Anorexia Nervosa and Anorexia Athletica

Anorexia nervosa and anorexia athletica are typified by restrained eating from a fear of becoming fat, with a resultant loss of weight that places these athletes at serious health risk. Individuals with anorexia athletica may have abnormal exercise patterns, including the desire to exercise while injured and compulsive exercise beyond the normal training regimens.

The restrictive caloric intakes of anorexia are associated with lower bone density, a failure to reach a desirable peak bone density in adolescence, and an increased risk of stress fractures.¹⁶ Although these conditions are serious in and of themselves, it should also be remembered that mortality rates from anorexia nervosa have been reported as high as 18 percent, usually attributable to fluid and electrolyte abnormalities or suicide.^17,18 Hormone replacement therapy (i.e., estrogen replacement) is a strategy for dealing with the sequelae of amenorrhea, but it seems logical to either decrease the intensity and duration of exercise or increase the caloric intake, or both, to return athletes diagnosed with this condition to an energy-balanced state. To successfully achieve this, athletes must understand that proper eating can better optimize athletic performance and appearance by encouraging muscle mass development while discouraging fat mass development.¹⁹ It is important that athletes understand the difference between wanting to be"thin"and needing to be"lean."