Athletes who compete in certain sports that emphasize weight and appearance are at especially high risk. Sports like figure skating are conducive to the development of eating disorders for numerous reasons. Many feel pressure that weight loss is needed to conform to aesthetic ideals to obtain better scores (Ziegler). It is also commonly assumed that leanness enhances performance and provides a competitive advantage from a biomechanical standpoint (Ziegler). In addition, the clothes are form fitting and all eyes are on you.
Recent studies show that in aesthetic and weight class sports, 33% of male athletes and 62% of female athletes experience disordered eating (NEDA). Additionally, in a study on the symptomology of eating disorders in Canadian competitive figure skaters, researchers found that 92.7% of the forty-one skaters surveyed reported pressure to lose weight. The skaters also indicated that in efforts to maintain the thin ideal encouraged by the sport, they engaged in various eating disorder behaviors in an attempt to control weight (Taylor & Ste-Marie).
Nourishing our bodies allows for growth and repair. Regardless of age, level, and gender, skating takes a huge toll on the body and food is critical to build up the body after breaking it down through exercise. By dieting, over-exercising, and engaging in disordered eating behaviors, athletes actually shorten their careers and are 8x more likely to get injured (Ziegler). Proper fuel and nourishment are needed to have the strength, endurance, and mental focus to execute difficult elements. As such, if someone isn't in "good enough physical shape" to be able to execute something, then it would be about strength and endurance training.
Accepting the body you have doesn't mean you stop taking care of it. It simply means getting adequate food intake, ditching perfectionism, developing a self-compassion practice, and acknowledging that the limits of the human body are not flaws, but actually here to protect us.
When we think about those affected by eating disorders, girls and young women come to mind. It is true that a large portion of those who struggle with eating disorders are women, but recent studies have unveiled that 25-40% of individuals with anorexia and bulimia are males (NEDA). Although eating disorders affect a higher proportion of males who identify as gay or bisexual than heterosexual, the majority of males with eating disorders are heterosexual. Research shows that 15% of gay or bisexual men and 5% of heterosexual men have a full or subthreshold eating disorder at some point in their lives (Feldman). Eating disorders affect people of all genders, but they are routinely characterized as a “women’s issue.”
The Rise in Eating Disorders in Young Men
Disordered eating in men is increasing at a faster rate in males than females. Eating disorders often manifest themselves differently in men, making it harder to detect by parents, coaches, teachers, and health providers who are unaware of the signs. Body dissatisfaction in males is typically characterized by a drive for muscularity rather than a drive for thinness. This preoccupation with body weight and shape leads to disordered eating and exercise practices (Walen). Studies show more than 90% of adolescent boys report exercising predominantly to increase muscle mass or tone, 66% report changing their diet to increase muscle size or tone, and 15% are using substances like anabolic steroids for the same purpose (Field et al, 2014).
Other common behaviors include excessive focus on and time spent exercising, rigidity around eating rituals, eating large amounts of food, going to the bathroom in the middle of meals or right after, refusing to eat certain food groups, obsessively reading nutrition information or counting calories, constantly weight themselves and body checking. In some cases, this can lead to steroid use or other over-the-counter supplements that “minimize body fat and increase muscle mass” (Frank).
Boys and young men with eating disorders, in particular anorexia nervosa, often exhibit low levels of testosterone and vitamin D. In addition, health consequences of eating disorders in men include damage to muscles, joints and tendons. If steroids are involved, this can cause further health problems such as testicular atrophy, decreased sperm count, high blood pressure, high cholesterol, abnormal liver function, constipation and bursts of anger. Eating disorders have the highest mortality rate of all mental illness (Frank). Men are more likely to die from an eating disorder than women due to the fact they lose weight more easily, lose body fat more quickly, and tend to be diagnosed later (if at all). Not to mention, many men with eating disorders suffer from comorbid conditions such as anxiety, depression and substance disorders (Hudson).
From 1999 to 2009, hospitalizations involving eating disorders for male patients increased by 53% (NEDA). And between 2010 and 2016 the number of men admitted to hospitals with eating disorders grew by 70% (Zhao). Because eating disorders are seen as a women’s issue, there is a lot of stigma and barriers facing these young boys and men. Men are also less likely to admit “weakness” and seek help” (Strother). Although society has made some progress in loosening the gender roles, many boys and young men feel they must maintain a tough appearance to avoid being viewed as “weak.”
