MENTAL AND PHYSICAL HEALTH NOT ALWAYS TREATED EQUALLY

By Al Mattei

Founder, TopOfTheCircle.com

The United States of America leads the world in three seemingly unrelated topics:

* Success in women's athletics;

* Health care innovation;

* Eating disorders.

But, are they so unrelated? Not when it comes to the pressures put on teenage athletes, especially females athletes in an era of unparalleled worldwide success in team sports.

Though most of us would like to think that there is an intrinsic good in beginning exposure to competitive sports at younger and younger ages, the fact remains that athletics is one of the major aggravating factors in cases of eating disorders.

With some athletes becoming household names at younger and younger ages (Tara Lipinski, Dominique Moceanu, Kobe Bryant, Jennifer Capriati), the pressures of competition can manifest themselves in eating disorders and other problems, both physical and mental.

"The prevalence of eating disorders is up, and the age of onset is getting younger and younger," says Dr. Brenda Sigall, the Maryland co-chair of Eating Disorders Awareness & Prevention (EDAP), the group which stages the annual Eating Disorders Awareness Week.

Often, the mid-level athlete may feel as though extra hours of workouts or the shaving of a few calories may help performance when it, in fact, may starve an efficient body of calories needed to play a game.

Fortunately, despite portrayals of eating disorders as a silent killer lurking deep in the American subculture, society has a greater awareness of eating disorders in recent years. Private foundations, theater companies, and public service announcments all have created an awareness of the dangers of anorexia, bulemia, and binge eating.

Certainly, the solutions to eating disorders are more and more refined and effective. Mental health treatments, which may include therapy, lifestyle changes, and medication, can be prescribed for one who wants help. Often, the treatments help people towards recovery.

The problem is that, despite the United States' leadership in health care, the options for treatment for eating disorders have become extremely limited.

"The focus on the prevention of eating disorders has come about as a result of our understanding that resources for treatment are less accessible to people," Dr. Sigall says.

Six years after the Harry and Louise commercials predicted that the Clinton health care reform act of 1993 would decrease health care choice, a remarkable 60 percent of Americans have no choice as to the content and scope of their health care plans. An estimated 43 million Americans have no health care insurance whatsoever.

Health maintenance organizations have made particularly pernicious cuts in mental health coverage. For many plans, patients are limited to one, and only one, set of treatments in a lifetime. If, for example, a treated anorexic has a bout of depression in later life, no further treatment is possible.

This, of course, is the kind of health care rationing which the fictional characters Harry and Louise ranted about.

But Sigall points to another kind of advertising which often sends young girls into danger: fashion spreads depicting rail-thin models. Examples like Twiggy and Kate Moss have been etched in popular culture because of their thinness.

Ironically, in recent issues of Sports Illustrated's annual swimsuit issue, real athletes have been photographed as part of the photo spreads. Still, the main draw of the magazine are the images of models Heidi Klum and Rebecca Romijn-Stamos -- not the more positive images of swimmer Dara Torres and golfer Annika Sorenstam.

"The messages about body images, about trying to conform to these standards that are so unrealistic and unhealthy, are getting to girls at younger and younger ages," Sigall says. "And we know that 37 percent of elementary schoolgirls are dieting, for example."

So, what is the solution when it comes to eating disorders, especially in athletes?

It's a tough call, since Sigall's call to action is to get young people, especially girls, to develop self-esteem for reasons other than appearance.

While athletics is a sure-fire way to get the youth of America to value their talents and intelligence, it can also lead to eating disorders if a coach or parent, through a poor choice of words or supervision, short-circuits the athlete's own need for self-validation.

A player may, for example, have a personal-best effort, only to have more demanded of them -- more than may be humanly possible.

When an athletic program and its contests are no longer about the valuation of collective work balancing the validation of its individuals, problems occur. They may take the form of a losing streak, dissention, or even an eating disorder.

And these instances have happened all too often in not only the field hockey community, but the world of athletics in general. 1