapy is nearly always used to help, as eating disorders are mental health conditions at their core. Cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), interpersonal psychotherapy (IPT), and family-based therapy (FBT) are all commonly recommended to help patients with varying conditions, including anorexia nervosa, bulimia nervosa, and binge eating disorder.

Nutritional counseling

Nutritional counseling is also nearly always utilized in eating disorders. This type of care helps patients create more positive relationships between themselves, food, eating, and their bodies, along with teaching them more appropriate and healthier eating habits.

Physical therapy

Those struggling with AA specifically may also benefit from types of physical help to soothe or heal sports-related injuries. Learning how to create a healthier relationship with exercise is also necessary.

Finding help for anorexia athletica

If you or a loved one are struggling with AA or another eating disorder, it's vital to seek out help. These conditions can be dangerous if left untreated, so it's best to seek guidance from a mental health professional.

Your primary care physician or therapist is a great place to start. These experts can help diagnose your condition or determine your next best steps.

Start your recovery today

At Within Health, we also offer help. We understand the various factors that work to develop and maintain eating disorders, and our team of multi-disciplinary experts creates tailored treatment plans to ensure each patient's specific history and needs are addressed.

Contact us today to see how you can get started.

Get help today

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Sudi, K., Ottl, K., Payerl, D., et al. (2004). Anorexia athletica. Nutrition, 20(7-8), 657-661.
  2. Kristjánsdóttir, H., Sigurðardóttir, P., Jónsdóttir, S., Þorsteinsdóttir, G., & Saavedra, J. (2019). Body Image Concern and Eating Disorder Symptoms Among Elite Icelandic Athletes. International Journal of Environmental Research and Public Health, 16(15), 2728.
  3. Wells, E. K., Chin, A. D., Tacke, J. A., & Bunn, J. A. (2015). Risk of Disordered Eating Among Division I Female College Athletes. International Journal of Exercise Science, 8(3), 256–264.
  4. Martin, J., Arostegui, I., Lorono, A., et al. (2019). Anxiety and depressive symptoms are related to core symptoms, general health outcome, and medical comorbidities in eating disorders. European Eating Disorders Review, 27(6), 603-613.
  5. Seladi-Schulman, J. (2020). What Is Anorexia Athletica? Healthline. Accessed December 2023.  
  6. Underweight. (n.d.). Office on Women’s Health. Accessed December 2023.
  7. Malnutrition. (n.d.). Cleveland Clinic. Accessed December 2023.
  8. Herbrich, L., Pfeiffer, E., Lehmkuhl, U., Schneider, N. (2011). Anorexia athletica in pre-professional ballet dancers. Journal of Sports Science, 29(11), 1115-23.
  9. Sundgot-Borgen, J., & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25–32.

FAQs

Further reading

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Further reading

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