It’s important we help boys understand that to fit in, they don’t need to be ultra-muscular and super-athletic. There is no need to hyper-control one’s body and the idea that you can “mold your body” into a cookie-cutter image is not realistic (Strother). It’s critical we help boys and young men understand their locust of control and value comes from interior characteristics, not exterior ones. Most kinds of power do not come from big muscles.
Currently most body image/dissatisfaction assessments tend to place emphasis on feminine ideals. As a result, there seems to be an invalid approximation of body image dissatisfaction levels in males due to the traditional focus on weight (Strother). There are few resources for males to use for support. In today’s world, men are expected to hide their vulnerabilities. Research suggests underreporting of eating disorder symptoms is a major inhibitor to diagnosis, treatment and accurate research for advancement in this area.
Athletes -
How can you combat the pressure to achieve or maintain a low body weight as a figure skater?
• Understand that successful skaters come in all shapes and sizes.
• Reassess your skating goals and intentions monthly.
• Define and communicate what “success” is to you with your coaches and support system.
• Get adequate food intake and follow the training routine assigned by your support staff.
• For pairs and dance, communicate body image concerns or fears of being “too big” with your
partner.
• Be gentle with yourself when you recognize yourself comparing your body to someone else.
What are some ways you can accept your growing and changing body as you progress through your skating career?
• Get adequate food intake
• Develop a self-compassion practice
• Ditch perfectionism (click here to learn about perfectionism)
• Remember that everyone grows at different times
• If your jumps get wobbly, practice patience as your muscle memory catches up
• Reassess your skating goals and intentions on a regular basis
• Define and communicate what "success" means to you with your coaches
Success is largely subjective. Some just want to skate for fun. Some want to be national champions and Olympians. One is not better than the other, everyone’s path is different and is deserving of respect. Regardless of level, success is distinguished by hard work and dedication to your sport. Your success is not determined by your body or your ability to keep it small.
Coaches -
What are some disordered eating behaviors to watch out for in your skaters?
• Frequent body checking (i.e., looking at reflection in the windows, adjusting clothes)
• Never removing jackets or outer layers
• Consistently skipping meals/snacks during ice cuts
• Making excuses to as of why they are not refueling
• Calluses on knuckles from inducing vomiting
• Excessive exercise beyond normal training routine or a refusal to decrease activity
• Withdrawing from normal social activities with teammates
• Leaving after snacks/meals to use the toilet
• Expression of depression, disgust, shame, or guilt about eating habits
Coaches have the unique ability to foster a culture that focuses less on body appearance and more on functionality.
Coaches can prevent disordered eating behaviors in their athletes by:
• Giving factual, performance-based reports rather than commenting on the skater’s physical
appearance.
• Focusing on the skater’s performance, rather than altering the skater’s body.
• Giving reminders that great skaters come in all shapes and sizes.
• Encouraging athletes to embrace and nourish their growing body.
• Encouraging athletes to view joyful movement as a lifetime pursuit.
To truly do no harm, we need to adopt a weight inclusive approach to figure skating, where all body sizes and shapes are accepted and respect. Explicit and implicit biases that higher weight bodies are less suitable for sports can be perpetuated by coaches' commentary, behavior, and lack of inclusive uniform options (Sabiston et al.)
It's incredibly important as a coach to work through any internalized fatphobia and continuously reevaluate whether any bias is seeping into your coaching. According to Virgie Tovar, "Fatphobia is a form of bigotry and a form of discrimination that says that people of higher weight are inferior physically, intellectually, morally and health-wise." To read about body weight, click here. Fatphobia perpetuates negative stereotypes and reinforces the false idea that there is one ideal body type for a figure skater.
What to do if you’re concerned that one of your athletes may be struggling with an eating disorder?
• Approach your athlete sensitively and in private.
• Provide evidence for your concern and the impact of their behaviors on current/future
performance.
• Express your concern for the athlete’s health and well-being.
• Make a prompt and appropriate medical referral to a healthcare specialist familiar with
treating eating disorders.
• Suggest a follow up with the athlete and/or parents in one week to confirm that they have
scheduled an appointment with a licensed professional.
