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Eating Disorders in Sports

A Thereapeutic Recreation approach to eating disorders in Sports

Sharon Hillier

on 17 April 2014

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Transcript of Eating Disorders in Sports

Evaluation of Outcomes
Tracey's History
Why Eating Disorders in Sports?

Mind map

our client/athlete Tracey

Therapeutic Recreation Service Delivery (APIE)

Tracey's Proposed Treatment

Evaluation of Outcomes
Why Eating Disorders in Sports?
personal experience with a best friend

participation in sports and eating disorders not uncommon

athlete and dancers at higher risk of developing anorexia, bulimia, or compulsive overeating

athletes tend to strive for perfection, overachieve, compete, are compulsive or people pleasing
Case Study
Tracey's Story
One year later during her pre-participation physical examination Tracey had lost another 5 pounds. Her body fat was only 7% (average 10% - 12%).

Although she was referred to a counselor and registered dietician these professionals did not have experience with this specific disorder. Tracey was found to be 'non-compliant' with her treatment program.

What can be done for Tracey who is going into her junior year at university?
Tracey's Proposed Treatment
FACTR-R (Functional Assessment of Characteristics for Therapeutic Recreation - Revised)
determine Tracey's needs on basic functional skills and behaviours
measures physical, cognitive, and social/emotional domains

Leisure Attitude Measurement (LAM)
cognitive, affective and behavioural attitude towards leisure

Leisure Interest Measure (LIM)
Tracey's interest in the 8 domains of leisure activities
physical, outdoor, mechanical, artistic, service, social, cultural, and reading
Eating Disorders in Sports
Sharon Hillier
Clare Weisser
remove Tracey from the team - probation

Adventure Therapy challenges Tracey without body image component

provide Cognitive Behaviour Therapy

guidance with a Dietician

interdisciplinary collaboration

Tracey's health and well-being priority before competing
Bachelor of Therapeutic Recreation
Semester 5, 3rd Year
Seneca College, King Campus
13990 Dufferin Street
King City, ON L7B 1B3

sports involvement can have a positive effect on an individual's development

Tracey's assessments, TR intervention plan, program development, documentation, evaluation, and interdisciplinary collaboration will assist in achieving her success

Adventure Therapy is an active approach with activities involving risk --> Tracey's own self-image perception
Dilemma in Sports
body weight is crucial for endurance, weight classification, and appearance sports such as cycling, wrestling, cross country skiing, gymnastics, and swimming, and cheerleading

the criteria involved to be a successful athlete may be the precursor in developing an eating disorder

coaches and athletes are preoccupied with body shape and weight control to increase performance

weigh-ins and body fat analysis occur weekly and usually in a public setting which can cause embarrassment to athletes

teammates and coaches greatly influence an athlete's behaviour and performance
Tracey is 18 years old and is entering her first year at university on a scholarship for long-distance running. Her physician has given her clearance to participate.

As an incoming freshman, her height is 5'3" and she is 85 pounds. She has had a history of amenorrhea for three years. This was not a concern for the sports medicine professional because Tracey's own physician had given her clearance.
Physical Assessment
Eating Disorders
abnormal attitude towards food that causes someone to change their eating habits and behaviour
immoderate food restriction
irrational fear of gaining weight
distorted self-perception of own body
excessive weight loss
Anorexia Nervosa

eating large amounts of food and then starving themselves

using laxatives
Compulsive Eating
Relies on food for emotional support
frequently eating large quantities

high caloric intake
Eating Disorders
Signs & Symptoms
obsessive thoughts
compulsive behaviour with food
regularly missing meals
complaining about being fat
constantly checking weight
only eating low-calorie/particular foods
comfortable eating in public
Causative Factors
stressful experiences
health problems
conforming to the ideal
spiritual quest
family dynamics
role model as a parent

education on the Healthy Food Guide and the importance of moderation

provide support network

awareness of consequences of eating disorders --> death
chart weight & height
calculate BMI
assess for dehydration
skin inspection
pulse, blood pressure, temperature
oral exam
general systems exams
pubertal Status
adventure therapy
experiential recreation therapy
stress management therapy
family therapy
clinical assessment

Counseling with a social worker and/or psychiatrist

diagnose disorder and medically treat accordingly

TR facilitated activities to help client move out of 'comfort' zone to 'courage' zone
compare baseline assessments

Leisure Interest Measure (LIM)

Leisure Attitude Measure (LAM)
Tracey's demonstrated measurable changes

Leisure Satisfaction Measure (LSM)
casual/formal observations to measure Tracey's progress

formative and summative evaluations determine progress in achieving goals
regular interviews with specific questions relating to her own progress

Critical Thinking in TR
Adventure Therapy

modify Tracey's perceptions and behaviours of her eating disorder

challenges and risks involved

avoid swimming --> body image

emphasize on locus of control, self-concept, and self-esteem
verbal/non-verbal reinforcers to maintain TR relationship

best TR practices

challenges: balanced nutrition, affective behaviour (emotion and motivation)

start with easy challenges and gradually increase challenge to provide and non-threatening and positive environment
... Critical Thinking in TR
Full transcript