PREVENTING AND MANAGING
EATING DISORDERS, Part 3
By Lisa Franseen, Ph.D., Clinical Sport Psychologist
From the Winter 1999 issue of Synchro Swimming USA magazine

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Eating disorders don't go away by themselves. To be free of eating and weight issues requires professional help and, even then, it is slow and difficult work. I've known women, some were athletes at one time, who had an eating disorder for over twenty years before they sought help! And, some don't survive. 6% die from having an eating disorder.
That's 6 out of 100, 3 out of 50, or 1 of every 17 persons.

Because the outlook - once someone develops an eating disorder- is not optimistic, prevention becomes absolutely essential! This cannot be overstated. It is each and every one of our responsibilities to address this issue proactively.

YOU Can Help to Prevent Eating Disorders

The more you know, the more you can help. The information in my three articles (see also Wtr '99 & Spg '00) is a good introduction to the area. Learn more by reading these excellent resources:

· Helping Athletes With Eating Disorders by Ron Thompson, PhD & Roberta Sherman, PhD. Human Kinetics Publisher: 1993.
· Eating Disorders Among Athletes by D.R. Black (Ed.). Association for the Advancement of Health & Physical Education, Recreation and Dance: Reston, VA. 1991.
· Eating, Body Weight, and Performance in Athletes: Disorders of Modern Society by K.D. Brownell, J. Rodin, & J.H. Wilmore (Eds.). Lea & Febiger: Philadelphia. 1992.
· The Beauty Myth by Naomi Smith. Morrow & Co.: 1991.
· Little Girls in Pretty Boxes by Joan Ryan. Doubleday: 1995.

Write letters to the editors of women's magazines (Seventeen, Cosmopolitan, Glamour, etc.) to dissuade them from advertisements & articles that promote obsession with weight and looks.

Become more aware of and work to dispel myths and misinformation about society's "ideal" body image, weight loss, dietary fat versus body fat, as well as body fat and performance.

How Coaches Can Help

Work to create a training and competitive environment that empowers the well-being of each synchronized swimmer and that de-emphasizes body weight.

Don't weigh your athletes. If an athlete appears to have a weight problem that will drastically influence their performance ratings then have a private discussion. Help them to develop a realistic weight-loss program through the help of a registered dietitian.
Prioritize budgetary needs for professionals to educate your team on nutrition, weight management and athletic performance, the dangers of dieting, body composition (scale weight versus leanness), etc.

Have your athletes work with a registered dietitian.

Have written information about eating and weight issues readily available to your athletes. Contact EDAP (Eating Disorder Awareness and Prevention, 206-382-3587) for such information.

If you have an eating disorder or issues around weight, body image, or compulsive dieting, please seek professional help, as hard as that may be. You are a role model to other athletes and your attitudes and feelings are contagious.

Develop and use a sport management team! You alone cannot help these athletes (see below).

Have the names on hand of mental health professionals and physicians you can refer athletes to. Make sure they have experience treating eating disordered persons and preferably athletes with eating disorders.

Encourage yourself to ask if you suspect one of your athletes may be struggling with eating and weight issues. If you are afraid to inquire, do it anyway. Remember, you don't need absolute proof before you ask them about it.

Refer the athlete for professional help as soon as you are made aware of a potential problem.

From Prevention to Management: The sport management team

Although prevention helps, there will still by synchronized swimmers who develop issues around their weight, body image, and eating. As a team member or a coach of someone who is struggling, to do nothing is to give the message that it doesn't matter and that you don't care. I understand that it is also a challenge to take action. It is hard to know what's best to do or how to do it. Telling a coach about one of your teammates might mean losing that person as a friend! I encourage you to tell anyway, just to give them the message that their personal health and well-being is more important than the friendship.

Because it is too difficult to manage this issue alone, I encourage coaches and administrators to develop what I call a sport management team. The team might include a physician, psychologist (preferably a clinical sport psychologist), physical trainer (who often gets first-hand information from athletes that others don't), a registered dietitian, sport physiologist, parents and, of course, the team coach.

The sport management team can pool their knowledge and resources and make decisions regarding preventative efforts. The team can also work together to best help an athlete with an eating disorder. It is important for everyone involved to be on the same page in their decisions and support. The challenging decisions that need to be made include:

-how to best approach an athlete suspected of struggling with issues around weight,

-how to best recommend an evaluation or treatment,

-whether an eating-disordered athlete should continue training and/or competing, (When the health of a swimmer has been compromised by the disorder or she is not following referral or treatment recommendations, it is sometimes best not to allow participation until the situation has been resolved, but not always.)

-what issues to consider in deciding whether a swimmer is ready to return to training and competition,

-who decides when it's best for an athlete to return,

-if and how teammates should best be involved, and

-how to best monitor and support an athlete that continues to train and compete.

About the author: Dr. Franseen is a clinical sport psychologist in Denver, Colorado, who began helping athletes with eating disorders when she worked at the Olympic Training Center in Colorado Springs. In 1999, she presented at the Annual Aquatics Convention in San Diego and to synchronized swimmers at the elite training camp in San Francisco. She also wrote a 3-Part Article on Eating Disorders for Synchro Swimming in 2000. She is available for presentations and workshops around the country and can be reached at franseen@pol.net.