This week (February 26 - March 3rd, 2024) is National Eating Disorder Awareness Week.
Eating disorders are serious medical, mental health conditions related to abnormal and persistent eating behaviors that negatively impact physical and mental health and ability to function in all different areas of life.
Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights, and often their root cause goes much deeper than just "food". In the United States, 28.8 million Americans will suffer from an eating disorder at some point in their lives and the average age an eating disorder starts is between 11 and 12 years old.
Unfortunately, athletes, especially aesthetic athletes are at an even higher risk of developing an eating disorder; the sport of gymnastics and eating disorders have been intertwined for decades. A 2009 study of all-sport female college athletes found that ~2% were clinically diagnosed with an eating disorder, while 25% showed disordered eating behaviors. When specifically looking at aesthetic athletes, including gymnasts, the prevalence of disordered eating behaviors almost doubled! And what's even more shocking, is that the prevalence of eating disorders and disordered eating are often significantly under-reported, meaning that even more gymnasts (upwards of 50-65%) are likely to be struggling!
While some of the most recognizable eating disorders include anorexia nervosa, bulimia, and binge eating disorder, one of the most common forms of disordered eating within the sport of gymnastics is orthorexia.
What is Orthorexia?
Orthorexia is an eating disorder that (although not formally recognized in the Diagnostic and Statistical Manual (DSM-5)) is recognized by mental health professionals, and awareness of it is rapidly increasing.
Orthorexia is defined as an obsession with “clean” or “healthy” eating.
The key phrase here is obsession. Being aware of what you are eating and being conscious about the nutritional value of your food is not usually a problem in and of itself (for most). However, the fixation and obsession with an unrealistic standard of “healthy” and “clean” eating can become problematic and can eventually lead to a major decline in performance, physical and mental health issues, and malnutrition. Orthorexia usually pertains to an obsession over the quality of the food (not the quantity, as in more commonly discussed eating disorders).
When does eating “healthy” become problematic? When does it become dangerous?
You may be thinking there is no way that eating “too healthy” could really be unhealthy, or that it could even get to the point of developing into an eating disorder. Unfortunately, it may be surprising that, not only can conscious eating morph into disordered eating behaviors, but is also extremely common in both our society as a whole and in the sport of gymnastics!
There is not a distinct line between being conscious about nutrition and an obsession with "clean" eating. It is not dangerous to focus on your nutrition and what you are fueling your body with. However, these thoughts and behaviors can become concerning when they turn into an obsession.
Often when eating disorders are discussed, we paint a stereotypical picture of someone diagnosed with anorexia nervosa or bulimia. But, these are not the only diagnosable eating disorders (and eating disorders do not have "a look ").
Healthy eating becomes more problematic when you are so concerned and worried about the food you are consuming, that it interferes with your quality of life, health, and ability to engage in daily activities, especially ones that revolve around eating. Meal time can become quite stressful and exhausting when you’re constantly worried about the nutritional quality and content of what you are consuming.
Some common tendencies or habits to be aware of that may indicate an athlete is experiencing orthorexia include:
Fixation on nutrition labels to determine whether or not a food is “acceptable”
Restricting what you can eat (think cutting out entire food groups)
Constantly thinking about and analyzing what you eat
Unable to eat at restaurants or food that is not prepared by you or a family member
Worrying about what others are eating
Not knowing how all foods can fit into an effective performance plate and fueling plan
Worried about consuming food that is not “clean” or “pure”
Worrying about food to the point that it affects your mental health and enjoyment in life
One of the tell-tale signs of Orthorexia is the restriction of certain types of foods or food groups. By cutting out entire food groups that are often portrayed as “bad” on the internet in an effort to eat “healthier” (carbs, sugar, dairy…), you could be led down a path that leads to nutrient deficiencies, neurological issues, gastrointestinal issues, cardiovascular complications, and decreased bone mineral density (AKA being at an increased risk for bone fractures). Often times, one or more types of macronutrients are often the first group of foods to be cut from normal eating habits in hopes of “eating clean.” Not eating enough macronutrients (fats, carbs, and proteins) will:
Decrease your energy levels leaving you feeling fatigued and lethargic
Increase recovery time in between practices and competitions
Make it hard to concentrate in school and at practice
Lead to nutrient deficiencies that can cause more serious health complications down the road
Additionally, eating disorders do not have to be clinically diagnosed to negatively impact your performance in sport and your life, or for you to seek out help.
