Journal points out differences, treatment techniques for behavior patterns
INDIANAPOLIS — Eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN) have been in news headlines for more than 20 years, yet thousands of active adults who do not identify with star athletes, film stars or fashion models follow a different pattern of disordered eating — neither AN nor BN — that is only now being recognized. While the extreme symptoms and severe consequences associated with AN and BN may not be evident, it is clear that an eating-related problem is present in these patients. This category, known as eating disorders not otherwise specified, (EDNOS), like AN and BN, is ten times more prevalent in females than males.

In the May/June issue of ACSM's Health & Fitness Journal®, Laura Kruskall, Lesley Johnson and Susan Meacham, all Ph.D., R.D.s at the University of Nevada, Las Vegas, present a summary of eating patterns and risk factors that fitness professionals and active adults should know about and understand. "We thought the public should be aware of symptoms that may not indicate a clinically diagnosed illness, but could lead to the development of an eating disorder," said Kruskall. "Destructive weight-control patterns can lead to serious health issues, and if the information is there, it's possible to catch the pattern before it becomes full-blown."

People suffering from disordered eating usually have extensive knowledge about food and its energy/fat content; they may weigh themselves frequently, eat secretly, overexercise to compensate for eating, and have an out-of-proportion preoccupation with weight, body image, and other food issues. Risk factors include being female, feeling a lack of control and a need for perfection, peer and societal pressure to be thin, and early maturation, among others. Female athletes, especially, are pressured to improve both performance and appearance, and the competitive sports setting could be a factor in development from simple disordered eating to a genuine eating disorder.

Treatment options, say the authors, could be complex, because disordered eating seems to indicate that simply eating normally will resolve the patterns. Because disordered eating is the result of combined sociocultural, psychological and physiological issues, however, a team approach is recommended. In a college setting, for example, a treatment team might combine the services of a physician, a dietitian, a psychologist and fitness professional. A non-judgmental approach is essential, and should include communication of concerns, exploration of concerns with another professional, avoidance of conflict, blame or guilt, continued support, and medical consultation.

The authors noted that emphasizing exercise or athletic competition for the sheer joy of feeling the body move and of experiencing gains in strength and improvements in health rather than a means for burning off energy, will be effective in identification and treatment referral of disordered eating to prevent development of eating disorders.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 18,000 International, National and Regional members are dedicated to promoting and integrating scientific research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness, health and quality of life.

Note: ACSM's Health & Fitness Journal® is a bimonthly publication available through ACSM's Certification Resource Center. Call 1-800-486-5643. Also available through the ACSM Communications and Public Information Department are brochures that address healthy activities for the general population. Single copies are free with a self-addressed stamped envelope. Send to ACSM at POB #1440 Indianapolis IN 46206.

Visit ACSM online at www.acsm.org

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