Question

Chapter 15: Eating and Exercise Disorders

Case 2 – Kate, the Marathon Runner

Kate is an experienced 22-year-old marathon runner who trained intensively to qualify for the Boston Marathon and successfully set a new personal record at a qualifying marathon 1 month ago. She will run the Boston Marathon in 3 months. Over the course of her training, Kate inadvertently lost about 15 pounds. She says she thinks it is because she religiously committed to a physical fitness program and after workouts never felt that hungry. She says that she would get home from a long day of work, which was followed by a training run, and at least two or three times per week, go right to bed with a small post-exercise snack but without dinner. She comes to you today as her coach and confides in you that her weight loss and feeling of guilt when she misses a workout is starting to concern her and she would like to get some help.

1. List at least four reasons that you are concerned about Kate’s story.

2. List at least four facts from Kate’s story that are reassuring.

3. What disordered eating and/or exercise patterns are possibilities for Kate, based on this scenario?

4. Based on the information presented, does Kate meet criteria for the diagnosis of any eating or exercise disorders?

5. What further information would you like to know?

6. What is your next step in helping Kate?

Answer 1

Eating and Exercise disorders:

Eating disorders : are any psychological disorders characterised by abnormal eating habits. Mainly two major types of Eating disorders are there ; Anorexia nervosa and Bulimia nervosa.  

Exercise disorder:

1. Four reasons for concern:

The reasons, for concern , about Kate are:

i) weight loss 15 pounds

ii) never feels hungry, after a long day of work out

iii) no dinner habit

iv) feeling guilty, when she misses a workout session.

2. Factors that are reassuring:

i) Her coach is a supportive person. Coaching style, that is Person- oriented rather than performance oriented is a reassuring factor.

ii) Kate is an athlete. Usually athletes have good self esteem

iii) Coach , who motivates the enthusiasm for sucess rather than body size and shape .

iv) Kate's identification that she need some help, is a positive sign.

3. Possibilities of Eating or Exercise disorder:

Possibilities of Eating or Exercise disorders:

She had the possibility of developing Anorexia nervosa, an eating disorder, and compulsive Exercise ( an Exercise disorder).

4. Criteria for the diagnosis of Eating or Exercise disorders:

Criteria for Anorexia nervosa are:

* Significant weight loss due to dietary restrictions

* Fear of fatness or a desire for thinness

*Distorted personal views such as, viewing herself as a fat person/overweight,when she is actually underweight or thinking that , by eating a small fruit , example: apple may increase her body weight.  

Compulsive Exercise:

* Will not miss out the work out, even if thre person get injury or sick.

* Guilty or anxious, while missing a workout session

* They will be preoccupied with their exercise routine and weight

* A significant amount of weight loss.

Kate meets the criteria for Exercise disorder, as she is having considerable weight loss , guilty feelings about missing the work out, and she is religiously committed to physical fitness programme.

5. Further information to know:

* Information about her desire on thinnes and body image perception: whether she is considering herself as a fat person.

* do she have the habits of purging/ induced vomiting and use of any laxatives

* Assess her self esteem

6. Next step in helping Kate:

* Assess for the criterias for any Eating and Exercise disorder.

* Monitor her body weight and inform her that her body weight is below average, as per her age and height.  

* Encourage her to maintain the standard body weight , so that her energy needs met well and it will help her for better performance.

* Educate her about the Eating and Exercise disorder and its criterias and complications .

* Help her to plan a healthy diet that help her to meet her energy needs and healthy weight gain/ or seek the Dietition's help.

* Educate her Coach to emphasise on factors like enthusiasm, motivation and inspirations that influence achievement, not on body shape or size.

* Encourage her coach to create an environment, that her teammates and she should have a healthy attitude towards the body size and shape.