Eating disorders in athletes: identifying unhealthy behaviors

The teenager gets support from the coachThe body is the athlete's most important tool. Many athletes learn to constantly monitor this tool, treating it as something that needs to be continually improved and improved. For some athletes, it means staying in good health, eating nutritious food and adopting a positive body approach to diet and weight loss. For others, a stabilization in the body can lead to eating disorders. A 2004 study of eating disorders in elite female athletes found that 20% had clinically significant evidence of at least one eating disorder.

Eating disorders can destroy an athlete's body and even claim their lives. Nervous anorexia has the highest mortality rate of any mental health diagnosis, killing about 10% of people who suffer. Therapy can save lives and athletic careers by helping an athlete develop a more positive relationship with their body.

It signals that an athlete may have an Eating Disorder

Athletes tend to stabilize exercise and nutrition more than the average person. Therefore, it can be difficult to tell the difference between a typical athlete's behavior and the symptoms of an eating disorder.

Some symptoms of eating disorders for athletes include:

  • Unusual or unhealthy food behaviors. An athlete may be very stabilized in the calories they consume or may not want to eat around others.
  • An extremely rigorous exercise. An athlete can work out without rest, even in inappropriate weather or after an injury.
  • A stabilization in appearance or body that is disproportionate or disconnected from the requirements of the sport. For example, a runner may focus on getting slim instead of getting faster or thinner.
  • Dress in a way that hides the body, even in hot weather. An athlete may have a distorted perception of his body, believing it to be larger or smaller than it actually is.
  • Frequent or excessive bathing trips. This sign is particularly noteworthy if the athlete also has tooth damage, as bulimia-related vomiting can affect dental health.
  • Malnutrition-related health disorders, such as constipation, dizziness, exhaustion or often cold.
  • Unexplained or unhealthy weight loss. An athlete can lose weight quickly without any apparent change in exercise or diet.

No behavior is evidence of an eating disorder, but the appearance of many red flags can be of concern. If you are worried about a loved one, consider getting professional help.

Who is at risk?

In the general population, rates of eating disorders are significantly higher among cisgender women than men. This is likely due to the enormous pressure women face to conform to an extraordinarily slim "ideal" beauty. A 2008 study found that 75% of Americans support at least some unhealthy thoughts or behaviors related to food and body image. Specifically, female athletes tend to experience greater pressure than male athletes, as women's sports often focus on subtlety as a sign of strength.

However, male athletes can and do have eating disorders. Some studies indicate that eating disorders can be subdivided and treated in men. In addition, some men – including homosexual and bisexual men – may be more vulnerable to eating disorders than others.

Gender is not the only risk factor for eating disorders. Specific risk factors for sport include:

  • Take part in a sport that emphasizes subtlety or adheres to a narrow physical ideal. Athletes in ballet, dance and similar sports are at greater risk.
  • Take part in a sport that has weight classes. For example, boxers and wrestlers may be involved in a disordered diet to meet the weight requirements for a competition.
  • Participate in a sport of endurance like running long distances.
  • Playing for a team or coach that places great emphasis on weight or appearance.
  • Parents who place great emphasis on the importance of athletic achievement.
  • Believing that weight is the most important predictor of athletic performance.

Personal risk factors for developing an eating disorder include:

  • Perfecting.
  • Negative attitudes about fat or weight, either to himself or to others. A person with a high risk of eating disorders may express meticulous comments or negative opinions about non-delinquent individuals.
  • Low self-esteem.
  • A family history of eating disorders.
  • History of trauma.

Female Trinity Athletes

The female athlete trinity refers to three dangerous health consequences some female athletes experience. The Trinity includes:

  1. Disturbed eating. This may include not eating enough food, eating only certain food groups, cleaning or yo-yo dieting.
  2. Menstrual abnormalities. When a cisgender woman's body fat falls too low, she no longer matures, preventing her from getting her period. Some athletes stop taking the period completely (amenorrhea), while others face irregular periods. Amenorrhea and other menstrual abnormalities can cause infertility. According to a 2012 analysis, the prevalence of amenorrhea among female athletes who focus on athleticism is as high as 69%.
  3. Osteoporosis. Estrogen levels drop in female athletes with unhealthy eating habits and very low body fat. This, in combination with inadequate intake of calcium and vitamin D, can cause osteoporosis – bone density deficiency that increases the risk of bone fracture. The risk of bone fractures is already higher among athletes than the general public.

Athletes with this trinity may feel exhausted for years. They can also be more injured and suffer a decline in their athletic performance. For athletes who believe that their performance is related to subtlety, these results can lead to even more unhealthy eating.

Help for athletes

Many athletes with disordered eating struggle with shame and low self esteem, so it's important for their loved ones not to be ashamed or bothered about their condition. Offending an athlete's body or lacking the attractiveness of his or her weakness can also be reversed. Instead, loved ones should emphasize the disadvantages of eating disorder and reassure the athlete that healing can and does work.

Eating disorders are particularly curative. Treatment often focuses on improving self-esteem. It can also cope with underlying mental problems such as perfectionism, trauma and depression. In therapy, the athlete can learn how to handle painful emotions and change their relationship with food. They can also identify unhealthy behaviors regarding body image, appearance, and performance, discussing how cultural messages reinforce these attitudes.

Some athletes may be concerned about how treatment of impaired eating will affect their athletic performance. A dietician can help athletes recover their lost weight and develop a diet plan that improves their athletic performance. Many athletes also need help managing the emotional challenges of competitive sports, such as negative comments about their appearance or constant pressure to be slim. A therapist who specializes in treating athletes or a sports psychologist can help manage these worries.

Bibliographical references:

  1. Currie, A. (2010). Sport and eating disorders – Understanding and managing risks. Asian Journal of Sports Medicine, 1(2), 63-68. Retrieved from
  2. Eating disorders and athletes. (2018, April 27). Retrieved from
  3. Insel, T. (2012, February 24). Published by former NIMH director Thomas Insel: Headlight on eating disorders. Retrieved from
  4. Nazem, T. G., & Ackerman, K. E. (2012). The female trinity of athletes. Sports Health, 4(4), 302-311. Retrieved from
  5. Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating disorders in men: Underdiagnosed, undertreated, and misunderstood. Eating disorders, 20(5), 346-355. Retrieved from
  6. Three out of four American women have disordered eating, according to research. (2008, April 23). Retrieved from
  7. Warning signs and symptoms. (2017, February 26). Retrieved from

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