Adölesan Sporcularda Yeme Bozuklukları: Yaygınlık, Tanı ve Tedavi Yönetimi

Yıl 2023, Cilt: 5 Sayı: 2, 43 - 52, 31.12.2023

Nesibe Büşra Diler Orakçı , Pınar Göbel

https://doi.org/10.51538/intjourexerpsyc.1272563

Öz

Yeme bozuklukları; düzensiz yeme davranışlarıyla başlayabilen, çeşitli sebeplerle ortaya çıkabilen, ciddi komplikasyonlara yol açabilen ve yüksek mortalite oranına sahip psikiyatrik bozukluklardır. Adölesan dönemde görülen beden-benlik ilişkisi, fiziksel ve sosyal olarak kabul görme/beğenilme arzusu yeme bozukluğunu artıran risk faktörlerindendir. Sporculuktaki mükemmeliyetçilik ve rekabetçilik durumu adölesan dönemle birleştiğinde bu oran çok daha fazla artmaktadır. Özellikle adölesan sporcularda; bedensel imaj kaygıları, takım arkadaşlarıyla kıyas, kaslı olma, zayıf görünme, başarı beklentisi, aile/çevre/antrenör baskısı gibi çok çeşitli endişeler sebebiyle sporcu olmayanlara göre yeme bozukluğu prevalansı çok daha yüksektir. Dönemin getirdiği parametreler de incelenerek adölesan sporcuları değerlendirmek tanı kriterleri açısından elzemdir. Spor hekimi, spor diyetisyeni, psikiyatrist, psikolog ve antrenörler iş birliği ile çalışmalı; tanı ve tedavi için multidisipliner yol izlenmelidir. Bu aşamada sporcuya özgü kullanılan tarama araçları, takip değerlendirmeleri kullanılmalıdır. Tanı, tedavi ve tüm yeme bozukluklarını önleme yaklaşımlarında; sporcunun, ailenin, antrenörün ve tüm spor çalışanlarının eğitimi oldukça önemlidir. Sporcu ve sporcuyla çalışan ekipte her bireyin bilinçli olması çeşitli yeme bozukluklarını önleyebilecek, olası durumlarda erken müdaheleyle hızlı iyileşmeyi sağlayacaktır. Bu çalışma; sporcular üzerinde düzensiz yeme ve yeme bozukluğunda tanı ve tedavi yöntemlerini değerlendirmek amacıyla güncel literatür taranarak yapılmıştır.

Anahtar Kelimeler

Adölesan, sporcu, yeme bozukluğu, eğitim, beslenme

Eating Disorders in Adolescent Athletes: Prevalence, Diagnosis and Treatment Management

Öz

Eating disorders; are psychiatric disorders that can start with irregular eating behaviors, occur for various reasons, lead to serious complications, and have a high mortality rate. The body-self relationship seen in adolescence and the desire to be accepted/liked physically and socially are among the risk factors that increase eating disorders. This rate increases much more when perfectionism and competitiveness in sportsmanship are combined with the adolescent period. Especially in adolescent athletes, the prevalence of eating disorders is much higher than in non-athletes due to a wide range of concerns such as body image concerns, comparison with teammates, being muscular, looking weak, expectation of success, and family/environment/coach pressure. It is essential to evaluate adolescent athletes by examining the parameters of the period in terms of diagnostic criteria. Sports physicians, dietitians, psychiatrists, psychologists and coaches should cooperate; multidisciplinary pathways should be followed for diagnosis and treatment. At this stage, screening tools and follow-up evaluations specific to the athlete should be used. In diagnosing, treating, and preventing all eating disorders, training the athlete, family, coach and all sports personnel is very important. The awareness of each individual in the team working with the athlete and the athlete will prevent various eating disorders and provide rapid recovery with early intervention in possible situations. This study; the current literature was searched in order to evaluate the diagnosis and treatment methods in disordered eating and eating disorders on sports athletes.

