Competitiveness and Perfectionism: Common Traits of Both Athletic Performance and Disordered Eating

CHICAGO—(BUSINESS WIRE)—Timberline Knolls, one of the country’s leaders in the treatment of eating disorders, is recognizing well-known tennis star, Monica Seles, for disclosing her history with an eating disorder in her new book Get a Grip. Ms. Seles’ display of courage and candor has the potential to help many others who have similar struggles, especially young female athletes.

It is estimated that more than 11 million Americans suffer from an eating disorder and 20 million more suffer from binge-eating disorder. And because of the secretiveness and shame associated with eating disorders, this number is likely much larger. According to Kimberly Dennis, M.D., medical director at Timberline Knolls, the prevalence eating disorders in female athletes occur at an even higher rate than the general population.

“There are several features of an eating disorder illness that are particularly exacerbated in for females in athletics,” said Dr. Dennis. “And because so much attention is placed on success in athletics, the signs of these illnesses are overlooked by many parents, coaches, teachers and even physicians and therapists.”

Core features of an eating disorder in athletes:

Denial of eating disorders in athletes exceeds that of non-athletes with eating disorders, which is often fed by coaches who rely on the exceptional talent and extreme drive for success that many athletes possess to win games, titles, awards, etc. When a female athlete is still winning or competing, it may be easier to disavow an active problem with food or eating. Perfectionism and competitiveness are both character traits abundantly present in patients with eating disorders. Because competitive athletes rely on precision and “perfect” execution of planned movements, behaviors, and training rituals in order to succeed and win, those predisposed genetic, familial, psychosocial predispositions for eating disorders are even more likely to develop the illness. There are also psychosexual implications of being a female may also contribute to the increased prevalence and risk of eating disorders among female athletes. Because many role models are male athletes, female athletes may feel more pressure to become more muscular and drastically change their body type, which often can lead to disordered eating. Early Detection - what to look for:

increased concern about body composition, body fat; increased concern about “healthy eating” and rigid behavior around food (eating fat free, not eating certain food groups, eating alone or in isolation); social withdrawal, loss of intimacy or closeness with peers and family members; rapid weight loss or gain; going to the bathroom after meals; unmanageability in other areas of life (school, relationships, substances/intoxication); loss of menses or irregularity of menses. Tips for women on how to avoid eating disorder behaviors while training:

exercise and train with a partner or in groups with other women (avoid isolation and secrecy around exercise and food); replenish fluids and follow a well-balanced food plan (including enough protein, iron, calcium, and fat intake); get guidance and help from a sports nutritionist; contact your physician if you begin to experience menstrual irregularity or lose menses; take 1-2 days off per week; avoid looking at “calories burned” displays on cardio equipment; seek professional help if you start to experience unmanageability in your eating, exercise, or weight and/or body concerns; avoid using diuretics, laxatives, stimulants, steroids for performance or training enhancement; women with histories of eating disorder: continue to receive maintenance care from a professional, continue to attend 12-step recovery groups for people in recovery from eating disorders. Tips for coaches and school administration:

provide education around prevention and recognition of eating disorders particularly to staff and coaches for female athletes; provide education around prevention and recognition of eating disorders to female athletes; make appropriate treatment recommendations for athletes who are suspected of having an illness; work with treatment team professionals to set clear expectations around necessary recovery parameters to resume or maintain athletic participation; foster a culture of safety around the athlete asking for help and expressing concerns about weight; allow for and enable a female athlete to express when a training schedule feels like too much or feels too intense; be part of the solution, rather than part of the problem (denial, shaming, etc.). ABOUT TIMBERLINE KNOLLS

Timberline Knolls specializes in helping women and adolescent girls 12 and older, offering treatment for complex co-occurring disorders that can include self-injury behavior (SIB), substance abuse, eating and other affective disorders. For more information on Timberline Knolls and the services offered visit

Kimberly Dennis, M.D. is the Associate Medical Director at Timberline Knolls. She is a member of the American Medical Association, Academy for Eating Disorders, the American Academy of Addiction Psychiatry and the American Society for Addiction Medicine. She is published in the area of gender differences in the development of psychopathology, and has done research on the use of medication with family-based therapy for adolescents with anorexia nervosa.


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