A strange paradox of sporting activity is that participation often leads to higher self-esteem, but - at least in certain sports - it can also lead to an increased risk of developing eating disorders such as anorexia nervosa and bulimia, both of which are usually associated with low self-esteem.

Certain sports seem to carry an increased risk of eating problems. For example, in the United States, about 93 per cent of collegiate athletes who develop eating disorders are female, and these athletes are usually found in a fairly small number of sports, including gymnastics, cross country, swimming, and track and field. The few cases reported in men are clustered in the sports of cross country, track and field, gymnastics, and wrestling.

What actually causes the eating disorders? A combination of individual and familial factors are often involved in producing an eating problem, and cultural factors apparently put females at especially high risk: Over the past three decades, the socially acceptable weight for women in Western societies has progressively decreased, while the incidence of eating disorders has steadily risen.

Why are eating disorders linked with certain sports? Individuals dissatisfied with their bodies may be drawn to calorie-burning' sports like running and swimming. In addition, scientific research suggesting that 'lean is better' for performance may contribute to the problem, and aesthetic sports such as gymnastics probably place far too high a premium on being super-thin.

Recovering from an eating disorder is a complex process involving counseling and the raising of self-esteem and self-acceptance. Athletes can do a number of things to reduce their risk of developing an eating disorder, and coaches should realize that they can take steps to help prevent eating disorders in their athletes. Alice Lindeman, an eating-disorder researcher at the University of Indiana, recommends that athletes be aware of the following facts:

(1) There is a range of weight which is appropriate for any particular sport. No one weight is ideal and the lowest-possible weight is usually NOT optimal.

(2) Eating too little can actually depress metabolism and make one fatter - not slimmer.

(3) Eating more food can be a great way to improve body composition, because the increased caloric intake replenishes muscles and allows higher-quality training, which burns away fat naturally.

(4) Fear of fat in the body shouldn't translate into fear of fat on the plate. Fat is an essential nutrient required for the absorption of vitamins D, E, A, and K, so some fat must be included in the diet.

(5) Taking in more calories can improve menstrual function, which heightens bone health and reduces the risk of osteoporosis.

Coaches should de-emphasize weight and refrain from commenting on body weight as they speak with their athletes. Coaches should also avoid group 'weigh-ins,' which can heighten humiliation and embarrassment for the athlete who feels too fat and may push an athlete onto the road leading to a full-blown eating problem.

('Self-Esteem: Its Application to Eating Disorders and Athletes,' International Journal of Sport Nutrition, vol. 4, pp. 237-252, 1994)

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