SPORCULARDA YEME BOZUKLUKLARI

Yıl 2019, Cilt: 4 Sayı: 1, 1 - 10, 19.06.2019

Dilek Kendir , Efsun Karabudak

Öz

Yeme bozuklukları yüksek mortalite oranına sahip klinik
ruhsal bozukluklardır. Yeme bozukluğu sporcularda genel popülasyondan daha
yüksek oranda gözlenmektedir. Yeme bozukluğu gelişimi açısından daha fazla risk
altında olan spor dalları ise; sıklet sporları (judo, boks, halter, güreş),
estetik sporlar (bale, jimnastik, artistik paten) ve dayanıklılık (uzun mesafe
koşu, bisiklet) sporlarıdır. Kadın sporcularda yeme bozuklukları, düşük vücut
ağırlığı ve yetersiz enerji alımının sonucu menstrual disfonksiyon, düşük
enerji kullanılabilirliği ve düşük kemik mineral yoğunluğu ile karakterize olan
sporcu triadı ile ilişkilidir. Yeme bozukluğu olan kadın sporcularda gözlenen
aşırı egzersiz yapma davranışı sonucunda yorgunluk, amenore, vücut ağırlık kaybı
ve uykusuzluk gibi belirtiler ile ortaya çıkan sürantrenman durumu gözlenmekte
ve performans bozulmaktadır. Yeme bozukluklarının erken dönemde saptanması hem
sağlık problemlerinin ortaya çıkmasını hem de sporcunun performansının olumsuz
etkilenmesini engellemektedir. Antrenörlere ve sporculara yeme bozuklukları
risk faktörleri konusunda eğitim verilmesi büyük önem taşımaktadır. Sporcuya
yeme bozukluğu tanısı konulduktan sonra; multidisipliner (spor hekimi, sporcu
diyetisyeni, spor psikoloğu ve antrenörden oluşan) bir ekiple tedavi sürecinin
planlanması oldukça önemlidir. Bu derleme sporcularda yeme bozukluğu
yaygınlığını, risk altındaki spor dallarını ve yeme bozukluklarına sebep olan
faktörleri değerlendirmek ve yeme bozuklukları ile ilgili genel bilgi vermek
amacıyla hazırlanmıştır.

