Reading about sports usually means reading about how good it is for you. Regular exercise is beneficial for one's health: exercise strengthens your self-esteem and your well-being, it reduces the risk of heart disease and so on. Hence, elite athletes have to be very healthy. How does an eating disorder come about in elite sports athletes. At first glance, it may seem confusing. In reality, infections and disorders in elite athletes are an issue.

A 2008 Norwegian study of athletes representing the national teams on a junior and senior level found that almost half of "leanness sports" (for example, gymnastics and figure skating) participants had clinical eating disorders. Like the non-sports world, females are more affected than men.

Eating disorders are one of the most severe psychosomatic illnesses. The physical consequences of an eating disorder are, for example, cardiac and circulatory troubles, abnormal blood counts or kidney troubles. These effects can be life threatening if the eating disorder lasts for a long period of time. Self-induced weight loss to less than 20% of the normal body weight and a ‘disordered body scheme' are characteristics of anorexia nervosa. A disordered body scheme means not being able to see one's body as it actually is. Looking in the mirror, even when underweight, one with anorexia nervosa would see oneself as obese. For girls, amenorrhea is another character. Patients affected by bulimia nervosa suffer additionally from eating attacks. They eat heavy loads of nutrition without any control. In fear of gaining weight, they use unhealthy and dangerous weight loss methods, such as self-induced vomiting, excessive exercise or use of laxatives.

On top of the sociocultural ideal of a lean body, in highly competitive sports, there is another risk factor for eating disorders in young athletes - the uncompromising will to win. Being successful in sports often means being thin - or at least, athletes believe in this equation. A low body weight does obviously bring advantages in technical sports, like ski jumping or gymnastics. In sports dealing with weight categories such as rowing or wrestling, athletes believe they have an advantage, if they lose weight right before a competition to compete in a lower weight category. Even in endurance sports, athletes can gain an advantage through a lower body weight.

But the thinner the better is not true! Striving to be lighter, some athletes lose more and more weight to try to gain high performance until they end up in the vicious cycle of an eating disorder.

Within my research in Vienna, I developed a program for preventing eating disorders in elite athletes. My target group is 12- to 16-year-old female elite athletes. In small groups of five to ten girls, issues like body image, are discussed in a sport-specific way. The program contains six units. From behind a theoretical model, explaining the appearance of eating disorders in elite sports, I deduced the factors capable of being influenced. As the advantage of being thin cannot be denied nor be reduced, the girls should be given some help to prevent eating disorders. First of all, such programs should provide athletes information that de-stigmatize disordered eating and body image-related problems through open, truthful and factual discussions. In fact, I do inform the girls about risks and harms of eating disorders. The girls learn to distinguish between healthy and unhealthy eating behavior patterns. As puberty is a risky age due to all the body changes and the insecurity of teenagers, I give information about these changes and female menstruation. Another unit deals with negative comments about one's body or weight. Trainers, parents, judges or teammates could give such comments -- most times without the aim of causing harm, but usually those comments hurt. And as research has shown, such comments could trigger eating disorders. For one of my research conclusions, that means learning how to deal with those comments should have a preventive effect. Another important risk factor for developing an eating disorder is a negative body image. Hence, my aim is to build a positive and healthy body image with the participants of my program. In order not to remind the girls of school lessons, all my units are interactive. I use games and practical exercises.

The first step to create such a program is finished. A pilot study was conducted with six volleyball-playing girls. This study brought out that the topic is relevant and interesting for girls. The girls taught me to use even more games and interactive exercises, also for the theoretical part. As a consequence of this first study, I removed my theoretical teaching and created a ‘puberty game'. Now the girls get the information while playing a game. Further research steps need to prove the positive effects of the program and show that the program can reduce the number of eating disorders in athletes. (Friederike Rasche, University of Vienna,