American Fitness Professionals & Associates

By: Scott Josephson

It’s no secret that beauty ideals evolve within each society, culture, and time period.
The obsession with attaining specific beauty ideals has escalated through the influence
of celebrities, filtered through several media portals. What happens to female athletes
and female clients who succumb to the pressures of reaching such beauty ideals? What
happens when they become so obsessed with their body image that their lives are at
stake?

Discover more about body image issues and how you can approach your female clients
who exhibit signs of eating disorders in this exclusive interview with Scott Josephson.
Unfortunately, body image issues usually correlate into an insatiable craving for burning calories that’s often accompanied by a great show of athleticism.

It’s no secret that beauty ideals evolve within each society, culture, and time period.
The obsession with attaining specific beauty ideals has escalated through the influence
of the celebrities, filtered through several media portals.

What happens to female athletes and female clients who succumb to the pressures of
reaching such beauty ideals? What happens when they become so obsessed with their body image that their lives are at stake?

What are some body image issues associated with female athletes?

For the most part,body image issues are a complex association of numerous factors.
It’s worth considering which really came first, “the athlete or the body image disorder”? Athletes have intense pressure to perform well and attain a certain image. In most cases, body image issues potentially start at a fairly young age.

Statistically speaking, about 80 percent of adolescent girls are afraid of gaining weight, 71 percent of college aged women have dieted, 68 percent of women are dissatisfied with their appearance, and 43 percent of adult women are currently on a diet.

Unfortunately, body image issues usually correlate into an insatiable craving for burning calories that’s often accompanied by a great show of athleticism. The media creates and markets “mixed messages” making it increasingly difficult for female athletes. Consider the fact that fashion models are 90 percent thinner than the population.

Remember Marilyn Monroe?

She was a size ten. How about Barbie and Ken then, versus Barbie and Ken today?
What slowly started as a body image issue might eventually become a body dimorphic
disorder where athletes find dissatisfaction with an area(s) of their body and embark
on a crusade to fix it. This can emerge into the A, B, and Cs known as anorexia,
bulimia, and compulsive eating.

What sports or activities most commonly have female athletes with body image disorders?

Body image is often associated with certain sports that require a competitive edge. It is estimated that about two million female runners, distant runners, cyclists, dancers, skaters, swimmers, divers,gymnasts, and body builders battle these elements. Research clearly shows that in sports being judged, most competitors can be extremely demanding on themselves.

This tends to separate the best from the rest and add additional pressure usually linked to body image issues and the prevalence of eating disorders.  This highly stressful situation alters the body’s natural hormonal balance that can lead to more complex problems physiologically, socially, and emotionally.

Not only are women participating in various physical activities at risk; it usually extends to  the general population since most females face societal pressure to be thin at some point in their lives. Females who want to be thinner to enhance performance may attempt to do so through dieting and excessive exercise. Societal perpetuation usually intensifies a woman’s desire for a better body as it quietly and harmfully increases other risks.

What are some physical and psychological things a female athlete can expect if she is experiencing an eating disorder?

The physical signs of an eating disorder usually occur in phases. This process often starts with a very low calorie intake and increased cardiovascular protocols with added duration, intensity, and frequency.  This quickly becomes an environment of fast weight loss, instant gratification, and euphoria.

As this pattern intensifies,catabolism emerges leading to several aspects including fatigue, heart palpitations caused by an imbalance between the sympathetic and parasympathetic nervous systems, lanugo or the growth of fine white hairs all over the body, weak nails, visible vertebrae or ribs, and dull eyes with dark circles regularly under them.

Based on this abnormal relationship associated with food, other physical signs could be insomnia, anemia, and amenor-fatigue, heart palpitations caused by an imbalance between the sympathetic and parasympathetic nervous systems, lanugo or the growth of fine white hairs all over the body,weak nails, visible vertebrae or ribs, and dull eyes with dark circles regularly under them.

Based on this abnormal relationship associated with food, other physical signs could be insomnia, anemia, and amenorrhea. Physiologically speaking, self-worth, self-hate,or self-control might dictate the mood each day. Some disorders develop as a result of many uncontrollable situations over a period of time. Disordered eating patterns tend to emerge accompanied by a very specific daily routine including extreme exercise patterns, precision calorie counting, and absolutely no fluctuation in eating patterns.

How can coaches and personal trainers approach a client with an eating disorder and body image issues?

Eating disorders can transition from anorexia to bulimia. Coaches and fitness professionals need to approach this delicately and remember “when in doubt, refer it  out”.