What are some things to keep in mind when approaching an athlete that may be struggling with an eating disorder?
• Use “I” statements (I’m concerned about
you because __.)
• Avoid “you” statements (You look too __,
You just need to __.)
• Do not discuss changes in weight or
appearance, instead focus on the
changes in behavior, mood, and
performance. Body shape, weight, and
physique comments and comparison
from coaches have been associated
with heightened negative body image,
emotions, and maladaptive eating
behaviors (Sabiston et al.)
What are some common myths about eating disorders in figure skaters?
Disordered eating is more common in singles skaters. Disordered eating does not significantly differ by skating discipline (i.e., singles, pairs, ice dancing, synchronized; Voelker, 2012).
Skate culture is to blame. Eating disorders are multifaceted. At the same time though, of the 106 (58.6%) female sub-elite figure skaters who reported “yes” to whether they agreed with the belief that figure skating is linked to pressures to lose or maintain weight:
36.5% indicated pressures come from other skaters;
26.9% perceived that the pressures are internal;
43.3% identified coaches as an especially important source of pressure to lose or maintain weight (Voelker, 2012).
Only upper level skaters struggle. Sub-elite figure skaters are not exempt from the development of disordered eating and may face weight pressures similar to their elite counterparts (Voelker, 2012).
Restricting food intake will improve performance. Athletes that engage in disordered eating behaviors actually shorten their careers and are 8x more likely to get injured (Ziegler).
It’s obvious which athletes are struggling. There are a lot of similarities between “good athlete” traits and the symptoms of disordered eating (Ziegler).
Disordered eating only occurs in females. Eating disorders do not discriminate. 25-40% of individuals identify as male (NEDA, 2021).
Health tracking apps support wellbeing. Health tracking apps (i.e., MyFitnessPal) may contribute to eating disorder symptoms (Lindaron & Messer, 2019).
References
Dolgoff, S., & Dolgoff, S. (2021, March). Implicit Weight Bias Is a Major Problem in Our Society — And It’s Getting Worse. Good Housekeeping. https://www.goodhousekeeping.com/health/a35422452/fat-phobia/
National Eating Disorder Association. Eating Disorders and Athletes. Retrieved from https://www.nationaleatingdisorders.org/eating-disorders-athletes on April 3, 2019.
Sabiston, C. M., Lucibello, K. M., Kuzmochka-Wilks, D., Koulanova, A., Pila, E., Sandmeyer-Graves, A. & Maginn, D. (2020). What’s a coach to do? Exploring coaches’ perspectives on body image in girls sport. Psychology of Sport & Exercise: 48.
Taylor, G. & Ste-Marie, D.M. (2001). Eating disorders symptoms in Canadian female pair and dance figure skaters. International Journal of Sport Psychology, 32, 21-28
Ziegler, P.J., Khoo, C.S., Sherr, B., Nelson, J.A., Larson, W.M., & Drewnowski, A. (1998). Body image and dieting behaviors among elite figure skaters. International Journal of Eating disorders, 24, 4.
Frank, C. (n.d.). Boys and Eating Disorders. Retrieved from https://childmind.org/article/boys-and-eating-disorders/?fbclid=IwAR3SdZNUFITAKfwlsu-zeqJsv5PeS
Feldman, M., Meyer, I. (2007) “Eating disorders in diverse, lesbian, gay, and bisexual populations.” International Journal of Eating Disorders, 40-3, 218-226.
Hudson, J., Hiripi, E., Pope, H., & Kessler, R. (2007) “The prevalence and correlates of eating disorders in the national comorbidity survey replication.” Biological Psychiatry, 61, 348–358.
Strother, E., Lemberg, R., Stanford, S. C. & Tuberville, D. (2012). Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Journal of Eating Disorders: 20(5): 346-355.
Zhao, Y., Encinosa, W. Update on Hospitalizations for Eating Disorders, 1999 to 2009. HCUP Statistical Brief #120. September, 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb120.pdf
Linardon, J., & Messer, M. (2019). My fitness pal usage in men: Associations with eating disorder symptoms and psychosocial impairment. Eat Behav,33, 13-17. Levinson, C. A., Fewell, L., & Brosof, L. C. (2017). My Fitness Pal calorie tracker usage in the eating disorders. Eat Behav,27, 14-16.