Triad:
(1) disordered eating
(2) amenorrhea
(3) osteoporosis
Athletes at risk:
(1) all adolescent and some young adult women
(2) often competing at the elite level
(3) experiences a pressure to excel, either self-imposed or from external sources
Categories of sports where often encountered:
(1) endurance sports (running, swimming)
(2) sports where appearance is considered important (figure skating, diving, gymnastics)
(3) sports with weight categories (horse racing, martial arts, rowing)
(4) sports with subjective judging
Features
Disordered eating:
(1) most extreme form includes anorexia nervosa or bulimia
(2) may include any disordered eating pattern such as sporadic eating, poor nutrition, unnecessary dieting, occasional binge eating and purging
(3) may believe that continued weight loss guarantees improvement in athletic performance
(4) concerned with achieving or maintaining an "ideal body weight" or "optimal body fat"
(5) may resort to laxatives, diuretics or dietary medications to ensure weight loss
(6) may hide the behavior, by eating alone or spending time in the bathroom after meals
(7) may increase aerobic exercise beyond the usual practice sessions as a means to increase weight loss
Amenorrhea:
(1) delayed menarche (> 16 years) in a woman with secondary sex characteristics
(2) secondary amenorrhea: absence of 3-6 consecutive menstrual cycles
(3) estrogen levels may drop to postmenopausal levels
Osteoporosis:
(1) premature bone loss and/or inadequate bone formation
(2) increased risk of fracture
(3) some of the damage to bone may be irreversible
