Going thin for the gold

Elite athletes more likely to have eating disorders
than regular mortals. Women bear the brunt

By Vincent del Castillo

Cases like tennis player Greg Rusedski's recent positive test for steroids have dominated sporting scandals of late. Another, lower profile but equally hazardous risk to athletes' health, eating disorders, continues to plague the world of elite athletics. The issue first burst into the public consciousness when Nadia Comaneci, the first gymnast to achieve a perfect score, revealed in the 90s that she had suffered from anorexia and bulimia for 15 years. Then in 1994, the sporting world was shocked by the death of US gymnast Christy Henrich from anorexia.

It's well established that athletes are at an increased risk of developing some form of eating disorder (ED), particularly women in weight-dependent sports like gymnastics and figure skating. Monitoring athletes to prevent EDs has always been a difficult task -- secrecy is an anorexic's watchword; the desire to stay on the team can lead athletes to lie in questionnaires about their eating habits.

A new study published in the January issue of the Clinical Journal of Sports Medicine has confirmed that the incidence of ED among elite athletes is indeed higher than within the general public.

Researchers tested all of the 1,620 male and female Norwegian elite athletes competing in national championships against 1,696 members of the general population. Research consisted of two phases: first, screening was done by questionnaire to identify all at-risk athletes and non-athletes. A representative sample of healthy athletes and non-athletes was selected as controls. In the second phase, a clinical analysis was conducted on both groups, seeking to diagnose ED as defined in the Diagnostic and Statistical Manual of Mental Disorders - IV.

The results showed that 13.5% of athletes suffered symptoms of ED compared to 4.6% of the general population. Grouped by gender and sports classification, the study showed the highest incidence of ED in female athletes competing in aesthetic sports like gymnastics and synchronized swimming (42%). Not surprisingly perhaps, among men, those competing in high jump, pole jump and long jump were most at risk (22%).

The authors stressed that physicians, coaches, athletes and their families are all responsible for fighting EDs and that concerted effort and education yields the best results in recognizing, preventing and treating EDs in athletes. But considering the obstacles, this may not always be practical. Said one Olympic athlete, David Allardice, a member of the British Speed Skating team: "There was a girl on our team who was thought to be at risk and was being monitored for anorexia. The coach told everyone on the team to be on the lookout, but I didn't really feel comfortable interfering. I feel that it's a personal thing, and not really my business."