Eating Disorders Affect Many People at Many Different Levels

By Barbara Day, M.S., R.D., C.N.

            After years of working with student athletes at the University of Louisville Athletic Department and with some of our local high schools who suffered from eating disorders, my approach had always been to reinforce the attitude that you need food (calories) to perform at your best. Your body is like a car, if you don’t put any gas in it – you won’t get very far. Food should not be the bad guy.  Restricting food can deplete fuel stores, cause amenorrhea, cause stress fractures, and cause fainting, weakness, fatigue which can ultimately impair performance. Chronic fatigue due to eating too few of calories ultimately leads to illness and injury.  Some athletes can live on a calorie deficit for a period but they then injury and lack of energy eventually takes its toll.


For some reason, food has become our national enemy.  However, with eating disorders, food is not really the problem – but food becomes the issue because it is the only thing that can be manipulated by the student athlete.  Their training and school schedules are very structured for student athletes but the athlete could control what went into their mouth or what didn’t.  In essence, the food strike became more of defiant statement against the establishment. Certain type of student athletes struggle with these issues whether they are brought on internally due to a personal issue like an underlying abuse issue or whether a coach was responsible for making the athlete focus too much on their body weight thus causing the disordered eating pattern.


Many sports are breeding grounds for eating disorders or disordered eating – such as sports with weight standards such as light weight rowing or wrestling, or sports that are aesthetic in appearance such as gymnastics, ballet dancing, cheerleading, figure skating, or sports like running, volleyball but eating disorders can be found in an array of sports.


When Dan Benardot, PhD, fromGeorgiaStateUniversityproved to the gymnasts and their coaches at USA Gymnastics that they could actually eat for performance – not eat like a bird, he gained the attention of many young athletes and their coaches. These gymnasts went onto win numerous Gold Medals for theUnited States.


Eating Disorders Statistics


→Eating disorders affect 5 – 10 millions American and 70 million worldwide. (Crowther, et al, 1995)

→Approximately 1 million males have an eating disorder. (Crowther, et al, 1995)

→It is estimated that currently 11% of high school students have been diagnosed with an eating disorder.

→Time Magazine reports that 80% of all children have been on a diet by the time that they have reached the fourth grade.

→The diet and diet related industry is a 50 billion dollar a year enterprise. (M. Maine, 2000)

→91% of 10 year olds are afraid of being fat.  51% of 9 and 10 year old girls feel better about themselves if they are on a diet.  (Mellin et al, 1992)

→Up to 19% of college aged women inAmericaare bulimic. (Radar Programs)

→0.5% – 3.7% of females suffer from Anorexia Nervosa in their lifetime. (NIMH, 2000)

→1.1 – 4.2% of females suffer from Bulimia Nervosa in their lifetime. (NIMH, 2000)

→2% – 5% of the American population experience Binge Eating Disorder. (NIMH, 2000)

→10 – 25% of all those battling anorexia will die as a direct result of the eating disorder. (ANAD)

→Bulimia often occurs in athletes such as gymnasts, wrestlers, dancers, horse jockeys, football players and runners.

→A study conducted byCornellUniversityfound that 40% of male football players surveyed engaged in some sort of disordered eating behavior.  (Newsweek, 1994)

→Men constitute as many as 40% of those exhibiting Binge Eating Disorder. (DSM IV, 1994)

→The mortality rate for anorexia is higher than for any other psychological disorder.  In fact, it’s the number one cause of death among young women.  Five to ten percent of anorexia die within ten years of onset.  18 – 20 percent diet within twenty years of onset, and only 50 percent report ever being cured.  (ANAD).





How do I know if I have an Eating Disorder?


Here’s a questionnaire that you can take to see if you have a potential eating disorder.  If you answer “yes” to any of the questions below you may have a problem with eating and should discuss you issues with a professional.


Does the diagnostic criteria for anorexia nervosa or diagnostic criteria for bulimia nervosa describe you? (See the Ask Your Doctor column on page …)

Are you constantly thinking about food, weight or body image?

Is it difficult to concentrate on the daily tasks of studying or work because of food and weight thoughts?

Do you worry about what your last meal is doing to your body?

Do you experience guilt or shame around eating?

Is it difficult for you to eat in public?

Do you count calories every time you eat or drink?

Do you chronically diet only to regain the weight after going “off” the diet?

Do you feel “out of control” when it comes to food?

When others tell you that you are too thin, do you still feel fat?

