Disordered Eating: The Dark Side of Fitness

TAN “CAIFAN” WEI YING

Wei Ying is a mixed vegetables rice connoisseur who can solve a Rubik’s cube while squatting his max. He is also an associate Psychologist who did his thesis on music in powerlifting at NUS. His keen interest in muscle dysmorphia (bigorexia) and sports psychology inspires him to bring more awareness on sports psychology and mental health into the realm of resistance training. With 7 years of experience in powerlifting, Wei Ying has contributed greatly to the community as the ex-President of Powerlifting NUS, the Vice-President of TheGymNation, and as an IPF referee. He also organized the first-ever Test of Strength (2018)

Trigger Warning: Eating disorders. Disclaimer: this article is meant to be a reflection on disordered eating rather than professional help. Names of interviewees have been changed for privacy purposes.

Food has always been a staple in our lives. There is no argument against its necessity or utility in our pursuit of strength. At the same time, certain behaviours appear to cause more harm than good, perhaps propagated by a ‘diet culture’. These behaviours were learnt with the intention of improving performance but over time have turned against us instead. In this two-part series, we interviewed 4 individuals about their experiences and relationships with food, to gain some insight into a field that has been relatively neglected.

We’re all too familiar with the concept of counting calories when we were first inducted into powerlifting, be it for bulking or cutting. Over time, we inculcate these behaviours into our daily lives, so much so that we don’t even blink when we think about the number of calories in that burger, when we choose the best food option for optimal protein.

Now, why would this is disordered? It’s clearly a behaviour to serve a certain purpose, be it to look ‘better’ or to improve performance. Certainly, we want to avoid pathologising every single behaviour, and yet there clearly is a problem in the ways the fitness community views food. Having unhealthy diets and leaving out complete food groups might still allow most people to function adequately, for now.

Disordered eating (DE) behaviours are often a precursor to eating disorders if not addressed and can lead to increased incidence of mood, anxiety, and substance abuse disorders (Hudson et al., 2007; El Ghoch et al., 2013). Identifying DE behaviours is essential, particularly in the athletic population, to halt the progression into an eating disorder (Mancine et al., 2020), as a staggering 13.5% of athletes were found to struggle with an eating disorder (El Ghoch et al., 2013). This is vastly higher than the general population (Sundgot-Borgen & Torstveit, 2004), where the prevalence of eating disorders is around 1-2%. Given the significantly higher prevalence, there is an urgency to identify such behaviours as soon as possible to begin interventions.

What is disordered eating?

Comparing against conventional eating habits, the term describes several abnormal eating behaviours that do not fit the criteria for an eating disorder. This can include excessive dieting, purging behaviours, e.g., vomiting, laxatives, diet pills, or the avoidance of certain food groups, e.g., fat, sugar (Wilson & O’Connor, 2017). These behaviours often strive towards a goal of achieving an athletic body specific to the individual’s sport (Torstveit et al., 2008).

In comparison, eating disorders are clinical diagnoses that meet the criteria in the Diagnostic and Statistical Manual 5th Edition (DSM-V; Psychiatrist/Psychologist’s bible). These include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Eating disorders also have the highest mortality rate of any psychiatric illness and can have lasting implications on physical health, as prolonged malnutrition can lead to Amenorrhea (loss of period in females), Osteoporosis, and other haematological and cardiovascular disruptions. Given the severity of the consequences, it is important to halt the progression of DE behaviours into eating disorders. 

In weight-class sports, such as powerlifting, the experience of cutting can increase incidence of DE (Artioli et al., 2010).These behaviours have been normalised and the experience of cutting weight seems to be integral in the competition process. This is done by undergoing caloric deficits, at times to the point of starvation; meticulously counting calories, macronutrients and sometimes micronutrients; dehydration; water cuts; sauna sessions; and avoidance of certain food groups. Yes, science dictates that some degree of precision is necessary in order to compete at the highest levels, but when it comes at the expense of both physical and mental health, the question begs — is it really worth it? The following points describe some of the consequences of DE behaviours.

Restriction

One way to reduce the number of calories you consume is through starving oneself or eating less than the recommended amount. The effects of prolonged starvation can have detrimental physical and psychological effects. Needless to say, tiredness and weakness are common but often, headaches and intestinal discomfort are also common complaints. Individuals also become more preoccupied with food and feel depressed, anxious, and more irritable when starved. Starvation also leads to difficulties in social relationships and concentrating (Garner & Garfinkel, 1997). Cutting out specific food groups and a lack of essential nutrients also leads to several negative consequences, including unhealthy hair, nails, decreased serotonin uptake, and headaches. 

“I felt very cold, tired, and my hair started dropping.  I also had no motivation to do anything.” – Charlotte

Of surprise to me was that these symptoms were shared among all interviewees, almost as if they had undergone the same experience. Perhaps the flip side of the pursuit of “thinness” was overshadowed by the potential reward of being “thin”. 

If you are experiencing any of these effects while on a caloric deficit, know that it is your body’s way of informing you that it is not able to function normally due to the insufficient calories and nutrients. This is not to say that being in a caloric deficit is bad, but that one should assess their wellbeing periodically to ensure that the deficit is not taken to an extreme or to the point where it hurts one’s physical health, and in context with their goals, athletic or otherwise. For reference, a recommended deficit would be 500kcal/day (Raynor & Champagne, 2016)

Social life

The social lives of individuals with DE behaviours are often impacted in a negative way. Individuals might experience decreased socialisation due to the anxiety of eating outside. As food served in restaurants/hawkers are generally more caloric dense or contain more fat, it might result in the individual consuming a larger amount of calories than desired or being unable to fulfil the macronutrient requirements. Furthermore, the specific macronutrient breakdown is unknown in most dishes, making it difficult to precisely track the macronutrients. This uncertainty can result in feelings of guilt or catastrophic thinking, causing the individual distress and react with a compensatory behaviour to ease these feelings, as described by Charlotte. 