Anahtar Kelimeler

Yeme bozuklukları, sporcu, spor dalı, performans

Kaynakça

• 1. Amerikan Psikiyatri Birliği Ruhsal Bozuklukların Tanısal ve Sayımsal El kitabı, Beşinci Baskı (DSM-5), Tanı Ölçütleri Başvuru El kitabı (çeviri Köroğlu E). Ankara: Hekimler Yayın Birliği; 2014. 2. World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992. 3. Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP; American College of Sports Medicine. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007; 39(10): 1867–1882. 4. Scherer FC, Martins CR, Pelegrini A, Matheus SC, Petroski EL. Body image among adolescents: association with sexual maturation and symptoms of eating disorders. Braz J Psychiatr. 2010; 59(3): 198–202. 5. Filaire E, Rouveix M, Pannafieux C, Ferrand C. Eating attitudes, perfectionism and body-esteem of elite male judoists and cyclists. J Sports Sci Med. 2007; 6(1): 50–57. 6. Torstveit MK, Rosenvinge JH, Sundgot-Borgen J. Prevalence of eating disorders and predictive power of risk models in female athletes elite: a controlled study. Scand J Med Sci Sports. 2008; 18(1): 108–118. 7. Martinsen M, Brantland-Sanda S, Eriksson AK, Sundgot-Borgen J. Dieting to win or to thin? A study of dieting and disordered eating among adolescent elite athletes and non-athlete controls. Br J Sports Med. 2010; 44(1): 70–76. 8. Fortes LS, Kakeshita IS, Almeida SS, Gomes AR, Ferreira MC. Eating behaviors in youths: A comparison between female and male athletes and non-athletes. Scand J Med Sci Sports. 2014; 24(1): e62–e68. 9. Schaal K, Tafflet M, Nassif H, Thibault V, Pichard C, Alcotte M. et al. Psychological balance in high level athletes: gender-based differences and sport-specific patterns. PLoS One. 2011; 6(5): 1–9. 10. Baum A. Eating disorders in the male athlete. Sports Med. 2006; 36(1): 1-6. 11. Byrne S, McLean N. Elite athletes: effects of the pressure to be thin. J Sci Med Sport. 2002; 5(2): 80-94. 12. Martınsen M, Bahr R, Børresen R, Holme I, Pensgaard AM, Sundgot-Borgen J. Preventing eating disorders among young elite athletes: a randomized controlled trial. Med Sci Sports Exerc. 2014; 46(3): 435-47. 13. Currie A. Sport and eating disorders - understanding and managing the risks. Asian J Sports Med. 2010; 1(2): 63-68. 14. Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW. et al. National athletic trainers’ association position statement: preventing, detecting, and managing disordered eating in athletes. J Athl Train. 2008; 43(1): 80-108. 15. Yücel B. Estetik bir kaygıdan hastalığa uzanan yol. Klinik Gelişim. 2009; 22(4): 9-44. 16. National Institute of Mental Health. U.S. Department of Health and Human Services. Eating Disorders. NIH Publication No: TR 17-4901. Revised 2018. 17. Yage J, Andersen AE. Anorexia nervosa. N Engl J Med. 2005; 353(14): 1481-1488. 18. Moskowitz L, Weiselberg E. Anorexia nervosa/atypical anorexia nervosa. Curr Probl Pediatr Adolesc Health Care. 2017; 47(4): 70-84. 19. Castillo M, Weiselberg E. Bulimia nervosa/purging disorder. Curr Probl Pediatr Adolesc Health Care. 2017; 47(4): 85-94. 20. Rosen DS; American Academy of Pediatrics Committee on Adolescence. Identification and management of eating disorders in children and adolescents. Pediatrics. 126(6); 1240-53. 21. Mairs R, Nicholls D. Assessment and treatment of eating disorders in children and adolescents. Arch Dis Child. 2016; 101(12): 1168-1175. 22. Sachs K, Mehler PS. Medical complications of bulimia nervosa and their treatments. Eat Weight Disord. 2016; 21(1): 13-18. 23. Sundgot-Borgen J, Torstveit MK. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med. 2004; 14(1): 25-32. 24. Martinsen M, Sundgot-Borgen J. Higher prevalence of eating disorders among adolescent elite athletes than controls. Med Sci Sport Exerc. 2013; 45(6): 1188–1197. 25. Knapp J, Aerni G, Anderson J. Eating disorders in female athletes: use of screening tools. Curr Sports Med Rep. 2014; 13(4): 214-8. 26. Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci. 2013; 13(5): 499-508. 27. McLester CN, Hardin R, Hoppe S. Susceptibility to eating disorders among collegiate female student–athletes. J Athl Train. 2014; 49(3): 406–410. 28. Hulley AJ, Hill AJ. Eating disorders and health in elite women distance runners. Int J Eat Disord. 2001; 30(3): 312-7. 