If you see yourself as thin, do you still obsess about your stomach, hips thighs, or buttocks being too big?

Do you weigh yourself several times daily?

Does the number on your scale determine your mood and outlook for the day?

When you are momentarily satisfied with your weight, do you resolve to be even more vigilant?

Do you punish yourself with more exercise or restrictions if you don’t like the number on the scale?

Do you exercise more than forty-five minutes, five times each week with a goal of burning calories?

Will you exercise to lose weight even if you are ill or injured?

Do you label foods as “good” or “bad?”

If you eat a “bad” or forbidden food do you berate yourself and compensate by skipping your next meal, purging or adding extra exercise?

Do you vomit after eating and/or use laxatives or diuretics to keep your weight down?

Do you severely limit your food intake?


Reprinted from Anorexia Nervosa: A Guide To Recovery. 


Eating Disorders Helpful Websites

Eating Disorder Referral and InformationCenter

Caring Online

Overcoming Overeating

National Eating Disorders Association

Eating Disorder Coalition

Harvard Eating Disorder Center

Support, Concern and Resources for Eating Disorders


The Renfrew Center Foundation

National Association of Anorexia Nervosa and Associated Disorders

National Eating Disorder Information Centre


Books Worth Looking Into

Anorexia Nervosa: A Guide to Recovery. Lindsay Hall and Monika Ostroff

Bulimia: A Guide to Recovery.   Lindsay Hall and Leigh Cohn

Anorexics on Anorexia.  Rosemary Shelley

Stick Figure: A Diary of My Former Self.  Lori Gottleib

Overcoming Overeating.  Jane R. Hirschman, M.S.W. and Carol Munter


For Parents:

Anorexia Nervosa: A Survival Guide to Families, Friends and Sufferers Janet Treasure

Diary of An Eating Disorder: A Mother and Daughter Share Their Healing Journey.    Chelesa Brown Smith with Beverly Runton

Like Mother, Like Daughter.  Debra Waterhouse, MPH, RD

When Your Child  Has An Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers.  Abigail H. Natenshon


For Teens:

Girl Power in the Mirror.  Helen Cordes

Starving to Win: Athletes and Eating Disorders.  Eileen O’Brien

Life in the Fat Lane.  Cherie Bennett

Eating Disorder Survivors Tell Their Story.  Christina Chiu.

Anorexia Nervosa:When Food is the Enemy.  Erica Smith

PERK! The Story of a Teenage with Bulimia.  Liza Hall

Exercise Addiction. Laurie Kaminker

Body Blues: Weight and Depression.  Laura Weeldreyer


The Do’s and Don’t of Helping a Friend with an Eating Disorder


The following list were compiled by Tiffany Clinton-Taylor, MS, NCC, LMHC


The DO’S

  1. Increase your knowledge about eating disorders (request information packets, read books, attend seminars).
  2. Talk with the person about your concerns in a loving and supportive way.  It is important to discuss these issues with honesty and respect.
  3. Talk with the person at an appropriate time and place – in private, free from distractions.
  4. Encourage the person to seek professional help as soon as possible. Suggest that she/he see someone who specializes in eating disorders (a physician, therapist or dietitian).
  5. Be prepared that the person may deny that she/he has a problem.  If so, and if she/he refuses to get help, it will be important to tell some else about your concerns.  If your friend is under 18, her/his parents need to know immediately.
  6. Listen with a nonjudgmental ear.
  7. Talk about things other than food, weight and exercise.
  8. Be available when your friends needs someone, but remember, it is okay to set limits on what you can and cannot do.
  9. Hang in there! It won’t be easy.



  1. Don’t try to solve her/his problems or help with the eating disorder on your own. Get help from others.
  2. Don’t confront your friend with a group of people or in front of a group of people.
  3. Don’t talk about weight, food, calories, or appearance.  Do not make any comments on what she/he looks like.
  4. Don’t try to force or encourage your friend to eat. Do not get into power struggles.
  5. Don’t let her/his peculiarities dominate or manipulate you.
  6. Don’t gossip about her/him to others.
  7. Don’t be scared to talk with her/him.
  8. Don’t expect to be the perfect friend – reach out for support when you need it.
  9. Don’t expect your friend to be “cured” after treatment.  Recovery is a long process.
  10. Don’t keep this a secret for your friend. Remember, her/his live may be in danger.


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Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition,, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, Barbara writes nutrition and health columns for as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 11 grandchildren.    


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