Cutting out foods and food groups unnecessarily and without the support of a registered dietitian can lead to nutrition deficiencies and what began as an attempt to eat “healthier” can morph into something very dangerous and harmful. There can be a multitude of health consequences to orthorexia, including cardiovascular, neurological, gastrointestinal and endocrine consequences to any eating disorder, and that includes orthorexia.
There’s a difference between being aware and conscious of your eating habits and nutrition as a whole, and becoming fixated on every nutritional component in the food you eat. As an athlete who has higher nutrient needs, it is important to understand and recognize the warning signs of Eating Disorders and Disordered Eating and seek professional help as soon as possible.
Why Are Gymnasts At Such A High Risk For Orthorexia?
Oftentimes, this quest for "healthy eating" starts off as an innocent attempt to improve fueling habits as a means of improving performance or matching mainstream nutrition information (and misinformation spread across social media), but can quickly turn into an obsession into eating too “clean.”
As a parent (and even gymnasts), like so many others like you, you may be worried about including enough fruits and vegetables at every meal and concerned about consuming too much “processed” or pre-packaged food that are often viewed as not as nutritious or “healthy.” In an attempt to eat healthier, you may feel the need to clear out any “junk food” or high calorie, carbohydrate, or fat options from your home in order to not derail your goals of eating “healthier.”
And while this almost always starts from a place of good intentions, it is important to understand that this mindset and behavior can quickly turn obsessive and can cause more harm than good.
Orthorexic tendencies are extremely common and prevalent both across our society as a whole and especially in the world of gymnastics. But, just because many of these behaviors are common, does not make them normal and does not mean they aren’t disordered. Navigating the world of “clean” and “healthy” eating can be confusing, especially for a young person. The internet and social media is full of misleading information preaching about “good vs bad”, “clean”, “unprocessed”, and “pure” foods.
As an active, growing athlete, gymnasts have increased energy and nutrient needs in order to support activities of daily living, growth, and development in addition to the hours spent in the gym and demands of recovery. By only eating as “clean” as possible, your athlete is likely not consuming enough calories and energy to feel satisfied and energized throughout the day.
As a gymnast who is used to hearing about “perfection” all the time it can be hard to not think about having “perfect” nutrition and fueling habits. When in reality, there is no such thing as being “perfectly fueled.” It is more important to focus on consuming enough energy from all the major food groups as opposed to restriction of food. It’s important to remember that as an athlete and a growing individual, you will need more energy than you think in order to perform and feel your best. I challenge you to think about how foods make you feel and how eating is more than just fueling your body, it can also be a social activity that is supposed to be enjoyed with others - not a stressful experience! Think about how you feel after certain meals, or how you energized you felt at practice. Even if that food isn’t what someone else may consider “clean” or “100% healthy”, if it served its purpose of making you feel good and full of energy or helped you feel less fatigued the next day, it can absolutely be included in an effective fueling plan or performance plate!
Remember that all foods can fit in your daily routine, but it is important to listen to your body about what makes you feel your best.
Every parent wants success for their kids both in the classroom and in the gym, but most important is their overall health and wellbeing and that they have a positive relationship with food and nutrition. If you feel that you or your athlete have a nutritional concern, it is best to contact a Registered Dietitian who can discuss appropriate measures based on lifestyle and performance goals to ensure a safe and effective approach to help meet your goals.
If you or someone you know is struggling with disordered eating or an eating disorder, you can find more information on The National Eating Disorders Association website.
Seeing a registered dietitian or therapist may be scary or feel unnecessary, but they can help you reflect on the root cause of your behaviors and help you develop a plan to reduce and stop these intrusive habits before they develop into further disordered eating and more severe eating disorders.
NEDA has a quick and easy screening tool (appropriate for ages 13 and up) to help determine if it's time to seek professional help.