Identifying and Treating Bulimia in Athletes Menu Verywell Fit Nutrition Weight Management Nutrition Facts Nutrition Basics Diets Meal Plans Meal Delivery Services View All News Fitness and Nutrition What to Buy How We Test Products Fitness Gear Nutrition Products Tools Recipe Nutrition Calculator Weight Loss Calorie Goal BMI Calculator Body Fat Percentage Calculator Calories Burned by Activity Daily Calories Burned Pace Calculator About Us Editorial Process Meet Our Review Board Search Sports Nutrition Athletes and Eating Disorders Even Healthy Athletes May Binge and Purge By Elizabeth Quinn Elizabeth Quinn Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. Learn about our editorial process Updated on November 17, 2020 Medically reviewed Verywell Fit articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Rachel Goldman, PhD, FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in weight management and eating behaviors. Learn about our Medical Review Board Print Getty Images / franckreporter Athletes face tremendous pressure to excel and many feel pressure to achieve a certain body shape or weight that they see in the media or in fitness magazines. Athletes who compete in sports that emphasize appearance, agility, or speed (gymnastics, running, wrestling, figure skating, dance, or horse racing) are often more prone to developing an eating disorder than are non-athletes or athletes in sports that require muscle mass and bulk (football, powerlifting, skiing). When an athlete goes to unhealthy extremes to achieve a particular and unnatural body shape and weight, they risk developing both physical and psychological health issues, including eating disorders. Bulimia is one such eating disorder that describes a cycle of binging and purging. Bulimia can begin when restrictive diets fail, or the feeling of hunger associated with reduced calorie intake leads to binge eating. In response to the binge, an athlete may feel guilty and purge by vomiting or taking laxatives, diet pills, drugs, or excessive training to reduce fluids. Athletes may alternate between periods of binging and calorie restriction or compulsive exercise in order to lose weight. Here's What Experts Have to Say About Low-Calorie Diets Patients diagnosed with bulimia average about 14 episodes per week. In general, people with bulimia have a normal to high-normal body weight, but it may fluctuate by more than 10 pounds because of the binge-purge cycle. The real threat to an athlete with an eating disorder is the extreme stress placed upon the body. The very practice of self-starvation, purging or obsessive exercise has a detrimental effect on performance. The process of binging and purging results in loss of fluid and low potassium levels, which can cause extreme weakness, as well as dangerous and sometimes lethal heart rhythms. This can be especially dangerous for athletes. Health Complications of Bulimia Laceration of the oral cavity (injury due to self-induced vomiting) Esophageal inflammation (acid from vomiting irritates the esophagus) Esophageal tears and ruptures (force from vomiting may cause the tears in the esophagus) Dental erosion (acid from vomiting erodes the dental enamel) Malnutrition. Abnormal heart rhythms (arrhythmias and bradycardia) Low Blood Pressure. Dehydration Electrolyte Imbalances Amenorrhea (interruption of the menstrual cycle) Signs and Symptoms of Bulimia Identifying athletes with an eating disorder is not easy. They are often secretive or blame their eating and exercise regimen on their training goals. More patients are identified by perceptive coaches, teammates, friends or family members who notice an athlete losing weight, exercising beyond their normal training regimen, or becoming overly preoccupied with food and weight. Some warning signs: Excessive weight loss or gainBeing overly concerned with one's weightVisiting the bathroom after mealsDepressionExcessive dieting, followed by binge eatingAlways criticizing one's bodySecretive eatingNot wanting to socialize when there is food aroundMakes excuses to not eat when others are eating The Female Athlete Triad Women athletes with eating disorders often fit into a condition called the female athlete triad, a combination of: Low energy availabilityMenstrual irregularitiesWeak bones (increased risk of stress fractures and osteoporosis) This attempt to reduce body fat by extreme measures not only leads to decreased exercise performance but also it can lead to severe health complications. Nutrient deficiencies and fluid/electrolyte imbalance from low food intake can lead to increased risk of fractures, illness, loss of reproductive function and serious medical conditions such as dehydration, and starvation. The medical complications of this triad involve almost every body function and include the cardiovascular, endocrine, reproductive, skeletal, gastrointestinal, renal, and central nervous systems. Getting Treatment for an Eating Disorder Eating disorders in an athlete are serious and can become life-threatening if left untreated. Bulimia is a serious health concern that often requires professional help to overcome. If you think you or a loved one is struggling with an eating disorder, speak to your healthcare professional. Your provider can help to identifying the type of eating disorder, but more importantly direct you towards the resources that can help you or your loved one find balance and wellness. Which Athletes are at Greatest Risk of Eating Disorders? Sources Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED), 2005. Eating Disorders - Patient Information. National Association of Anorexia Nervosa and Associated Disorders. By Elizabeth Quinn Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Related Articles Risks of Eating Disorders in Athletes How Disordered Eating and Eating Disorders Differ and What You Need You Need to Know Do I Really Need Electrolyte Drinks? Should Female Athletes Worry About Amenorrhea? Food Freedom: What It Is and Why It Matters Why You Should (or Shouldn't) Try a Water Fast Can You Really Have a Healthy Diet Eating Only Fruit? 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