Andrew Bloodworth

Investigating eating disorders in elite gymnasts: Conceptual, ethical and methodological issues

Abstract Elite gymnastics, and other sports where athletes and coaches are particularly concerned with aesthetic considerations, weight and shape, are fields within which the risk of eating disorders may be unusually high. Adolescent gymnasts, developing their own sense of self, at a time of life where body image concerns are common, often compete at the very top of the sport with a need to maintain a body shape and weight optimal for elite performance. Research into this field should address the range of sociological and ethical aspects of eating disorders in elite sport, their prevalence as well as the ethos of the sport itself. This paper addresses a range of conceptual, ethical and methodological issues relevant to conducting research in this sensitive yet important field.

Sport, physical activity and well-being: an objectivist account

It is widely maintained that sport and physical activities contribute to the development of young peoples well-being. Others argue that sports’ contribution to good living is so strong that it is even thought to be a human right. Typically, however, the value of physical activity and sport to our well-being is conceptualized and researched within a subjectivist framework. We reject this framework on three grounds: (1) its impermanence; (2) its hedonistic shallowness; and (3) its epistemological inadequacy. In contrast, we argue that the value of sports and physical activities ought to be situated in fundamental arguments about the necessary conditions for human flourishing. According to this objectivist view, there are certain constituents of a good life without which human flourishing becomes impossible. We argue that sports and physical activities offer distinctive ways to help realize these objective constituents. It follows that, to the extent to which certain sections of society are deprived of opportunities to engage in sport and physical activity, or are offered diminished provision thereof, they thereby suffer a deficit in well-being.

Conceptions of Well-Being in Psychology and Exercise Psychology Research: A Philosophical Critique

The potential of physical activity to improve our health has been the subject of extensive research [38]. The relationship between physical activity and well-being has prompted substantial interest from exercise psychologists in particular [3], and it seems, is generating increasing interest outside the academic community in healthcare policy and practice inter alia through GP referrals for exercise. Researchers in the field have benefited from a rich tradition within psychology that investigates subjective well-being and its antecedents [7]. We argue that the exercise and health psychology research suffers from this intellectual ancestry specifically in the form of two significant conceptual limitations. First, short-term pleasure and enjoyment which are associated with exercise induced well-being may mask activities that are doing us no good or even harm us [18]. Second, focusing on pleasure entails unacceptable methodological reductionism which undermines the validity of such research by excluding other ways in which our well-being may be enhanced in non-hedonistic terms.

Understanding Eating Disorders in Elite Gymnastics: Ethical and Conceptual Challenges.

Eating disorders and disordered eating are more common in high performance sports than the general population, and particularly so in high performance aesthetic sports. This paper presents some of the conceptual difficulties in understanding and diagnosing eating disorders in high performance gymnasts. It presents qualitative and quantitative data from a study designed to ascertain the pattern of eating disorder symptoms, depressive symptoms and levels of self-esteem among national and international level gymnasts from the UK in the gymnastic disciplines of sport acrobatics, tumbling, and rhythmic gymnastics.

Prudence, Well-being and Sport

Participation in sport, in particular intensive elite sport may be associated with shorter and longer term risks to health. Elite sport participation might also be associated with a narrow focus, to the detriment of developing in other ways, perhaps with regard to friendships or education. This paper explores the issues surrounding prudence and sport. It begins by examining two central aspects of the rationale for prudential engagement with sport and physical activity. (1) The contention that each stage of life counts equally in assessing well-being over a life; and (2) The need to detach from present concerns and commitments to maintain a range of options from which to pursue well-being in the future. These aspects of a prudential athletic lifestyle, along with the contention that prudence can be defended in terms of rationality are explored and challenged. These challenges are not found to be persuasive in terms of abandoning altogether the notion that a prudent engagement with sports and physical activity is a rational one. Stronger objections to the current understanding of the recommendations of prudence are found upon examination of Griffin’s theory of well-being. The fact that values on a list such as Griffin’s might be realised in multiple ways casts doubt on the contention that certain choices now will necessarily risk future well-being. Second, Griffin’s understanding of the relationship between health and well-being (health as a means to well-being) throws into doubt common interpretations of harms to health and their impact upon well-being. Accepting that there are multiple ways in which to fulfil those values constitutive of well-being, and that health is a purely instrumental good, offers a strong challenge to construing certain choices in the sports and exercise domain as imprudent and ultimately detrimental to well-being.

