Colleges may be liable for athletes' eating disorders, report says.

U.S. college and university athletic departments may be vulnerable to lawsuits because they do not pay enough attention to athletes with eating disorders, especially women, according to a University of North Carolina (UNC) at Chapel Hill legal expert.

Many sports programs allow athletes to put their health, reproductive ability, and, in some cases, lives at risk, said Barbara Bickford, an attorney and assistant professor of exercise and sport science at UNC, in a recently published report. (Barbara Bickford, The Legal Duty of a College Athletics Department to Athletes with Eating Disorders: A Risk Management Perspective, 10 Marq. Sports L.J. 87 (1999).) By addressing the growing problem, coaches, trainers, and administrators can protect not only their schools, but also their athletes' well-being, she said.

While associate director of athletics at Brandeis University, Bickford became concerned about the increasing number of athletes who were "visibly eating-disordered, meaning that they were anorexic.

"We're really talking about emaciated women competing in college athletics nationwide," Bickford said. "Eating disorders are a serious health risk, particularly in sports because participants' bodies are being stressed not only by the eating disorder, but also by the rigors of training and competition."

In her article, Bickford discusses colleges' and universities' potential legal liability if they allow athletes with eating disorders to participate in sports. She outlines a risk-management program for athletic departments to meet their legal duties to athletes and limit their liability in case of serious injury or death. Her proposal includes education for athletic department personnel about eating disorders and their symptoms and warning signs; written protocols for intervention once symptoms are detected; treatment by a physician or psychologist trained in eating disorders; and preventative education programs for athletes on diet, nutrition, weight loss, and athletics performance.

Studies have estimated that as many as 10 percent of female athletes overall and up to 30 percent in certain sports engage in such potentially dangerous behaviors as not eating enough and inducing vomiting after meals, Bickford said. Many coaches and administrators ignore the problems, possibly because they consider it a women's issue or do not think they should become involved in athletes' personal lives.

To date, few cases have been filed against schools over injuries from participation in school athletics. According to Bickford's research, no cases have been filed involving an athlete suing a coach or college or university for injuries related to eating disorders and participation in sports.

Every sport has athletes with eating disorders, but the problem is especially prevalent in gymnastics, cross-country running, diving, synchronized swimming, and figure skating, according to the report. Male athletes, such as wrestlers who throw up to stay below weight limits, are also at risk.

To obtain a copy of Bickford's report, send an e-mail message to [e-mail] or write to Barbara Bickford, University of North Carolina, CB #8605, Chapel Hill, NC 27599.