Addictive and Unhealthy Behaviors

1. Addictiveand Unhealthy Behaviors Addictiveand Unhealthy Behaviors

2. Session Outline Eating Disorders – Defining and understanding anorexia and bulimia – Prevalence of eating disorders in sport – Predisposing factors – Recognition and referral of an athlete with eating problems – Eating disorders dos and don’ts – Preventing eating disorders (continued)

3. Session Outline Compulsive Gambling: An Odds-On Favorite for Trouble – Prevalence of sports gambling – Signs of compulsive gambling

4. Defining Anorexia Nervosa Anorexia nervosa:A psychobiological disease characterized by an intense fear of becoming obese, a disturbed body image, a significant weight loss, the refusal to maintain normal body weight, and amenorrhea.

5. Characteristics of Anorexia Nervosa Weight loss to 15% below normal Intense fear of gaining weight or being fat, despite being underweight Disturbance in one’s experience of body weight, size, and shape Females: absence of at least three consecutive expected menstrual cycles (APA, 1994)

6. Defining Bulimia Bulimia An episodic eating pattern of uncontrollable food bingeing followed by purging; it is characterized by an awareness that the pattern is abnormal, fear of being unable to stop eating voluntarily, depressed mood, and self-deprecation.

7. Characteristics of Bulimia Recurrent binge eating A sense of lacking control over eating behavior during the binges Engaging in regular self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain Average minimum of two binge-eating episodes a week for three months Consistent overconcern with body shape and weight (APA, 1994)

8. Prevalence of Eating Disorders Accurate assessment is difficult to achieve because of the secretive nature of the disorder.

9. Research on the Prevalence of Eating Disorders Athletes appear to have a greater occurrence of eating-related problems than does the general population. A significant percentage of athletes engage in pathogenic eating or weight-loss behaviors (e.g., bingeing, fasting), although subclinical in intensity. Eating disorders and pathogenic weight-loss techniques tend to have a sport-specific prevalence (e.g., among wrestlers vs. archers).

10. Predisposing Factors Weight restrictions and standards Coach and peer pressure Performance demands Judging criteria

11. Recognition and Referral of an Athlete with an Eating Problem Be able to recognize the physical and psychological signs and symptoms of these conditions. If you suspect an eating disorder, make a referral to a specialist in the area.

12. Making Referrals The person who has the rapport with the individual should schedule a private meeting to discuss the matter. Emphasize feelings rather than directly focusing on eating behaviors. Be supportive and keep all information confidential. Make a referral to a specific clinic or person.

13. Physical Signs of Eating Disorders Weight too low Considerable weight loss Extreme weight fluctuations Bloating Swollen salivary glands Amenorrhea (continued)

14. Physical Signs of Eating Disorders Carotinemia—yellowish palms or soles of feet Sores or callouses on knuckles or back of hand from inducing vomiting Hypoglycemia—low blood sugar Muscle cramps Stomach complaints (continued)

15. Physical Signs of Eating Disorders Headaches, dizziness, or weakness from electrolyte disturbances Numbness and tingling in limbs due to electrolyte disturbances Stress fractures (See Table 20.1 on page 418 of text)

16. Psychological–Behavioral Signs of Eating Disorders Excessive dieting Excessive eating without weight gain Excessive exercise that is not part of normal training program Guilt about eating Claims of feeling fat at normal weight despite reassurance from others (continued)

17. Psychological–Behavioral Signs of Eating Disorders Preoccupation with food Avoidance of eating in public and denial of hunger Hoarding food Disappearing after meals Frequent weighing Binge eating (continued)

18. Psychological–Behavioral Signs of Eating Disorders Evidence of self-induced vomiting Use of drugs such as diet pills, laxatives, and diuretics to control weight (See Table 20.1 on page 418 of text)

19. Dos and Don’ts for Dealing With Eating Disorders DO get help and advice from a specialist. DO be supportive and empathetic. DO express concern about general feelings, not specifically about weight. DO make referrals to a specific person and, when possible, make appointments for them. (continued)

20. Dos and Don’ts for Dealing With Eating Disorders DO emphasize the importance of long-term good nutrition. DO provide information about eating disorders. (continued)

21. Dos and Don’ts for Dealing With Eating Disorders DON’T ask the athlete to leave team or curtail participation, unless so instructed by a specialist. DON’T recommend weight loss or gain. DON’T hold team weigh-ins. DON’T single out or treat the individual unlike other participants. (continued)

22. Dos and Don’ts for Dealing With Eating Disorders DON’T talk about the problem with nonprofessionals who are not directly involved. DON’T demand the problem be stopped immediately. DON’T make insensitive remarks or tease individuals regarding their weight. (See Table 20.2 on page 420 of text)

23. Preventing Eating Disorders in Athletes and Coaches Promote proper nutritional practices. Focus on fitness, not body weight. Be sensitive to weight issues. Promote healthy management of weight.

24. Compulsive Gambling:An Odds–On Favorite for Trouble Compulsive gambling, despite its long history in competitive sport, is only now getting public attention. Gambling on sporting events is widespread.

25. Prevalence of Compulsive Gambling 1.5% of the U.S. population are “compulsive” gamblers, 4.0% are “problem” gamblers. 6% to 8% of college students are compulsive gamblers. Teenage gambling by high school students is thought to be widespread.

26. Typical Parental Reactions to Teenage Gambling Afraid; imagine organized crime. Think they can handle it (most common reaction). “Thank God, it’s not drugs.”

27. Characteristics of Compulsive Gamblers Boastfulness Arrogance Optimism External competitiveness Intelligence

28. Signs of Compulsive Gambling Keys: Identification is next to impossible. Use Gamblers Anonymous 20 Questions for self-identification. Sport psychology professionals should make referrals when negative consequences appear.

29. Gambler’s Anonymous 20 Questions Do you lose time from work due to gambling? 1. Does gambling make your home life unhappy? 2. Does gambling affect your reputation? 3. Do you ever feel remorse after gambling? 4. Do you ever gamble to get money with which to pay debts or to otherwise solve financial difficulties? 5. (continued)

30. Gambler’s Anonymous 20 Questions 6. Does gambling cause a decrease in your ambition or efficiency? 7. After losing, do you feel you must return as soon as possible to win back your losses? After a win, do you have a strong urge to return and win more? 8. Do you often gamble until your last dollar is gone? 9. Do you ever borrow to finance your gambling? 10. (continued)

31. Gambler’s Anonymous 20 Questions Do you ever sell anything to finance gambling? 11. 12. Are you reluctant to use “gambling money” for normal expenditures? Does gambling make you careless about the welfare of your family? 13. Do you ever gamble longer than you planned? 14. Do you ever gamble to escape worry or trouble? 15. (continued)

32. Gambler’s Anonymous 20 Questions Do you ever commit, or consider committing, an illegal act to finance your gambling? 16. 17. Does gambling cause you to have difficulty sleeping? Do arguments, disappointments, or frustrations create within you an urge to gamble? 18. (continued)

33. Gambler’s Anonymous 20 Questions Do you have an urge to celebrate good fortune by a few hours of gambling? 19. Do you ever consider self-destruction as a result of your gambling? 20.