Athletes, especially women, can fall prey to eating disorders

Eating disorders have become a serious health concern. Athletes are no exception and in fact may be particularly vulnerable to one of these conditions. 

Anorexia nervosa, bulimia nervosa and binge-eating disorder are the most commonly recognized disturbances of eating and weight regulation. The finding that anorexia is associated with the highest mortality rate of any psychiatric disorder emphasizes the seriousness of these disorders.

Young women who participate in gymnastics, cheer and running events are particularly vulnerable. It has been reported that between 15 percent and 62 percent of female college athletes have disordered eating. This wide variation is indicative of how little is known about the prevalence of these conditions.

Another area of confusion is whether an eating disorder developes as a result of participation in a particular sport or if a person with an eating disorder choses a sport that will allow for this behavior. 

The classic triad of low energy levels, delayed or absent menstrual periods and osteoporosis is a hallmark of these conditions. Considering 90 percent of bone development in women occurs before the age of 19, lifelong vulnerability to bone fractures are a consequence.

“Eating disorders are common in adolescent athletes training at a high-level. Some may go down a dangerous path trying to attain a supposed 'ideal' body type to enhance performance,” states Dr. Kathryn Ackerman, an endocrinologist specializing in conditions affecting female athletes. “While initial improvements in performance are often seen, these are unfortunately followed by more injuries, poorer recovery, more illnesses, and a decline in performance. Often the athlete struggles mentally and physically and the eating disorder that has developed gets overlooked.”

Denial on the part of athletes can play a big role in delaying diagnosis. Coaches and parents must be aware of early signs of an eating disorder and intervene immediately.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at

Allergic rhinitis can impede spring sports performance

Most competitive and participatory sports get underway in the spring. Many of these outdoor activities are played around a variety of grasses and trees that can trigger an allergic condition and interfere with athletic performance. 

The most common condition is allergic rhinitis or hay fever. Symptoms include sneezing, runny nose, coughing, postnasal drip, sore throat, eye irritation and a feeling of generalized fatigue. It is no surprise that these symptoms can be an obstacle to athletic success.

The allergic response is based on a series of events that are triggered by exposure to an allergen. In the case of allergic rhinitis the allergen is typically pollen, ragweed or a mold. After exposure, a cascade of actions follows. This cascade consists of a cellular response that includes inflammatory cells. 

Similar to other forms of inflammation, swelling of tissues and pressure-like pain are common. Treatment is directed toward desensitizing the body against reactions to a particular allergen or interrupting the inflammatory response at several levels.

Antihistamines are the most commonly used medications to reduce irritation of the eyes and nasal membranes. Often these are combined with a decongestant that may be sedating and should be avoided by athletes. Nasal and oral steroids can reduce the overall response to allergens but may be among banned substances for competitive athletes and would require a therapeutic exemption.

Newer drugs originally designed to treat asthma, like Singulaire, block inflammatory chemicals and are a very effective treatment for allergic rhinitis in athletes.

“Untreated allergies can lead to worsening of nasal congestion and reactive airway disease or asthma which can impair breathing and oxygen absorption,” reports Dr. Gregory Lesnik, a Norwich ear, nose and throat specialist. “Additionally, untreated allergies can result in an overall decline in energy levels causing suboptimal athletic performance.”

Effective treatment of seasonal allergic rhinitis can provide a needed boost toward achieving athletic goals before taking the field.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at