Physiologic impacts of bulimia nervosa on athletic performance

Overall, the impact of an eating disorder is related to the severity and duration of the condition, individual health status, and body stature and genetics. Below we list common symptoms observed in athletes who have an eating disorder. Coaches and trainers should be aware of these symptoms in any individual they work with who has a known or suspected eating disorder. These symptoms can occur because of malnutrition, dehydration, electrolyte imbalance, or osteoporosis.

General symptoms in an active athlete with any type of eating disorder

  • Fatigue
  • Dizziness
  • Loss of endurance
  • Loss of coordination
  • Loss of muscular strength
  • Loss of speed
  • Muscle cramps
  • Overheating

Female Athlete Triad

Many female athletes with an eating disorder are at risk for a syndrome known as “Female Athlete Triad,” in which they show one or more of the following symptoms:

  • Low energy availability, generally caused by either severe calorie restriction or excessive use of energy via exercise
  • Abnormal or total loss of menstrual function (amenorrhea)
  • Low bone mineral density. Sometimes this syndrome is discovered when an athlete begins to suffer stress fractures and is sent for a bone density scan.

Medical problems that can arise from specific eating disorders

Many of these problems can affect athletic performance as well as presenting serious health risks to the affected person. While having an eating disorder should not automatically disqualify an individual from participating in sports, coaches need to be aware of the impact an eating disorder can have on an athlete’s health and safety and ensure medical clearances for participation are current.

Bulimia nervosa

  • Erosion of tooth enamel from the acid produced by vomiting
  • Inflammation or rupture of the esophagus (the tube in the throat through which food passes to the stomach)
  • Enlarged glands near the cheeks (giving the appearance of swollen cheeks)
  • Damage to the stomach from frequent vomiting
  • Irregular heartbeat
  • Heart failure
  • Electrolyte imbalances (loss of important minerals like potassium) that can lead to sudden death
  • Peptic ulcers
  • Pancreatitis (inflammation of the pancreas, which is a large gland that aids digestion)
  • Long-term constipation and potentially life-threatening intestinal blockages

Binge-eating disorder

  • Joint pain
  • High blood pressure
  • High cholesterol
  • Type 2 diabetes
  • Diseased arteries
  • Gallbladder disease
  • Joint pain

Anorexia nervosa

  • Heart failure
  • Brittle hair and nails, dry skin
  • Mild anemia
  • Swollen joints
  • Reduced muscle mass
  • Osteoporosis