Does bodybuilding create or attract eating disorders?
One thing is for sure; there IS a link. Let’s unpack what we know..
Bodybuilding and the pursuit of extreme physique goals is just that, and extreme. And with that, we acknowledge the extreme methods that are employed in order to reach the goal. One thing we can be certain off the bat, is that there IS a link between competitive bodybuilding (over recreational hypertrophy training), and the spectrum of disordered eating, all the way to full flown eating disorder.
From both my personal decade of experience within the sport, and professional experience almost 6 years out of the sport supporting women to regain health post extremes, its no secret that the sport is magnet for those who come from previous ED backgrounds, or struggle with disordered eating tendencies.
As ‘bodybuilding requires us to focus on areas we may limit for general health; increased body checking, monitoring of scale weight etc. (Due to the nature of the sport) ‘participants may be vulnerable to developing unhealthy eating and weight control practices’. (Goldfield GS, 2009)
The sport often gives the individual a ‘socially acceptable’ way to continue engaging in disordered behaviours, under the guise of the ‘sport’, (‘Oh I have to do this I compete..’ I’ve been there too guys..)
But due to the extreme measures involved that both impair health on a psychological level as well as physical;
Micromanaging food intake
Equating food intake to calories burned
Placing body composition as the main focus and measure of success
Micro tracking all input and output
Hyper vigilance on the physique
The physical extremes of;
Unhealthy levels of body fat
Impaired hormonal health
Reduction in dietary diversity leading to deficiency as well as impaired gut health.
It is tough to see the line between and eating disorder, and the ‘sport’ at times, with ‘‘high rates of weight and shape preoccupation, body dissatisfaction, bulimic practices, and anabolic steroid use were reported among competitive female bodybuilders’
(Goldfield GS, 2009)
Anecdotally as a coach and nutritionist, many individuals I work with who come from previous ED background way prior to their involvement in bodybuilding, comment on how the behaviours, rituals, feelings and thought pattens mirrored that of their ED, and research tells us that from those questioned, many ‘competitive female bodybuilders also ‘appear to share many eating-related features with women with bulimia nervosa.’ (Goldfield GS, 2009) (as categorised by the DSM-5 criteria)
The scientific research doesn’t tell us a great deal right now. ‘Few studies have specifically examined competitive bodybuilders, as opposed to the much larger group of "recreational" bodybuilders who do not compete.’ (Steele IH, Pope HG Jr, Kanayama G., 2019)
Not only is disordered eating research relatively new, the bodybuilding population is still tiny cohort of the overall population, therefore making so many data pools too small to see true correlation or causation.
The limited research we do have. however, ‘suggests that competitive bodybuilders may show an ’increased risk for four categories of psychopathology: muscle dysmorphia, eating disorders, abuse of appearance- and performance-enhancing drugs, and exercise dependence.’
(Steele IH, Pope HG Jr, Kanayama G., 2019)
It is not clear from research ‘whether women with disordered eating or a history of bulimia nervosa disproportionately gravitate to competitive bodybuilding, and/or whether competitive bodybuilding fosters body dissatisfaction, disordered eating, bulimia nervosa, and anabolic steroid use.’
(Goldfield GS, 2009)
But what we DO know, and what the most important thing for YOU to recognise, is that the link IS there, and an incredibly fine line between necessary ‘behaviours for the sport’, and eating disorder tendencies, and we ‘must carefully distinguish between the planned and dedicated behaviours required for success in the sport, as opposed to frankly pathological behaviours that impair social or occupational function, cause subjective distress, or lead to adverse health consequences.’
(Steele IH, Pope HG Jr, Kanayama G., 2019)
So if you’re someone previous history ED or disordered eating, and feels comfort in controlling behaviours - you may want to be mindful and get very clear on WHY you are pursuing body building, and what the sport is giving you outside of a plastic trophy and perceived status among your echo chamber.
Equally, if you find yourself within sport, regularly checking in with yourself and your behaviours, asking yourself if you have normalised disordered behaviours, how easily you can step out of this into normal life again, and seeking the right support to reverse those behaviours should that be the case.
We can catch disordered tendencies before they become a full blown diagnosable eating disorders, and ofcourse this is preferable, both for your health, and also chances of efficient reversal / recovery toward healthful behaviours.
Ofcourse there are ways we can engage in competitive bodybuilding to protect these areas much as possible - however, it is important acknowledge (and irresponsible of the coaches that do not acknowledge this..) that micromanaging the body, using exercise solely control physical outcome, micromanaging food intake and output IS disordered in itself, despite what your favourite bikini competitor is telling you, who is still currently in the sport herself, on her own journey, and the closest to ‘normal’ she gets is a few days away from tracking her calories and protein when ‘allowed’ in off season (under the conditions she doesnt ‘go too far’, right..)
If you recognise yourself in this, can feel that you are slipping into a cycle of disordered tendencies, fearing letting go and only feeling comfortable in the control that the sport gives you, I promise you it doesn't have to be this way.
I support people like you to transition out of disordered tendencies, into flourishing health in all aspects, where nutrition and training enhance their life and health, over controlling and dictating it.
And if you feel you are closer to the ED side of the spectrum and in need of further clinical / professional support; you can contact organisation such as BEAT, or your GP for further clinical guidance.
BEAT (www.beateatingdisorders.org.uk)
References:
Steele IH, Pope HG Jr, Kanayama G. (2019) Competitive Bodybuilding: Fitness, Pathology, or Both? Harv Rev Psychiatry
Goldfield GS. (2009) Body image, disordered eating and anabolic steroid use in female bodybuilders. Eat Disord.
Suffolk, M. T. (2014). Competitive Bodybuilding: Positive Deviance, Body Image Pathology, or Modern Day Competitive Sport?, Journal of Clinical Sport Psychology