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Too many athletes unsuccessfully try to design their own nutrition programs.
The mention of “eating disorders” often brings to mind adolescent girls or young women, but at least two-thirds of young men are also dissatisfied with their bodies. Fifty percent or more want to lose weight, and the others wish to build muscle mass (J Psychosom Res. 2004; 56:853). As a result, they may turn to excessive exercise and use of nutritional supplements, even those that contain banned drugs or substances, as well as anabolic steroids. In one study of 212 male and female athletic competitors, those taking nutritional supplements were 3.5 times more likely to admit doping and had a more positive attitude about using drugs in their sports (Psychol Addict Behav. 2012; 26:955). This practice is not limited to young men; young women also turn to these supplements for energy and weight loss (Inquir Sport Phys Educ Psychol Rev. 2013; 11:65).
Easy access to the Internet also plays a role. Many commercials for weight gain products purport to enhance performance and body image as well. Information about side effects of these products is usually lacking; one study showed that none of a group of teens could name any negative effects from taking such supplements (Health Educ Res. 2003; 18:98).
A unique profile among males
A team at the University of California, San Francisco, and UCLA recently published an update on eating disorders in adolescent boys and young men. Dr. Jason M. Nagata and colleagues at Simmons University, Boston, and the University of Toronto reviewed the recent literature on eating disorders and disordered eating behaviors among adolescent boys and young men, including epidemiology, assessment, medical complications, treatment outcomes, and special populations (Curr Opin Pediatr. 2020; 32:476). The authors found that eating disorders and disordered eating behaviors in boys and men might present differently than in girls and women, particularly with muscularity-oriented disordered eating. They also suggest that treatment of eating disorders in boys and men should be adapted to address their unique concerns.
In one of the earlier studies of the relationship of between doping and body dissatisfaction, use of weight gain supplements and attitudes toward enhancing performance by using performance–enhancing drugs, Drs. Zali Yager and Jennifer O’Dea of Victoria University, Melbourne, Australia studied 1148 young men. The boys and men, between 11 and 21 years of age, completed self-report questionnaires measuring weight changes, use of supplements, and body dissatisfaction (Male Body Attitudes Scale, or MBAS), and then recorded their attitudes toward doping in sports (the Performance Enhancing Attitudes Survey, or PEAS) (J Int Soc Sports Nutr. 014; 11:13). The researchers found a positive correlation between total MBAS and PEAS scores. Thus, young men who were attempting to lose or gain weight and those drinking energy drinks and taking vitamin-mineral supplements were also significantly more supportive of some degree of doping in sports. Two exceptions were men involved in weight lifting and those taking protein powders.
A more lenient attitude may play a role in doping in sports
Drs. Yager and O’Shea suggest that more lenient attitudes toward body dissatisfaction, weight change behaviors, and supplement use among boys and young men may play a role in doping in sport. Future research might examine whether combining educational content aimed at preventing body dissatisfaction and the use of drugs in sport may have a greater preventive impact than the current programs designed for young men.
[Note: The International Olympic Committee (IOC) has published a very helpful and thorough article, “Dietary Supplements and the High Performance Athlete” (https://doi.org/10.1123/ijsnem.2018-0020). It describes the rationale for using certain nutrients, for example, omega fatty acids, that have documented evidence of improving performance when used in specific scenarios. The IOC group, headed by Dr. Ronald G. Maughan of the University of Saint Andrews, Scotland, concluded that while a small number of supplements can benefit an athlete’s training program, a strict benefit-risk analysis by a well-informed sports nutrition expert is essential before an athlete chooses his or her own nutrition program.]
Sports that may promote eating disorders
- Sports that require competition clothing that reveals body shape, such as swimming and volleyball
- Sports that emphasize muscle mass, such as bodybuilding
- Endurance sports, such as triathlons, cycling, and cross-country skiing
- Aesthetic sports, such as dance, figure skating, gymnastics, synchronized swimming
- Sports with weight categories, such as martial arts, boxing and wrestling. These may lead to bulimic-type behaviors.
- Sports that promote a low body weight, such as riding or cycling