"For me it was especially bad that no one noticed when I felt really bad and when I reached out for help. Later, I realised that I was hoping to get help from those people who were putting so much pressure on me and were the reason why it all started. But the signals were never heard. Today I know that I first sought help from the wrong people. Now, with the right help, I have found a good overview of myself. It's going up."

(Quote from a concerned world class athlete)

Eating disorders are a widespread topic, especially in the field of sports and competitive sports. Particularly because sport climbing is a leanness focussed sport, it is no exception. There are no percentages in the literature, but various studies at university sports clubs in the USA show that 20-40% of athletes have pathological changes in eating habits. In risk sports, there were even 50-70%. For athletes whose discipline requires a low weight for aesthetic, physiological and biomechanical reasons special caution is required. Most athletes start with restrained food or chronic dieting.

The aim of this article is to create more awareness – what an eating disorder is – in particular “anorexia athletica”, how they develop and what the consequences are from a clinical psychological perspective. Clara Rhomberg, our guest author today, is a certified clinical psychologist from Austria and passionate recreational climber. She gives us an insight into this topic. Obviously, not everyone is affected by it and by reading this, you shouldn’t get paranoid. You know how they say that all medicine students get paranoid to have all kinds of diseases when they have pathology in class? Same with psychology students when they learn about psychopathology. Well, this article definitely doesn’t aim to make you believe that you have an eating disorder. But it should create more awareness and sensitivity about this topic. We believe that not only medical doctors, clinical psychologists or psychiatrists should know about this issue, but also everyone else. There have been professional athletes suffering from eating disorders, often silently, who maybe – if even – dared to talk about it years later. Isn’t it time to openly talk about it – not years later, but now? To address this topic and acknowledge that it’s an issue, talk about prevention – and protection of athletes?

What is anorexia athletica?

In contrast to anorexia nervosa, which causes a disturbance of self-perception, the athlete's anorexia athletica is not a psychiatric illness. It is a subclinical eating disorder. The goal of "being thin" is to increase athletic performance beyond what is achievable through pure training and achieve certain athletic performance through weight reduction. The calorie intake is either reduced or the energy consumption is increased by additional training. Especially before competitions both methods are increasingly practiced. After the competition season, the eating habits often return to normal. Nevertheless, gliding over into anorexia nervosa is possible.

What are the origins of eating disorders?

In fact, there are hardly any scientific studies about this topic. However, it is assumed to have a multifactorial genesis. The psychosocial factors are based on character traits such as determination, perfectionism, obsession and self-control. These are normally characteristics typical for competitive athletes. Other factors that might play an important role in the origins of eating disorders are e.g. conscience, conventions, performance and order. In addition, conflicts are rarely openly resolved, but kept secret. Usually, modesty and grace is ritualised. In addition, there is often a lack of self-confidence, an inability to resolve conflicts or problems, or to cope with crises. An eating disorder aims to give back control.

Socioculturally, the beauty ideal "being thin" is considered important, as well as the average weight in the population. Genetic and biological factors can also increase the risk, but there also has to be a conscious reduction in diet or excessive physical activity for something to manifest.

There are several predisposing factors in sport that foster the formation of eating disorders, such (as said) certain sports that e.g. require leanness, a desired high performance level, influence of trainers or caregivers. Additionally, lack of support in losing weight, inadequate qualifications and low training levels of the trainers, thoughtless negative statements of people from the athletic environment about someone’s figure, mentally stressful events (illness, loss of the coach, problems at school, violence, sexual assault), training despite injuries or overtraining, as well as dieting and weight training at a young age.

What are the consequences of having an eating disorder such as athletica anorexia?

Eating disorders, as well as partial aspects of it, can lead to different consequences in the long run. There are various deficiency symptoms such as undersupply of carbohydrates (hypoglycaemia, brain damage to death), protein deficiency (anemia, edema), fat supply disorder (concentration disorders), potassium deficiency (cardiac arrhythmia, cardiac arrest), iron deficiency (anemia), magnesium deficiency (spasms), calcium deficiency (osteoporosis , stress fractures), as well as trace element and vitamin deficiency (fatigue, increased susceptibility to infections, lack of regeneration capacity). Likewise, hormone changes occur. This affects the sex hormones (infertility, libido and potency loss, the hormones of the adrenal cortex (cortisol deficiency – hair loss, skin lesions, mental illnesses, decrease in performance), the thyroid hormones and the autonomic nervous system (heart rate, blood pressure, body temperature low).

We should also not to forget the psychological and social consequences that affect the quality of life. People with eating disorders gradually lose their joy in life and self-confidence. Likewise, the interest in the environment decreases. The stress that is associated with these social consequences leads to irritation and withdrawal. The ability to concentrate, the efficiency and the interest in sexuality decreases. It often leads to withdrawal. Severe depression can even be the result.

Long-term consequences are mostly in the area of ​​social competence, obsessive-compulsive disorder, alcohol and drug abuse as well as in the area of ​​psychotic diseases. This requires intensive psychiatric therapy and competitive sports are no longer possible. Similarly, high costs of food and medicines can lead to financial problems.

For competitive athletes, who are already under intense emotional pressure anyway, training courses, training camps and competitions are particularly stressful. Anorectic athletes can barely hide their low intake of food.

Did you find this article helpful? If you have any more questions, leave a comment below. They will be forwarded to Clara Rhomberg.