Disordered Eating

Female adolescents who participate in sports where there is emphasis on a lean physique may be at increased risk of disordered eating. Some young athletes develop clinical eating disorders such as anorexia nervosa, bulimia nervosa, or eating disorders not otherwise specified. Eating disorders appear to peak in prevalence and severity during adolescence and may be related to physiological, psychological, and social changes that occur during this time.

 Restrictive eating in young females can impair reproductive and skeletal health. The interrelationship between energy availability, menstrual function, and bone mineral density is described as the female athlete triad. Most negative effects occur when energy availability is below 30 kcal.kg–1 of fat-free mass per day. Menstrual dysfunction or functional hypothalamic amenorrhea (secondary amenorrhea) can result in low peak bone density (z-score of –1.0 to –2.0 below the expected range for age). Poor bone density and menstrual irregularity is associated with increased rate of stress fractures. The prevalence of delayed menarche (primary amenorrhea) has been shown to be 22in adolescent female athletes in comparison with 1of the general population. Secondary amenorrhea (loss of menstruation) has been shown to be higher (67) in female runners of less than 15 years of gynecological age compared with their older counterparts (9). Young athletes who have been identified with the female athlete triad will require multidisciplinary treatment including a physician, a mental health practitioner, and a dietician. The younger the athlete, the greater the need for family involvement in the treatment.