By Anne Harding

NEW YORK (Reuters Health) - More and more male athletes are developing unhealthy eating behaviors after seeing the competitive advantage a leaner physique can bring, a sports medicine doctor warns in a new report.

Recent deaths among wrestlers have raised awareness of eating disorders and their potentially deadly consequences among male athletes, but Dr. James L. Glazer told Reuters Health he's increasingly seeing problematic eating behavior among men engaged in other sports at the recreational level, such as cyclists, triathletes and Nordic skiers.

Eating problems may first arise in a recreational athlete when he loses a few pounds as a result of training, explained Glazer, of the Maine Medical Center in Portland.

"Often he'll notice that he's getting faster and that his placement when he competes is getting higher and better," he added. "That will change what is a good and a healthy dieting pattern into one that becomes a little problematic and dangerous."

Eventually, Glazer noted, a man may lose so much weight that his performance starts to suffer. Seeing this change for the worse may be enough to convince him to change his habits for the better, he added.

"Many men can turn things around just with a little bit of increased awareness about nutrition and healthy weight," Glazer said.

However, men with body dysmorphic disorder, who see themselves as overweight even if they are emaciated, may come up with other reasons for their drop in performance, and resist the idea that they have a problem. "Those can be very difficult cases to treat," Glazer commented.

Anyone with an eating disorder should see a nutritionist and either a psychologist or psychiatrist, he advised. "Sometimes medications are appropriate and helpful and sometimes athletes get into so much trouble with unhealthy eating that they need to be hospitalized, but that's a real minority."

Glazer acknowledged that while the current emphasis on fighting obesity and inactivity has been of great benefit to public health, it may also have led many health professionals to overlook the potential for eating disorders in men who are too thin and perhaps even too active.

Also, he added, there is currently no established consensus on when it is safe for a male athlete with a history of disordered eating to return to his sport.

SOURCE: Current Sports Medicine Reports, November/December 2008.

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