Anahtar Kelimeler

adolescent, athlete, eating disorder, education, nutrition

Kaynakça

• Agüera, Z., Lozano-Madrid, M., Mallorquí-Bagué, N., Jimenez-Murcia, S., Menchon, J. M., & Fernandez-Aranda, F. (2021). A review of binge eating disorder and obesity. Neuropsychiatrie, 35, 57–67. https://doi.org/10.1007/s40211-020-00346-w
• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5nd ed.). American Psychiatric Association.
• Bakırcan, H. (2021). Adolesan sporcuların yeme bağımlılığı eğilimlerinin değerlendirilmesi [Yayımlanmamış yüksek lisans tezi]. Hitit Üniversitesi.
• Barrack, M. T., Fredericson, M., Tenforde, A. S., & Nattiv, A. (2017). Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes. British Journal of Sports Medicine, 51(3), 200-205. http://dx.doi.org/10.1136/bjsports-2016-096698
• de Borja, C., Holtzman, B., McCall, L. M., Carson, T. L., Moretti, L. J., Farnsworth, N., & Ackerman, K. E. (2021). Specific dietary practices in female athletes and their association with positive screening for disordered eating. Journal of Eating Disorders, 9, 1-10. https://doi.org/10.1186/s40337-021-00407-7
• Chang, C., Putukian, M., Aerni, G., Diamond, A., Hong, G., Ingram, Y., ... & Wolanin, A. (2020). Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary. British Journal of Sports Medicine, 54(4), 216-220. http://dx.doi.org/10.1136/bjsports-2019-101583
• Cheng, J., Santiago, K. A., Abutalib, Z., Temme, K. E., Hulme, A., Goolsby, M. A., ... & Casey, E. K. (2021). Menstrual irregularity, hormonal contraceptive use, and bone stress injuries in collegiate female athletes in the United States. PM&R, 13(11), 1207-1215. https://doi.org/10.1002/pmrj.12539
• Chidiac, C. W. (2019). An update on the medical consequences of anorexia nervosa. Current Opinion in Pediatrics, 31(4), 448-453. https://doi.org/10.1097/MOP.0000000000000755
• Conviser, J. H., Tierney, A. S., & Nickols, R. (2018). Essentials for best practice: Treatment approaches for athletes with eating disorders. Journal of Clinical Sport Psychology, 12(4), 495-507. https://doi.org/10.1123/jcsp.2018-0013
• Van Durme, K., Goossens, L., & Braet, C. (2012). Adolescent aesthetic athletes: a group at risk for eating pathology?. Eating Behaviors, 13(2), 119-122. https://doi.org/10.1016/j.eatbeh.2011.11.002
• El Ghoch, M., Soave, F., Calugi, S., & Dalle Grave, R. (2013). Eating disorders, physical fitness and sport performance: A systematic review. Nutrients, 5(12), 5140-5160. https://doi.org/10.3390/nu5125140
• Nagata, J. M., Carlson, J. L., Golden, N. H., Murray, S. B., Long, J., Leonard, M. B., & Peebles, R. (2019). Associations between exercise, bone mineral density, and body composition in adolescents with anorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24, 939-945. https://doi.org/10.1007/s40519-018-0521-2
• Jankauskiene, R., & Baceviciene, M. (2019). Body image concerns and body weight overestimation do not promote healthy behaviour: evidence from adolescents in Lithuania. International Journal of Environmental Research and Public Health, 16(5), 864. https://doi.org/10.3390/ijerph16050864
• Jankauskiene, R., & Baceviciene, M. (2019). Body image and disturbed eating attitudes and behaviors in sport-involved adolescents: the role of gender and sport characteristics. Nutrients, 11(12), 3061. https://doi.org/10.3390/nu11123061
• Joy, E., Kussman, A., & Nattiv, A. (2016). 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British Journal of Sports Medicine, 50(3), 154-162. http://dx.doi.org/10.1136/bjsports-2015-095735
• Kennedy, S. F., Kovan, J., Werner, E., Mancine, R., Gusfa, D., & Kleiman, H. (2021). Initial validation of a screening tool for disordered eating in adolescent athletes. Journal of Eating Disorders, 9, 1-11. https://doi.org/10.1186/s40337-020-00364-7
• Knapp, J., Aerni, G., & Anderson, J. (2014). Eating disorders in female athletes: use of screening tools. Current Sports Medicine Reports, 13(4), 214-218. https://doi.org/10.1249/JSR.0000000000000074
• Krentz, E. M., & Warschburger, P. (2013). A longitudinal investigation of sports‐related risk factors for disordered eating in aesthetic sports. Scandinavian Journal of Medicine & Science in Sports, 23(3), 303-310. https://doi.org/10.1111/j.1600-0838.2011.01380.x
