Consequences of pressure to perform: Anorexia athletica: taboo topic of eating disorders in competitive sports

When world-class gymnast Kim Bui trains with young athletes today, the ex-athlete is not only interested in the sport.

Consequences of pressure to perform: Anorexia athletica: taboo topic of eating disorders in competitive sports

When world-class gymnast Kim Bui trains with young athletes today, the ex-athlete is not only interested in the sport. She wants to clarify. About a topic that is still taboo in competitive sports.

"I started throwing up when I was 15. It had to come out, I just wasn't allowed to gain weight," says the 34-year-old in the ARD documentary "Hunger for Gold" about her bulimia.

She is not alone in going public. Formula 1 driver Valtteri Bottas, French tennis player Caroline Garcia and Swiss biathlete Lena Häcki-Groß also recently made it public that they were affected by eating disorders. "I trained myself physically and mentally ill," Bottas confessed on Finnish television. At that time he mainly ate broccoli. "It got out of control and became an addiction.".

"Athletes have an increased risk of developing eating disorders in competitive sports," said sports physician Wilhelm Bloch of the German Press Agency. Between ten and twenty percent of all athletes are affected. Sports in which weight and aesthetics play a role, such as rhythmic gymnastics, ski jumping or endurance sports such as long-distance running, are particularly susceptible.

The clinical picture "anorexia athletica"

The debate about eating disorders in competitive sports is not new. Around 20 years ago, pictures of the emaciated ski jumper Sven Hannawald caused discussions. "It just had to be, because in my opinion, weight was the recipe for success," says the ex-ski jumper today.

In 2004, the World Ski Association Fis introduced a rule for the body mass index (BMI). A BMI that is too low, which is calculated from weight and height, leads to a reduction in ski length. "I would wish that more sports would pay attention to this and also introduce certain weight limits," said Bloch. "But it's not as easy in every sport as it is in ski jumping over the length of the ski. When it comes to running, it's a lot more difficult."

Ever thinner athletes

In athletics in particular, he observes a trend towards ever thinner athletes. "When athletes with a BMI of 15 or 16 go into a competition, this is critical and, in the long run, a health hazard," explained the scientist from the German Sport University in Cologne.

The clinical picture behind it: "anorexia athletica". "Anorexia athletica is defined as I'm not taking in enough energy, my body is losing mass, and I'm getting to a critical level in terms of my mass to perform better," explained Bloch.

But losing weight for top athletic performance can have long-term consequences: the absence of menstruation due to a disrupted hormone balance in women, bone problems associated with a higher risk of osteoporosis and an increased susceptibility to injury. But also gastrointestinal complaints or organic damage up to depression. It is therefore all the more important to educate athletes and coaches, emphasized Bloch.

How the DOSB wants to reduce the number of cases

The German Olympic Sports Confederation (DOSB) would also like to contribute to this. "As an umbrella organization, we have to fly at a very high level, which means that we have to raise the level of knowledge in the overall system and help improve cooperation in the network," said Birte Steven-Vitense, head of health management at the DOSB. Conferences for sports physicians, nutritionists and trainers, but also for management staff, are intended to provide information about eating disorders.

Gymnast Kim Bui was also helped by a trainer who noticed her behavior and asked her to get help. "It was tough, but it was also a relief," said Bui, who then sought treatment.

The DOSB wants to identify problems at an early stage in mandatory annual health checks for all squad athletes at one of 27 examination centers throughout Germany. "The system has existed for many years and is used to keep athletes healthy," explained sports psychologist Steven-Vitense. Even if the suspicion of an eating disorder does not always lead directly to an unfitness for sports, there is always a referral to specialist staff.

"Even the best systems and our work will never be able to prevent eating disorders 100 percent. However, through prevention approaches and training measures, we can raise awareness at all levels and hopefully reduce the number of cases," said Steven-Vitense.

At the same time, new scientific findings should always flow into the work. The DOSB is currently working in Tübingen, for example, with nutrition questionnaires as part of the athlete checks. Findings from this should help in dealing with eating disorders and competitive sports in the future.