During a lecture on Nutrition in sports, my lecturer highlighted a thin line of difference. This line exists between a dedicated athlete and a misguided person with an eating disorder. It also lies between a fitness fanatic. That line is almost scary. Many athletes have been toeing it for ages. Several have slipped over to the wrong side before they can even realize it.

The same attitude can be seen when it comes to training. An athlete spending hours in the gym is often committed to training. Yet, there is a thin line before it becomes excessive exercise leading to injury.

In the same line as the above comes a pursuit of excellence seen in athletes. A infinite urge to better themselves and their performance. But when does that urge to being the best turn into self-harming perfectionism? When does the coach-able athlete become overly compliant? At what point do they need education on recognizing excess? Much worse, when does a dedicated athlete who endures pain for performance become someone who denies their own pain?

While all of the above questions do seem scary at first, it all boils down to awareness. Such transitions are rarely seen in senior athletes. They have developed into a level of self awareness. They also have an understanding of their own bodies. This type of understanding must be taught to amateurs. It is crucial for collegiate athletes too, since these are the highly prone age groups.

It is important for a coach and/or sports physician to watch for signs of slippage. They should help the athlete before it gets harder to return. Watch for Over-Training Syndrome (OTS) in your athletes. Look out for noticeable signs of eating disorders. OTS may seem simple at first. However, it could become a complicated mental health issue when combined with eating disorders. These signs go beyond being a mental health issue. They could be the first step into developing RED-S (Relative Energy Deficiency in Sport). Preventing RED-S is of utmost importance.

This post is merely a call for awareness. It is a wake-up call for anyone in charge of player health. They need to keep an eye out. Players coming back from an injury are probably going to be extra motivated. They are dedicated to perform. They could easily put a foot down the wrong crevice.

If the questions posted above haven’t shaken you enough to wake up to this issue, think about this. Here are some stats that could help push you along.

• A study was published in the British Journal of Sports Medicine. It showed that 44% of athletes needed physio treatment for the first time in the London Olympics. They reported that they had been overdoing it.
• A study conducted among Spanish athletes in 2005 revealed that athletes were at a higher risk of developing eating disorders when compared to the general population (22.6% in athletes vs 4.1% prevalence in non-athletes).
• Here are a few names. Freddie Flintoff is an English cricketer. Molly Bartrip is an English footballer. Nadia Comaneci is a gymnast who won 9 Olympic gold medals. Finally, Mia St. John is a boxer who won the title of female Lightweight Champion of the World. Christian Moser and  Stefan Zund (male ski-jumpers) are also notable examples. All of them and more have suffered from eating disorders, overtraining and body image issues.

Hopefully, this article will have an impact on athletes and coaches alike. Train well, train hard, work on getting fit, push towards excellence and performance. But always keep a tab on how much is too much.

Author – Dr Harini Muralidharan, Founder & Co-Director