Morgan’s Conventionalism versus WADA’s Use of the Prohibited List: The Case of Thyroxine

ABSTRACT Morgan has argued that attitudes to the medicalisation of sports are historically conditioned.While the history of doping offers contested versions of when the sports world turned againstconservative forces, Morgan has argued that these attitudes are out of step with prevailingnorms and that the World Anti Doping Agencys policy needs to be modified to better reflectthis. As an advocate of critical democracies in sports, he argues that anti-doping policy mustacknowledge and reflect these shifts in order to secure their legitimacy. In response, wecritically present the World Anti-Doping Agencys policy that incorporates the Prohibited Listof Substances and Methods for athletes. We evaluate the validity of the therapy-enhancementdistinction in relation to its role in both justifying and sustaining the operation of theProhibited List. In particular, we focus on the case of thyroxine, which has been the subjectof controversy in athletic doping. While thyroxine is not currently banned, critics haveclaimed that its use in the absence of a relevant pathology is tantamount to doping. Wechallenge Morgans claim that a conventionalist defence of the therapy-enhancementdistinction is the best available, and his conclusion that this properly supports a morepermissive stance towards performance-enhancing drug use. Furthermore, we reject hisconventionalist support for democratic line drawing in relation to doping and in particular thestatus of thyroxine with regard to the prohibited list. We offer a modified defence of the statusquo, a qualified, naturalist account of health and disease, where athletes may be prescribeddrugs that are genuine responses to medical necessity that do not, or do not typically, threatenthe goods of athletic excellence.

Sport, Society, and Anti-Doping Policy: An Ethical Overview

The purpose of this chapter is to provide an overview of the philosophical and ethical underpinnings of anti-doping policy. The nature of sport and its gratuitous logic is explored. The doping rules in sport, such as the Prohibited List, are ways of drawing a line to facilitate a certain sort of competition. Sports can be understood as a means of testing the natural physical abilities of the athlete, combined with the hard work they put into improving their performance. A test promoted by the anti-doping laws. Permitting certain forms of performance enhancement would threaten the special nature of such a test. Doping can be seen as a threat to the integrity of sport, not just because of the rule breaking doping currently entails. The chapter explores the ethical issues that arise with such forms of enhancement, such as fairness, harms to health, and indeed a refusal to accept human limitations. Finally, the criteria upon which a substance or method may be prohibited by the World Anti-Doping Agency (WADA) is addressed. The 3-part criteria, concerning (1) enhancement, (2) health, and (3) the spirit of sport are described, and literature that takes a critical line is addressed. Particular reference is made to the public health agenda explicit within anti-doping policy.

The World Health Organisation's Rationale for Physical Activity: a Philosophical Critique

The World Health Organisations Rationale for Physical Activity: a Philosophical Critique The World Health Organisations rationale for physical activity draws heavily on scientific evidence regarding disease and obesity. Greater philosophical reflection on such concepts, along with a recognition that supposed scientific facts are rarely value-free, allow for a more positive and considered argument for physical activity and its benefits. Olympism, Olympic culture, sports education, pedagogy of sport

Rationality and Compulsion: Applying Action Theory to Psychiatry

The author begins by clearly outlining the three basic purposes of the book. The first is to introduce philosophical action theory. The second is to develop concepts central to the text, such as ability, rationality and compulsion. The third purpose of the text to which Nordenfelt refers is the analysis of the concept health, and of some aspects of mental disorder. Indeed the clear and methodical introduction is reflective of the book as a whole. The introduction to action theory, and subsequent analysis and development of the concepts compulsion and rationality is extensive. Understanding as the analysis and application of action theory progresses is facilitated by a clear style, widespread employment of subheadings and, if the reader requires, a glossary of terms located at the end of the text. The author is clear with regard to his target audience, psychiatrists and psychologists with particular interest in the theory behind mental disorder. This interest in theory is essential as a large part of the text is dedicated to action theory and the subsequent development of central concepts. Nevertheless, the systematic fashion in which concepts such as health, vital goals and compulsion, are applied in the analysis of mental illness, and in particular delusions in the latter parts of the book, reinforces the importance of a clear theoretical grounding. This emphasis on theory and Nordenfelt’s development of the concepts compulsion and irrationality in particular, result in a text also of interest to philosophers. Action theory is rigorously applied in the latter part of the book, but the intention is not to establish the causes of mental illness, or indeed to address directly the classification of mental illness. Action theory is applied to ‘discuss and clarify the relation between certain mental illnesses and agency, primarily on the part of the bearer of illness’ [1, p. 157]. The tools that a proper understanding of action theory