Disordered eating in high performance sport position statement

The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport. Kimberley Wells, Nikki Jeacocke, Renee Appaneal, Hilary Smith, Nicole Vlahovich, Louise Burke, David Hughes.

The AIS partnered with the NEDC and produced a position statement to assist sporting organisations to address this serious, but often misunderstood area. The guidelines are for athletes, coaches, support staff, clinicians and sporting organisations.

The position statement is a call to action to all involved in sport to be aware of poor self-image and poor body image among athletes. The guidelines support the prevention and recognition of disordered eating and promote early intervention to optimise nutrition for performance in a safe, supported, purposeful and individualised manner.

• 35992_Disordered-Eating-Position-Statement.pdf

High performance toolkit

To complement the position statement, there are also a range of resources that have been created to support coaches, support staff, clinicians and sporting organisations improve the early identification and prevention of disordered eating in high performance athletes.

Disordered eating early identification and prevention guideline/policy template

This disordered eating early identification and prevention guideline/policy template is designed to assist sporting organisations to develop and implement their own national guideline/policy. It provides a framework to address key areas for the early identification and prevention of disordered eating in elite athletes and guide policy and practice in this space.

To assist organisations to develop their own guideline or policy based on this template, the AIS recommends organisations engage the support of their Core Multidisciplinary Team (CMT). If this does not exist, then organisations might engage relevant professional support to ensure the specific of their context are considered.

Why do sports need a Disordered eating early identification and prevention guideline/policy?

In 2020 the Australian Institute of Sport (AIS) and the National Eating Disorders Collaboration (NEDC) released the “AIS-NEDC position statement on disordered eating in high performance sport”.

The position statement is a ‘call-to-action’, aimed at highlighting a significant but often under-acknowledged issue within the high performance sporting environment.

All high performance sporting organisations have a responsibility to prioritise the physical and mental health of their athletes. This can be assisted by the implementation of a disordered eating early identification and prevention guideline/policy.

Templates

• DE-prevention-and-early-ID-guideline-policy-template-v2_FINAL.docx(DOCX • 1.7 mb)
• DE-prevention-and-early-ID-guideline-policy-template.docx(DOCX • 2.4 mb)

Body composition assessment - considerations relating to disordered eating

These considerations have been developed to guide policy and practice within high performance sport in the area of body composition assessment and the specific considerations that arise in relation to disordered eating. They may be used as a reference for the development of minimum standards by National Sporting Organisations (NSOs) or adopted in full. It’s recommended that NSOs and National Institute Network (NIN) partners contemplate adopting these considerations.

While these considerations are specific to the assessment of body composition, the same principles should be considered when related assessment of athlete’s bodies are undertaken.

This includes but is not limited to:

• Monitoring changes in body mass to assess hydration themes
• Assessing power to weight ratios in strength testing
• Marking up for movement analysis

Overview

Assessments of body composition provide a useful tool to determine the impact of nutrition strategies and training interventions.

However, in particular athletes, such activities have the potential to cause harm. Protocols should be established and implemented before, during and after assessments of body composition to reduce this risk.

Resources and templates

• Disordered-eating-body-composition-considerations.pdf(PDF • 150.4 kb)

Eating disorder in sport workshop

Eating Disorders in Sport (EDiS) is an interactive workshop developed by the AIS and the NEDC for all role holders (coaches and performance support staff) within the high performance sporting system.  EDiS has been designed to be consistent with and compliment the AIS Mental Health in Sport workshop. The aims of EDiS are to:

1. Increase participant awareness and knowledge of:

• The signs and symptoms of disordered eating and eating disorders in athletes.
• The importance of prevention and early identification of disordered eating and eating disorders in athletes.

2. Increase participant confidence to help an athlete with disordered eating or an eating disorder up to the scope of their role.

Date: TBC

To express your interest in attending a workshop, contact disorderedeating@ausport.gov.au.

Inaugural EDiS workshop, March 2020.

Body Image and Eating Behaviours During Isolation

In these unprecedented times even the most resilient athlete will face challenges. Physical distancing, isolation and disruption to training and competition may negatively affect athletes’ body image and eating behaviours.

The AIS and National Eating Disorders Collaboration have partnered to develop targeted resources for athletes, coaches and high-performance staff with information to help recognise warning signs and to encourage athletes to seek help. You can download these useful fact sheets below.

Athletes are encouraged to reach out to a health professional within their sporting organisation (Doctor, Psychologist or Sports Dietitian) if they are struggling. If this isn’t available then you can call the AIS Mental Health Referral Network on +61 2 6214 1130.

Resources

• 35837_Disordered-Eating-fact-sheet-athletes_acc.pdf[PDF]
• 35837_Disordered-Eating-fact-sheet-coaches_3acc.pdf [PDF]
• More disordered eating information and resources are available here

What sporting organisations can do

Creating a healthy sport system

Creating and embedding an environment and culture that assists in the prevention of DE is of utmost importance to promoting the health of all athletes and minimising DE risk and incidence. Education is the best evidence-based method for primary prevention of DE and EDs. Athletes, coaches, support staff members and judges should undergo an initial comprehensive education program and regular refresher education sessions.

Sports have a responsibility to all athletes across the entire high performance pathway to create a healthy sport system, both in the environment and culture of the sport.

Early identification

DE in athletes can occur at any time; both precipitating, or being precipitated by, challenges in the athlete’s life as well as occurring during a time of successful performance. DE may manifest in a variety of ways that are unique to the individual.

Rapport between the athlete and service provider, or knowledge of the athlete’s baseline health and function can be helpful in the identification of DE and EDs.

View our Resources Toolkit to access a Disordered Eating Early Identification and Prevention Guideline/Policy Template.

Create a core multidisciplinary team

The core multidisciplinary team (CMT) comprising doctor, sports dietitian and psychologist, together coordinate the prevention, assessment, management and maintenance care in possible DE cases. Each member of the CMT provides expertise in a mutually supportive manner to deliver optimal care for the athlete in a safe, supported, individualised and purposeful way.

Education

Creating and embedding an environment and culture that assists in the prevention of DE is of utmost importance to promoting the health of all athletes and minimising DE risk and incidence.

Education is the best evidence-based method for primary prevention of DE and EDs. Athletes, coaches, support staff members and judges should undergo an initial comprehensive education program and regular refresher education sessions.

Contact

For more information, or for support using these resources, please contact disorderedeating@ausport.gov.au