Psychologists rely on the Diagnostic and Statistical Manual of Mental Disorders (5th edition) (DSM-V) to diagnose mental health disorders, and one category of mental health issues includes feeding and eating disorders. Although this is a category within the DSM-V, anorexia athletica is not an official diagnostic category. Anorexia athletica is a condition that was first identified by Dr. William Glasser in 1976 during his time working with runners. Anorexia athletica is also called exercise bulimia, compulsive exercising, sports anorexia, and hypergymnasia. It is characterized with an obsession to exercise, and individuals with anorexia athletica are constantly obsessed with planning their exercise, similar to the obsession with food that accompanies individuals with anorexia nervosa. The focus of individuals struggling with this condition is more on performance than body image and some common struggles might include feeling depressed, irritable or anxious if missing a workout, becoming restless if they are not able to work out every day, exercising even when sick or injured, and prioritizing exercise over relationships.
The estimated prevalence is from 1% to 7% of people who are committed to exercising, and it is thought that up to 50% of people with eating disorders are dependent on exercise to manage body composition.
Notably, this condition is more common in people who participate in sports where lean body mass is prioritized. Anorexia athletica can lead to several health issues, including endocrine and metabolic irregularities, delayed menarche, organ failure, and decreased bone density. Individuals struggling with this condition may have underlying issues with stress, management, self-image, anxiety, depression and self-esteem. Similar to other eating disorders, symptoms associated with this condition may be denied. The first step to treatment is recognizing that their behavior is hurting them, followed by an interdisciplinary support team. Anorexia athletica could be considered in the context of the female athlete triad (De Souza et al., 2014) and/or the relative energy deficiency syndrome (RED-S) (Mountjoy et al., 2014).
References
De Souza, M. J., Nattiv, A., Joy, E., Misra, M., Williams, N. I., Mallinson, R. J., et al. (2014). Female athlete triad coalition consensus statement on the treatment and return to play of the female athlete triad. British Journal of Sports Medicine, 48, 289.
Glasser, W. (1976). Positive addiction. Oxford, England: Harper & Row. https://amzn.to/3QFerZp
Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., et al. (2014). The IOC consensus statement; Beyond the female athlete triad-relative energy deficiency in sport (RED-S). British Journal of Sports Medicine, 48, 491 497.
***Contributed by Adrienne Leslie-Toogood for Hackfort, D., Schinke, R. J., & Strauss, B. (Eds.). (2019). Dictionary of sport psychology:sport, exercise, and performing arts. Academic Press. https://amzn.to/3ZxARzT