• Ljungqvist, A., Jenoure, P., Engebretsen, L., Alonso, J. M., Bahr, R., Clough, A., ... & Thill, C. (2009). The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. British Journal of Sports Medicine, 43(9), 631-643. http://dx.doi.org/10.1136/bjsm.2009.064394
• Mancine, R., Kennedy, S., Stephan, P., & Ley, A. (2020). Disordered eating and eating disorders in adolescent athletes. Spartan Medical Research Journal, 4(2). http://dx.doi.org/10.51894/001c.11595
• Martinsen, M., Holme, I., Pensgaard, A. M., Torstveit, M. K., & Sundgot-Borgen, J. (2014). The development of the brief eating disorder in athletes questionnaire. Medicine & Science in Sports & Exercise, 46(8), 1666-1675. http://dx.doi.org/10.1249/MSS.0000000000000276
• Martinsen, M., & Sundgot-Borgen, J. (2013). Higher prevalence of eating disorders among adolescent elite athletes than controls. Medicine & Science in Sports & Exercise, 45(6), 1188-1197. http://dx.doi.org/10.1249/MSS.0b013e318281a939
• Mitchison, D., Mond, J., Bussey, K., Griffiths, S., Trompeter, N., Lonergan, A., ... & Hay, P. (2020). DSM-5 full syndrome, other specified, and unspecified eating disorders in Australian adolescents: prevalence and clinical significance. Psychological Medicine, 50(6), 981-990. http://dx.doi.org/10.1017/S0033291719000898
• Montani, J. P., Schutz, Y., & Dulloo, A. G. (2015). Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?. Obesity Reviews, 16, 7-18. https://doi.org/10.1111/obr.12251
• Murray, S. B., Griffiths, S., & Nagata, J. M. (2018). Community-based eating disorder research in males: a call to action. Journal of Adolescent Health, 62(6), 649-650. https://doi.org/10.1016/j.jadohealth.2018.03.008
• Nagata, J. M., Ganson, K. T., & Murray, S. B. (2020). Eating disorders in adolescent boys and young men: an update. Current Opinion in Pediatrics, 32(4), 476. https://doi.org/10.1097/MOP.0000000000000911
• Nagata, J. M., Golden, N. H., Peebles, R., Long, J., Murray, S. B., Leonard, M. B., & Carlson, J. L. (2017). Assessment of sex differences in body composition among adolescents with anorexia nervosa. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 60(4), 455–459. https://doi.org/10.1016/j.jadohealth.2016.11.005
• Nagata, J. M., Murray, S. B., Bibbins‐Domingo, K., Garber, A. K., Mitchison, D., & Griffiths, S. (2019). Predictors of muscularity‐oriented disordered eating behaviors in US young adults: A prospective cohort study. International Journal of Eating Disorders, 52(12), 1380-1388. https://doi.org/10.1002/eat.23094
• Nagata, J. M., Park, K. T., Colditz, K., & Golden, N. H. (2015). Associations of elevated liver enzymes among hospitalized adolescents with anorexia nervosa. The Journal of Pediatrics, 166(2), 439-443. https://doi.org/10.1016/j.jpeds.2014.10.048
• Thein-Nissenbaum, J., & Hammer, E. (2017). Treatment strategies for the female athlete triad in the adolescent athlete: current perspectives. Open Access Journal of Sports Medicine, 8, 85-95. https://doi.org/10.2147/OAJSM.S100026
• Petisco-Rodríguez, C., Sánchez-Sánchez, L. C., Fernández-García, R., Sánchez-Sánchez, J., & García-Montes, J. M. (2020). Disordered eating attitudes, anxiety, self-esteem and perfectionism in young athletes and non-athletes. International Journal of Environmental Research and Public Health, 17(18), 6754. https://doi.org/10.3390/ijerph17186754
• Plateau, C. R., Arcelus, J., Leung, N., & Meyer, C. (2017). Female athlete experiences of seeking and receiving treatment for an eating disorder. Eating Disorders, 25(3), 273-277. https://doi.org/10.1080/10640266.2016.1269551
• Power, K., Kovacs, S., Butcher-Poffley, L., Wu, J., & Sarwer, D. (2020). Disordered eating and compulsive exercise in collegiate athletes: Applications for Sport and Research. The Sport Journal, 23(7), 41. http://thesportjournal.org/article/tag/disordered_eating
• Quadflieg, N., Strobel, C., Naab, S., Voderholzer, U., & Fichter, M. M. (2019). Mortality in males treated for an eating disorder—a large prospective study. International Journal of Eating Disorders, 52(12), 1365-1369. https://doi.org/10.1002/eat.23135
• Rancourt, D., & McCullough, M. B. (2015). Overlap in eating disorders and obesity in adolescence. Current Diabetes Reports, 15, 1-9. https://doi.org/10.1007/s11892-015-0645-y
• Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., ... & Engebretsen, L. (2019). Mental health in elite athletes: International Olympic Committee consensus statement (2019). British Journal of Sports Medicine, 53(11), 667-699. http://dx.doi.org/10.1136/bjsports-2019-100715
• Recio-Barbero, M., Fuertes-Soriano, S., Cabezas-Garduño, J., López-Atanes, M., Peña-Rotella, A., & Sáenz-Herrero, M. (2019). Delayed diagnosis of an eating disorder in a male patient with superior mesenteric artery syndrome: results from a case study. Frontiers in Psychiatry, 10, 731. https://doi.org/10.3389/fpsyt.2019.00731
• Rosa-Caldwell, M. E., Todden, C., Caldwell, A. R., & Breithaupt, L. E. (2018). Confidence in eating disorder knowledge does not predict actual knowledge in collegiate female athletes. PeerJ, 6, e5868. https://doi.org/10.7717/peerj.5868
• Rousselet, M., Guérineau, B., Paruit, M. C., Guinot, M., Lise, S., Destrube, B., ... & Prétagut, S. (2017). Disordered eating in French high-level athletes: association with type of sport, doping behavior, and psychological features. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22, 61-68. https://doi.org/10.1007/s40519-016-0342-0
• Schorr, M., Drabkin, A., Rothman, M. S., Meenaghan, E., Lashen, G. T., Mascolo, M., ... & Miller, K. K. (2019). Bone mineral density and estimated hip strength in men with anorexia nervosa, atypical anorexia nervosa and avoidant/restrictive food intake disorder. Clinical Endocrinology, 90(6), 789-797. https://doi.org/10.1111/cen.13960
• Soylu, Y. (2021). Mücadele sporcularında duygusal yeme, bilinçli farkındalık ve psikolojik iyi oluş. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 10(3), 542-549. https://doi.org/10.37989/gumussagbil.957866
• Sundgot-Borgen, J., & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25-32. https://journals.lww.com/cjsportsmed/Fulltext/2004/01000/Prevalence_of_Eating_Disorders_in_Elite_Athletes.5.as
• Sundgot-Borgen, J., Meyer, N. L., Lohman, T. G., Ackland, T. R., Maughan, R. J., Stewart, A. D., & Müller, W. (2013). 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. British Journal of Sports Medicine, 47(16), 1012-1022. http://dx.doi.org/10.1136/bjsports-2013-092966
• Taylor, S. A., Ditch, S., & Hansen, S. (2018). Identifying and preventing eating disorders in adolescent patients with obesity. Pediatric Annals, 47(6), e232-e237. https://doi.org/10.3928/19382359-20180522-01
• Thiemann, P., Legenbauer, T., Vocks, S., Platen, P., Auyeung, B., & Herpertz, S. (2015). Eating disorders and their putative risk factors among female German professional athletes. European Eating Disorders Review, 23(4), 269-276. https://doi.org/10.1002/erv.2360
• Trexler, E. T., Smith-Ryan, A. E., & Norton, L. E. (2014). Metabolic adaptation to weight loss: implications for the athlete. Journal of the International Society of Sports Nutrition, 11(1), 7. https://doi.org/10.1186/1550-2783-11-7
• Tuğal, D. (2019). Sporcuların besin seçimlerinin beden imajı ve yeme davranışına göre değerlendirilmesi [Yayımlanmamış Yüksek Lisans Tezi]. Hacettepe Üniversitesi.
• Tuzgöl, T., Emiroğlu, E., & Güneş, F. E. (2018). Atletlerde Yeme Bozuklukları. Türkiye Klinikleri Journal of Sports Sciences, 10(2),88-96. https://doi.org/10.5336/sportsci.2018-59780
• Vo, M., Lau, J., & Rubinstein, M. (2016). Eating disorders in adolescent and young adult males: presenting characteristics. Journal of Adolescent Health, 59(4), 397-400. https://doi.org/10.1016/j.jadohealth.2016.04.005
• Walsh, J. M., Wheat, M. E., & Freund, K. (2000). Detection, evaluation, and treatment of eating disorders: the role of the primary care physician. Journal of General Internal Medicine, 15, 577-590. https://doi.org/10.1046/j.1525-1497.2000.02439.x
• Weber, A. M., Cislaghi, B., Meausoone, V., Abdalla, S., Mejía-Guevara, I., Loftus, P., ... & Gupta, G. R. (2019). Gender norms and health: insights from global survey data. The Lancet, 393(10189), 2455-2468. https://doi.org/10.1016/S0140-6736(19)30765-2
• WHO, 2019. https://www.who.int/maternal_child_adolescent/adolescence/en
• Williams, G. (2016). Binge eating and binge eating disorder in athletes: A review of theory and evidence. The Sport Journal, 19, 1-1. http://thesportjournal.org/article/binge-eating-and-binge-eating-disorder-in-athletes-a-review-of-theory-and-evidence