Paola Falcoski, Advanced Specialist Eating Disorders Dietitian and Sports Nutritionist, discusses the fine line between eating disorders and sports nutrition.

By Paola Falcoski

I am a specialist Eating disorder dietitian and also a Sports nutritionist. I had the pleasure to work with both nonprofessional and Olympic athletes in various modalities. I was a swimmer for most of my life until I fell in love with Triathlon (mainly Ironman). Due to my experience, I often say that there is a fine line between Eating Disorders and Sports nutrition – do you know why?

Because the nature of sports nutrition is being very prescriptive, very rigid, based on numbers and so the ED behaviours… one (possibly) feeding into the other…

Individuals with a pressure to win (in a professional or nonprofessional level) will do ANYTHING to achieve their goals – including being sometimes on a very restrictive diet/regimen if they believe or are told that this will help increase their performance. Not to mention that in some sports where body/shape and weight are emphasised, this can be another contributing factor to physical and psychological stress.

Of course nutrition is of great importance in sports and without a proper food intake for energy and recovery, performance can definitely be impacted. However, athletes have up to 58%1 increased chance of developing an Eating Disorder than non-athletes. Not to count those who present what we call disordered eating which means they present with some eating disorders behaviours but do not meet criteria for ED. This doesn’t mean however that the case is less complex. One study with females has shown that 42% had disordered eating and they are 8 x more likely to incur injury3. In another one, 26% of women reported having menstrual dysfunction3.

Some of the eating disorder behaviours frequently seen in athletes include – fear of eating anything out of their meal plan, having the idea of good and bad foods, restricting their intake in order to lose weight (expecting to be beneficial to performance), fear of gaining weight, not being able to eat socially, body and shape concerns – to name a few.

Some risk factors are – individual sports (versus team sports), endurance sports, overvalued belief that the thinner they are the faster they will be, overly competitive environment and mental health in general (anxiety, low mood, for example).

So the biggest question is – when does it get obsessive or even pathological?

There is no straight forward answer but there are some red flags to note:

How is your quality of life?
Are you able to relax on weekends/ holidays/ off season?
Are you able to eat out without thinking about calories?
Do you feel guilty after eating?
Do you feel the need to compensate (i.e. exercising more or harder) if you have eaten something that was not planned?
Do you fear eating specific foods?
Are you able to eat the same food as your friends/family? i.e pizza when going to a pizzeria OR having a birthday cake

As parents, coaches, clinicians we need to keep in mind these red flags. It can be of great importance in order to identify a possible eating disorder early on. And if this is the case - to GET HELP before things get worse.

As dieticians we need to help clients to have a good relationship with food and body, we need to ensure they have adequate intake, we need to help them to be aware of their body signs but ultimately we need to ensure they are safe.