(October 30, 2007) — Being an overachiever and a perfectionist can help high school and college athletes such as Makenna Moriarty do their best on the field or court. But those same traits can turn destructive when applied to body image.

The Webster Thomas High School field hockey and basketball player, now 17, thought she was too big a year ago and switched to diet foods. She obsessively measured portions and took laxatives. Even after losing 40 pounds and suffering back problems because of her inadequate eating, she continued to believe she was too large. She saw no need for help.

Athletes, especially females, are more at risk than nonathletes of developing an eating disorder, but many coaches lack knowledge about the problem, say specialists in the Rochester area. The specialists couldn't provide exact numbers but said they are seeing more teens and young adults with a range of eating disorders, including bingeing and disordered eating, as well as anorexia nervosa. Because of the problem, they are presenting a free seminar Friday for coaches, school counselors and parents to help them identify and help secondary and college students who may have an eating disorder.

"This illness can't keep itself going when all the adults are on the same page, applying caring, warm pressure," said Mary Tantillo, director of the Western New York Comprehensive Care Center for Eating Disorders and part of Unity Health System. "Coaches play a very important role in kids' lives."

About 2 in 100 people have an eating disorder among the general population, Tantillo said. Among college students, the rate climbs to 10 or 15 per 100 people. That would mean 8,000 to 12,000 cases just among the nearly 80,000 college students in the Rochester region.

Athletes have a higher-than-average risk for several reasons. They tend to have driven, people-pleasing, sometimes compulsive personalities. They may believe that losing fat or pounds will improve their sports performance. They want to do their best for the coach and may over-respond to a comment about their weight or size. On top of that, some sports, such as wrestling, ballet, dance, gymnastics and figure skating, emphasize body size and shape.

Girls see dieting as normal, and female athletes may believe it's normal to stop menstruating because of their high activity level, but Tantillo said both can harm bones.

Warning signs of an eating disorder include exercising despite injury, not eating more during a sports season to fuel the body's extra work, and being obsessed with appearance and size. Eating disorders can affect people of any weight, including thin people.

"Teammates can see things often that coaches don't see," said Tantillo. Perhaps a player heads to the bathroom right after meals, has laxatives or empty wrappers around, or talks frequently about a need to lower weight or amount of body fat.

While sports can be a route into an eating disorder, it also can provide an incentive to recover, said Tantillo.

That was true for Makenna, but it's been a struggle.

Her doctor noticed she had lost weight in the summer of 2006 and told her not to lose any more. But when field hockey season started, Makenna wasn't eating more to match her level of exercise, and she lost more weight.

Her mother, Sue Moriarty, a reading specialist at Webster's State Road Elementary School, became very concerned: "Every time I talked to her about it, it made it worse." Moriarty said she wishes that they'd turned to professional treatment sooner.

Makenna eventually saw specialists at Golisano Children's Hospital at Strong and at Unity Health.

At first, she was allowed to continue field hockey as long as she gained weight. Her coach, Dana Tucker, had a friend in high school who suffered an eating disorder. "I think it's such a real topic that coaches need to be more aware," said Tucker.

Makenna wasn't able to gain weight, so she had to drop out of field hockey and attend inpatient treatment at Unity starting last October — the same time her mother was diagnosed with breast cancer.

Moriarty was struck by the fact that flowers, cards and gifts arrived for her, while her daughter's illness was less understood. "Cancer is a lot easier than an eating disorder," said Moriarty, 47, because the treatment tends to be clear and people talk about cancer openly.

An athlete's disordered control over eating is a symptom of psychological troubles, rather than just a food problem, specialists say. When Makenna's brother was home from college, he'd tell Makenna: "Just eat." Makenna would say she was fine and she seemed fine. But on the inside, she wasn't.

"I just felt like I never really fit in," said Makenna, who is 6 feet tall and struggled with towering over her classmates for years. In the midst of treatment, she didn't think she would ever get better, yet she didn't want help.

She missed a lot of her junior year — including most of field hockey and all of the basketball season — because of her illness.

Makenna still thinks she's heavy and has to convince herself daily to eat. But treatment helped her see how the disorder twisted her thinking. She was able to return to the Titans field hockey team this fall and had more stamina than when she wasn't eating well.

Makenna is doing her senior school project on eating disorders, hoping others will recognize dangerous symptoms and get help. "I feel like they just caught it in time," she said of her own experience.

Her message to others is that they're not alone. "Seek help, seek guidance," she said.

"It's a mental illness you can't control."