CSSD Eating Disorders in Athletes 5 — Questions and Answers
Question 1: A sports dietitian notices a gymnast consistently avoids team meals, over-exercises after practice, and has dental erosion. Which eating disorder is most likely?
- Anorexia nervosa, restricting type
- Binge eating disorder
- Bulimia nervosa (Correct answer)
- Orthorexia nervosa
Correct answer: Bulimia nervosa
Dental erosion from acid exposure (purging), social meal avoidance, and compensatory exercise are classic signs of bulimia nervosa.
Question 2: According to the IOC consensus on RED-S, which performance outcome is NOT directly linked to low energy availability?
- Decreased endurance performance
- Impaired coordination
- Decreased muscle strength
- Increased maximal oxygen uptake (VO2 max) (Correct answer)
Correct answer: Increased maximal oxygen uptake (VO2 max)
Low energy availability impairs multiple performance parameters but does not increase VO2 max; aerobic capacity is generally compromised or unchanged, not enhanced.
Question 3: Which psychological model best explains why perfectionism is considered a risk factor for eating disorders in elite athletes?
- Social learning theory — athletes copy peers' restrictive behaviors
- Cognitive-behavioral model — perfectionism drives rigid dietary rules and fear of imperfection (Correct answer)
- Attachment theory — insecure attachment leads to emotional eating
- Self-determination theory — lack of autonomy leads to restriction
Correct answer: Cognitive-behavioral model — perfectionism drives rigid dietary rules and fear of imperfection
The cognitive-behavioral model links perfectionism to eating disorders through rigid, all-or-nothing thinking about food, body, and performance that drives restrictive or compensatory behaviors.
Question 4: When an athlete with bulimia nervosa is medically cleared to continue training, what nutrition strategy should the dietitian prioritize first?
- Prescribing a strict low-calorie diet to establish control
- Establishing regular structured meal and snack timing to reduce binge-purge urges (Correct answer)
- Eliminating all 'trigger foods' from the athlete's diet
- Increasing protein intake to suppress appetite
Correct answer: Establishing regular structured meal and snack timing to reduce binge-purge urges
Regular structured eating is the cornerstone nutritional intervention for bulimia nervosa, as irregular eating patterns drive hunger and precipitate binge episodes.
Question 5: Which characteristic of an athlete's training environment is identified in research as a 'sport-specific risk factor' for developing eating disorders?
- Access to a well-stocked training kitchen
- Coaches who comment negatively on athletes' body weight or shape (Correct answer)
- High training volume in isolation from peers
- Use of heart rate monitors during training
Correct answer: Coaches who comment negatively on athletes' body weight or shape
Research consistently identifies coach comments about body weight or shape as a significant sport-specific environmental risk factor for eating disorders in athletes.
Question 6: A sports dietitian is working with an athlete recently diagnosed with anorexia nervosa. Which level of care is most appropriate if the athlete has a heart rate of 44 bpm, orthostatic hypotension, and BMI of 15.2?
- Outpatient individual therapy only
- Intensive outpatient program (IOP)
- Inpatient medical stabilization (Correct answer)
- Standard weekly sports nutrition counseling
Correct answer: Inpatient medical stabilization
Severe bradycardia, orthostatic hypotension, and very low BMI indicate medically unstable anorexia nervosa requiring inpatient hospitalization for medical stabilization.
Question 7: What is the term for the clinical syndrome in which an athlete has all three components of low bone mineral density, menstrual dysfunction, and low energy availability?
- Overtraining syndrome
- The Female Athlete Triad (Correct answer)
- RED-S
- Anorexia athletica
Correct answer: The Female Athlete Triad
The Female Athlete Triad specifically describes the interrelated trio of low energy availability, menstrual dysfunction, and low bone mineral density.
CSSD Eating Disorders in Athletes 5
A sports dietitian notices a gymnast consistently avoids team meals, over-exercises after practice, and has dental erosion.
Which eating disorder is most likely?