Despite the prevalence of eating disorders in adolescent girls, it’s difficult to find information about longer term health consequences in adults, as little follow-up has been done. A new article in the journal Maturitas on the long-term health consequences of the female athlete triad, a syndrome that may include eating disorders, is an important contribution to the research.
First defined in the early 1990s, female athlete triad used to be defined as the combination of an eating disorder, amenorrhea (lack of a menstrual period), and osteoporosis.
The definition was adjusted in 2007 to focus more on a spectrum of health and now includes low energy (with or without an eating disorder), menstrual function, and bone mineral density. These are interrelated; it is thought that the lack of energy due to excessive exercise or disordered eating leads to changes in menstrual cycles and loss of bone mineral density.
While it’s not original research, the new review by Jill Thein-Nissenbaum of the University of Wisconsin-Madison’s physical therapy program points out some important health issues for women beyond the teen years.
Of major concern, based on a review of the literature, are the long-term effects of decreased bone mineral density associated with the triad. Women who restricted their energy intake may have missed crucial bone mass building time, and this bone density may not be made up even with eating disorder recovery.
Thus, as women age, they are losing additional bone mass from an already depleted system. Thein-Nissenbaum notes that women with the triad may also be at greater risk of musculoskeletal injury, and these injuries may have negative effects throughout life.
Thein-Nissenbaum suggests that women who currently have or have recovered from female athlete triad discuss with their healthcare provider their history of eating behaviors and menstrual history, dating back to adolescence, and review details from previous bone scans.
She also cites the need for bone mineral density assessment in women who have had a history of disordered eating behaviors, menstrual irregularity, or more than one stress fracture.
The National Eating Disorders Association provides a toolkit for coaches and athletic trainers that includes a section on the female athlete triad, including causes, treatment, and behaviors to look out for. The guide also has information on other types of eating disorders and the role of coaches and trainers in prevention and early intervention.
Plus: Eating disorders are most commonly associated with adolescents, but adults are also susceptible to anorexia, bulimia, binge eating and other disorders, and they face a unique set of challenges, says Cynthia M. Bulik, author of the new book “Midlife Eating Disorders.” Women’s eNews recently published an excerpt.
“If we look at the numbers,” writes Bulik, “the most common profile of someone with an eating disorder is a woman in her 30s or 40s who struggles with weight control and suffers from binge eating disorder. But countless women and men in midlife and beyond — from all racial, ethnic and socioeconomic backgrounds — wake up each morning to an ongoing battle with eating and body image, with many suffering from anorexia nervosa, bulimia nervosa, purging disorder, binge eating disorder and night eating syndrome.”