“I feel anxious and guilty after eating oily food, and have to reach home as soon as possible to purge.” – Charlotte

Eating in a social setting also comes with a particular set of unspoken rules. Friends might not understand dieting behaviours, such as eating meal-prepped chicken breast and sweet potatoes, resulting in an unwanted bout of questioning. The pressure of conformity in a group setting by eating the same types of food ordered by the group can also lead to the individual feeling anxious. Thus, given the inability to predict what exactly is being consumed and the discomfort in these social settings, individuals choose to avoid such situations altogether.

“I felt extremely guilty because I couldn’t enjoy the food with others and that others might feel bad about being with me” – Alice

Tips for prevention

1. Focus on function

“Choose function over form, because after all it is really just a number and shouldn’t define who you are as a person” – Yvonne

In DE behaviours, the focus on the utility of food is on weight and body image. The beliefs surrounding bodies can drive an individual to consume foods in a manner that would seemingly allow them to achieve a body that is thought to be ‘ideal’. This creates a negative relationship with body image, that it is something that should be ‘slimmer’ and smaller, almost as if the body is an object.

Our bodies are so much more than just an object we control. It is a vessel that we use to go through every single experience in life. To put distance between these incorrect beliefs, we can try to focus on what our bodies can do rather than focusing on what is “wrong” with it. Sarah recounts that her sport has led to her discovery of the other functions of her body. With a negative body image, individuals can sometimes forget that appearance is merely one aspect of the body. 

“Focusing on my sport allowed me to realise that there are things that my body can do, even though I’m small, which is very empowering.” – Sarah

Here are some questions you can ask to reframe the thoughts about body image: 

  1. What do you use your body for? 
  2. How else can you use your body?
  3. How can you achieve those functions?
  4. What functions can your body not do if it was different? 

2. Social comparisons

“Social media influenced my body image as there are ‘socially accepted bodies’, but I’ve accepted that everyone has a different body type and I don’t have to fit myself into the ideal beauty standards because my hobbies and sports are different” – Yvonne

Comparing your body with others often comes in many forms, and it is totally normal to do so. Social media often promotes the best side of individuals, and we unknowingly make comparisons. These images often involve ideal posing, time taken to select the best shots, and are often unrealistic. One’s body does not look the same 24/7. Bodybuilders do not look stage-ready all the time, and your favourite influencer’s physique requires the right combination of lighting and posing to achieve. 

Monitor your thoughts when comparing yourself with others. What are some of these beliefs underlying these comparisons? How is this impacting your mood and emotions? What happens when you shift the focus of your attention to other people? Observe how they behave, what their emotions are, and how they express it. To quote Aristotle, “the whole is greater than the sum of its parts, and an individual quality does not define the entire person”.

3. Values

Think about what you value here, achieving first place in a small, local competition or getting stronger? Are your eating habits aligned with your values? In our pursuit of what we think makes us happy, we often forget what we actually value. Sure, achieving goals give us that dopamine boost we so crave, and supply us with the motivation needed to get through a difficult time. But as we take a step back and look at the bigger picture, are our behaviours aligned with our values? 

What is it that we truly value? Is it winning first place in a powerlifting competition, or did you begin powerlifting in the pursuit of being stronger and healthier? It’s okay if you’ve strayed from that path, take the time out to realign your actions with your values. For example, if you value winning and staying healthy, ask yourself if going on a massive cut is the only solution. Are there other ways which you can achieve both and not have to let go of either?

Now this is not to take away the utility of goals. They definitely have a place in our journey and often keep us motivated and are checkpoints that ensure we are on the right path. But what lies at the end is our values, which are lifelong. As you look forward in your life, ask yourself, what matters more? 

“I don’t recommend that people cut a significant amount of weight to drop weight classes, it’s not worth it, your mental health and physical health is more important than competitions. If you damage your body, it might be irreversible and not worth it at all.” – Sarah

Here is a list of values that we often have. As you scan through them, ask yourself which one of these you identify with, and set your goals as such.

Conclusion

Here’s some food for thought (pun-intended ha ha). Think about the choices you are making about food and why you are making them. Are you feeling anxious about eating or constantly being preoccupied by food-related decisions? Know that these feelings are normal, especially in an environment where food and nutrition is being talked about all the time. 

Understand what your motivations are behind the choices you make. If they aren’t aligned with what you value in life, is it possible to change them? As an athlete, it might feel as if we should be putting in 100% of the work all the time towards our craft, and failing to do so might mean we do not have the grit required to do so. Perhaps it is time to change that narrative – can we achieve our goals in a sustainable manner, one that allows us to retain health? 

If you feel that your relationship with food or body image is severely impacting your well-being, please do not hesitate to seek professional help. Here are some resources for you.

Further questions? Feel free to contact us at [email protected].

References

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Barley, O. R., Chapman, D. W., & Abbiss, C. R. (2019). The Current State of Weight-Cutting in Combat Sports-Weight-Cutting in Combat Sports. Sports (Basel, Switzerland), 7(5), 123. https://doi.org/10.3390/sports7050123

 

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Mancine, R.P., Gusfa, D.W., Moshrefi, A. et al. (2020). Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type – a systematic review. J Eat Disord 8, 47. https://doi.org/10.1186/s40337-020-00323-2

 

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Sundgot-Borgen J, Torstveit MK. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med, 14(1), 25–32.

 

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Wilson D, O’Connor EL. Mindfulness, personality and disordered eating. Personal Individ Differ. 2017;119:7–12.