Disordered eating occurs behind closed doors with or without laxatives and ipecac syrup. However, the physical signs of teeth erosion from stomach acid, aggravated acne, and broken blood vessels from violent vomiting are clearly visible.

Fitness professionals are in a great position to make a positive impact but often feel it does not apply to them. This is for your regular clients, recreational and  fitness enthusiasts; not just for thin celebrities and elite athletes. As their trainer, be honest about what you observe. Always be non-judgmental and warmly ask if her body dissatisfactions are affecting other parts of her life.

It may also be worth mentioning that a sports psychologist is usually a terrific referral. This type of psychologist is often perceived as less threatening than a clinical psychologist. For one reason, they teach visualization and relaxation techniques associated with overall better performance.

Sometimes, treatment requires a team approach of medical professionals aligned with
a psychologist, nutritionist, parents, and coaches to create a full range approach and
prevent a disastrous outcome.

What is the Female Athlete Triad and what should all coaches and trainers know about it?

The Female Athlete Triad is a syndrome of three interrelated conditions that exist on a continuum of severity including:

1. Energy Deficit/Disordered Eating
2. Menstrual Disturbances/Amenorrhea
3. Bone Loss/Osteoporosis

Energy deficit eating disorders are an imbalance between the amount of energy consumed and the amount of energy expended during exercise. The primary cause of the Female Athlete Triad is energy deficiency. Often, this involves a conscious restriction of food intake, intense problems with body image, and the constant pursuit of thinness. Sometimes, these conditions can lead to disordered eating or more serious eating problems like anorexia or bulimia.

The most serious menstrual disturbance associated with the Triad is amenorrhea defined as no menstrual period for three months or more. An element known as anovulation is marked by low levels of estrogen and progesterone that deter follicular development and the absence of ovulation.

This creates luteal suppression and decreased estrogen levels. Low estrogen levels and poor nutrition, especially low calcium intake,can lead to bone loss and eventually osteoporosis, the third aspect of the triad. Osteoporosis is a weakening of the bones due to low bone density and improper bone formation. This condition can ruin a female athlete’s career because it may lead to stress fractures and other injuries.

Although coaches and trainers do not diagnose, they should take notice to these symptoms. Recognizing elements of the triad include continuing to diet in spite of weight loss, a huge pre-occupation with food and weight, general fatigue or decreased ability to concentrate, stress fractures that occurred without a significant injury, sensitivity to cold, low heart rate, low blood pressure, heart irregularities, and brittle hair.

Certain components are difficult to be aware of based on symptoms of  eating disorders such as frequent trips to the bathroom during and after meals, using laxatives, and dental cavities since tooth enamel is worn away by frequent vomiting.

What are some things that most trainers or coaches don’t know about eating
disorders?

Over your lifetime, at least 50,000 people will die as a direct result of an eating disorder.
It may or may not be the girl next door, but it may be someone who, given the opportunity to recover, could have. Since so many people are immersed in their eating disorders, we may never know unless we act.

The factors that lead to an individual’s development of an eating disorder can include genetics, family dynamics, personality, and the existence of other problems like anxiety, depression, low self-esteem, and academic pressure.

There is a lot that we as coaches and trainers can do and most importantly, we have to be able to discuss eating disorders without fear. We need to be comfortable and delicate in talking to our clients, yet positively voice our concerns. It’s so important to value our passions and the quality of life that cannot be measured instead of how much we weigh.

As we properly educate our clients, they will realize that wellness is what really counts.
The best results occur when you professionally encourage, affirm, support,and validate.
It’s crucial to understand your body mechanics so hormones can stay regulated and not
fluctuate,which can create less thyroxin and alter your hypothalamus to operate abnormally.

Each part of the triad can impair health and sport performance, so realize your health is more important than competitive success. Taking health risks for a perceived competitive edge will make you lose in the long run. Appreciate your accomplishments and understand that optimal weight for health and performance is different for everyone.

Now that’s “food for thought!” Energy deficit eating disorders are an imbalance between
the amount of energy consumed and the amount of energy expended during exercise.

Scott Josephson, M.S. is the Director of Operations at Hippocrates Health Institute, a
premier life changing property in West Palm Beach, Florida.Scott is a national level
conference speaker throughout the United States and Canada, a recipient of numerous
awards and is frequently published covering a wide range of industry topics.
In addition to several certifications, he holds a degree from the University of Miami
and is on the advisory board of the American Fitness Professionals and Associates.
His work portfolio includes Geraldo Rivera, Wimbledon Champion Chris Evert and athletes
from the New York Giants and New York Mets.