What Drives the Connection Between Eating Disorders and Certain Sports?

Dara Torres, celebrating a record time in the 2008 U.S. Olympic trials, battled bulimia in college. (Photo: AP Photo/Mark J. Terrill)

In her 2010 book Age Is Just a Number, swimming legend Dara Torres chronicles her all-consuming battle with bulimia during college. “I was extremely dark and moody,” she writes. “Pretty much all I thought about during college was what I ate, what I wanted to eat, what other people ate, what I’d need to do to get rid of the calories I’d ingested, how much exercise I got, and how I would look in my swimsuit when I mounted the blocks.”

While Torres has now recovered from her eating disorder from college days, when she was one of the nation’s best swimmers, she is among a special group vulnerable to eating disorcers: Athletes. High-profile athletes like gymnast Shawn Johnson, swimmer Amanda Beard and tennis star Monica Seles have all come forward with histories of this type of psychological disorder, particularly damaging to young competitive athletes.

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In a 2004 study, researchers looked at the rates of EDs among athletes compared to non-athletes, and found that prevalence was higher in the more active set. Eating disorders were more common among women, and within lean- and weight-dependent sports like swimming, wrestling, gymnastics, and running. Roughly 35 percent of female athletes were high-risk for developing anorexia, and 38 percent for bulimia.

Gymnast Shawn Johnson, a silver medal winner in 2008 in Beijing, also battled an eating disorder. (Photo: AP Photo/Amy Sancetta)

Certain sports — especially Olympic favorites like swimming, gymnastics, and track — provide the perfect conditions for an ED to take hold, according to Claire Mysko, CEO of the National Eating Disorders Association (NEDA). “Participants in sports that emphasize appearance, weight requirements or muscularity, such as gymnastics, diving, dance, bodybuilding, crew or wrestling, are particularly at risk,” she tells Yahoo Beauty. “Athletes in endurance sports, and sports that focus on the performance of the individual rather than a team — track and field, running, swimming, for example — are also at increased risk.”

This was definitely the case with former Olympic gold-medalist swimmer Misty Hyman, who suffered from disordered eating during her teenage years.

“Competitive swimming can be really extreme — you’re training a lot,” Hyman said earlier this month, according to USA Today. “You do have to have a lot of calories. You do end up with shoulders that are bigger than the average woman, sometimes bigger than your guy friends… Now, I see that as something that’s beautiful and strong, and I celebrate that. When I was a teen it was very hard to separate those ideas of what femininity is, what beauty is and what my identity was in relation to that as an athlete.”

Misty Hyman, who won gold in Sydney in 2000, struggled with an eating disorder as a teen. (Photo: AP Photo/David Longstreath)

Athletes are often operating in taxed, rigid conditions to train for their sport, dealing with the can-do-anything drive to alter their nutrition and appearance for desired results — making an eating disorder easy to develop, yet trickier to track and treat. They can hide in plain sight. While extremism is often lauded in competitive sports as a mechanism to get to the top, it’s also a key reason an ED can slide past friends, family and coaches, according to Jennifer Carter, PhD, Director of Sport Psychology at the Ohio State University Wexner Medical Center and a former college swimmer.

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ED symptoms may look different in athletes than in the general population, Carter tells Yahoo Beauty. “Athletes may be more likely to try to purge calories through compulsive exercise,” she explains. “In fact, athletes who use exercise solely to burn calories or exercise outside of their team practice are often admired, when this behavior may be an eating disorder symptom.”

Athletes also may not reach body weights as low as non-athletes with EDs, since muscle weighs more than fat. “Aspects of the sports culture, like athletic injury, non-experts setting weight goals, and perfectionism can be risk factors for developing eating disorders,” Carter says.

Monica Seles, who won bronze in Olympic women’s singles tennis in 2000, has been forthcoming about her eating disorder. (Photo: AP Photo/Roberto Borea)

The descent from perfectionism into eating disorder can often be hard to notice. It’s very internally-driven for most athletes, according to Jennifer Beck, MD, a UCLA sports medicine specialist, pediatric orthopedist and former college gymnast, who has seen the devastating effects as both an athlete and a doctor.

She says it’s a combination of an athlete’s personality and the high-stakes stress of sports today. “We see a lot of competitive, obsessive-compulsive, extremist, type-A personalities out there gunning for gold,” Beck tells Yahoo Beauty. “While the drive is internal, there may be an external stimulus — like a coach pointing out a cheeseburger that athlete ‘shouldn’t have eaten.’”

According to Beck, a coach first told her parents that she needed to adjust her diet to lose weight at age eight — something her mom and dad decided not to share with her for years. And the culture of competitive sports is only getting more overbearing with each passing year. Eating disorders are beginning to take hold in younger and younger athletes.

Beck says her youngest eating disorder patient is an 11-year-old runner, suffering stress fractures rooted in overuse and malnutrition. “We’re living in an age where young athletes are getting pushed harder than ever,” she explains, “and we know we’re overtraining a lot of kids. We are just starting to see the effects of that, ranging from injuries to eating disorders.”

We need to teach coaches, parents, and other athletes do be on guard for an athlete playing through an ED, not just an injury. Mysko says it’s important to watch out for setting-specific symptoms in young athletes: decreased concentration, energy, muscle function, coordination, or speed while competing; more frequent muscle strains, sprains, or fractures from malnutrition; complaints of lightheadedness, dizziness or abdominal pain; avoidance of water or excessive water intake; preoccupation with one’s own food or what others are food eating, perhaps even teammates; and additional training above and beyond what’s required for the sport.

If you suspect an athlete is battling unhealthy fueling habits, it’s never an easy conversation — especially if they feel they’re doing well in competition, and functioning fine overall. Mysko says to voice concerns with honesty and compassion, even if they appear okay. “Talk openly with the person who is struggling with eating or body image problems earlier rather than later,” Mysko suggests. “Avoiding that conversation or ignoring issues won’t help, and early detection increases the chance for full recovery.”

Beck says many young athletes point to their accomplishments as proof they’re making healthy, decent choices. “‘I’m eating this way, and I’m still winning, so I must be fine,’” she explains of frequent pushback from athletes with EDs. “I like to address the short-term goals, but also their long-term goals. It can be hard for a teenager to think about life in 20, 30, or 40 years, but it’s in how you phrase the repercussions. You want them to see what the effects might be. For instance, ‘If you’re getting stress fractures now, this is what osteoporosis might be like later on.’”

In addition to an open dialogue about fueling up right, Beck also likes to pair struggling athletes with the a sports nutritionist and a doctor well-trained in EDs and hormone imbalances. Having a full team of support in the medical community can help athletes get on their feet again, so don’t be afraid to ask a PCP or pediatrician for more guidance on special concerns in young athletes.

Carter says that with education and the right approach, sports can also carry protective factors against EDs. “Things like increased social support and better self-esteem,” she explains, reiterating the importance of athletics on overall development. Just make sure you’re not falling victim to the classic media representation of an eating disorder.

A sufferer can be a skinny teen in baggy clothing — or a strong, successful athlete in a snug uniform. “One myth about eating disorders is that they only occur in underweight teenage girls,” Mysko says. “People of all weights, sizes, ages, and genders have eating disorders. They are biological illnesses with a strong basis in the brain, and require specialized treatment, so it’s also important to seek professional help as soon as possible.”

If you suspect that you or someone you know is suffering from an eating disorder, call the National Eating Disorders Helpline – 800.931.2237 – for resources and treatment options.

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