29. Sundgot Borgen, J. Prevalence of eating disorders in elite female athletes. Int J Sport Nutr. 1993; 3(1): 29–40. 30. Giel KE, Hermann-Werner A, Mayer J, Diehl K, Schneider S, Thiel A. et al. Eating disorder pathology in elite adolescent athletes. Int J Eat Disord. 2016; 49(6): 553–562. 31. Pelma MT, Koszewski WM, Romani W, Case JG, Zuiderhof NJ, McCoy PM. Identifying college athletes at risk for pathogenic eating. Br J Sports Med. 2002; 36: 45-50. 32. Hamilton LH, Gunn JB, Warren MP. Sociocultural influences on eating disorders in professional female ballet dancers. Int J Eat Disord. 1985; 4(4): 4105-477. 33. Krentz EM, Warschburger P. A longitudinal investigation of sports-related risk factors for disordered eating in aesthetic sports. Scand J Med Sci Sports. 2013; 23(3): 303–310. 34. Sundgot Borgen J, Meyer NL, Lohman TG, Ackland TR, Maughan RJ, Stewart AD. et al. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. Br J Sports Med. 2013; 47(16): 1012–1022. 35. Borgen JS, Corbın CB. Eating disorders among female athlete. Phys Sportsmed. 1987; 15(2): 89-93. 36. Kuruoğlu AÇ. Yeme bozukluklarında genetik etkenler. Klinik Psikofarmokoloji Bülteni. 2000; 10(1): 32-37. 37. Harriger JA, Witherington DC, Bryan AD. Eating pathology in female gymnasts: potential risk and protective factors. Body Image. 2014; 11(4): 501-8. 38. Taylor CB, Sharpe T, Shisslak C, Bryson S, Estes LS, Gray N. et al. Factors associated with weight concerns in adolescent girls. Int J Eat Disord. 1998; 24(1): 31-42. 39. Augestad LB. Prevalence and gender differences in eating attitudes and physical activity among Norwegians. Eat Weight Disord. 2000; 5(2): 62-72. 40. Sundgot Borgen J. Risk and trigger factors for the development of eating disorders in female elite athletes. Med Sci Sports Exerc. 1994; 26(4): 414-419. 41. Davison KK, Earnest MB, Birch, LL. Participation in aesthetic sports and girls’ weight concerns at ages 5 and 7 years. Int J Eat Disord. 2002; 31(3): 312–317. 42. Ackard DM, Henderson JB, Wonderlich AL. The associations between childhood dance participation and adult disordered eating and related psychopathology. J Psychosom Res. 2004; 57(5): 485-90. 43. Sudi K, Ottl K, Payerl D, Baumgartl P, Tauschmann K, Müller W. Anorexia athletica. Nutrition. 2004; 20(7–8): 657–661. 44. Hobart JA, Smucker DR. The female athlete triad. Am Fam Physician. 2000; 61(11): 3357-3364. 45. El Ghoch M, Soave F, Calugi S, Grave RD. Eating disorders, physical fitness and sport performance: a systematic review. Nutrients. 2013; 5(12): 5140-5160. 46. Şahin Özdemir FN, Ersöz G. Kadın sporcu üçlemesi. Türkiye Klinikleri Spor Bilimleri Dergisi. 2013; 5(2): 86-95. 47. Tan J, Bloodworth A, McNamee M, Hewitt J. Investigating eating disorders in elite gymnasts: conceptual, ethical and methodological issues. Eur J Sport Sci. 2014; 14(1) :60-68. 48. Garner DM, Garfinkel PE. The eating attitudes test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979; 9(2): 273-9. 49. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982; 12(4): 871-8. 50. Van Strein T, Frijters J, Bergers G, Defares P. The Dutch eating behaviour questionnaire (DEBQ) for assesment of restrained,emotional and external eating behaviour. Int J Eat Disord. 1986; 5(2) : 295-315. 51. Fairburn CG, Beglin SJ. Assessment of eating disorders: Interview or self‐report questionnaire? Int J Eat Disord. 1994; 16(4): 363-370. 52. Yücel B, Polat A, Ikiz T, Dusgor BP, Elif Yavuz A, Sertel Berk O. The Turkish version of the eating disorder examination questionnaire: reliability and validity in adolescents. Eur Eat Disord Rev. 2011; 19(6): 509-511. 53. Tuzgöl T, Emiroğlu E, Güneş FE. Atletlerde yeme bozuklukları. Türkiye Klinikleri Spor Bilimleri Dergisi. 2018; 10(2): 88-96. 54. Aydemir Ö, Köksal B, Sapmaz ŞY, Yüceyar H. Kadın üniversite öğrencilerinde REZZY yeme bozuklukları ölçeği Türkçe formunun güvenilirlik ve geçerliliği. Anadolu Psikiyatri Dergisi. 2015; 16(1): 31-35. 55. Black DR, Larkin LJS, Coster DC, Leverenz LJ, Abood DA. Physiologic screening test for eating disorders/disordered eating among female collegiate athletes. J Athl Train. 2003; 38(4): 286–297. 56. Coelho GM, Gomes AI, Ribeiro BG, Soares EA. Prevention of eating disorders in female athletes. J Sports Med. 2014; 5: 105-113.