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If the physician and/or eating disorder specialist recommends treatment, the athlete shall be considered “unfit” and agree to treatment in order to later be allowed to return to training and competition. The physician shall also determine whether further medical specialist consultations are necessary (e.g., psychiatry, endocrinology, gynecology, and others). Athletes diagnosed with disordered eating, but no other underlying medical disorder, who are unable or unwilling to follow the eating recommendations made by the nutritionist and/or physician shall be referred to an eating disorder treatment specialist experienced in working with athletes. Athletes and especially elite athletes constitute a unique population, and special diagnostic considerations should be made when working with this group (Thompson & Sherman, 1993; Beals & Manore, 1994; Sundgot-Borgen, 1996). Identifying disordered eating gambling among elite athletes must go beyond focusing on those who meet diagnoses for eating disorders to include those who have too low energy availability and/or are practicing pathogenic weight control behaviors.
It is important to determine whether the athlete's abnormal eating and dieting behaviors are transient behaviors associated with the specific demands of the sport (“anorexia athletica”) or whether the symptoms are more stable and part of a clinical eating disorder (Sundgot-Borgen, 1996; Drinkwater et al., 2005). It is not enough to document behaviors; the emotional and psychological state of the athlete must also be examined. Research on youth sports gives us a glimpse into the origins and dynamics of parental commitment to the sport participation of children. Services markets are proposed to exist along an identification continuum based upon levels of consumer commitment and emotional involvement. We illustrate the impact of social identification by focusing on one service industry, the sports marketplace, an industry typified by exceedingly high levels of identification between consumer and market offering. The authors examine four characteristics of the services environment (group experience, history/tradition, physical facility, rituals) that marketers can leverage to enhance consumers’ identification with a service and, ultimately, increase brand equity. The authors speculated that their observations were attributable to the differences in soy protein digestion as compared to milk protein digestion. The increase in protein net balance and muscle protein synthesis was most pronounced with the consumption of 500 mL of fat-free milk as compared to an isoenergetic, isonitrogenous, and macronutrient matched soy-protein beverage (745 Kj, 18.2 g protein, 1.5 g fat, and 23 g carbohydrate).
The milk group gained 1.6 ± 0.4 kg of FFST mass, while the carbohydrate electrolyte beverage group only gained 0.8 ± 0.5 kg of FFST mass. However, there was an interesting trend for the milk group to have a greater increase in fat-free soft tissue (FFST) mass. This study did not determine what contributed to the change in net balance (change in synthesis, change in breakdown, or both), however, the evidence did show that protein metabolism was enhanced with a single bolus intake of milk after the resistance exercise. Follow-up studies have directly investigated the impact of milk consumption on the acute protein metabolic response following resistance exercise. Based on the acute changes in protein metabolism with milk consumption following resistance exercise, a number of questions arise. Nonetheless, this was the first study to look at the long term interaction of milk consumption and resistance training. Recent research has addressed the long term influence of milk consumption after resistance training. Therefore, it is reasonable to hypothesize that milk beverages, when consumed soon after resistance exercise, can lead to enhanced improvements in protein metabolism following resistance exercise. Essentially, no differences were observed for any of the measured variables when the group that consumed milk post exercise was compared to the group that consumed the commercial sports drink.