Eating Disorders in Long Distance Runners

Running. For some, this word in itself brings thoughts of agony, something that should only be done if absolutely necessary. For others however, running is a form of pleasure or escape, a source of great strength and empowerment. The sport of running can take a variety of forms, from track sprints to a leisure jog to the marathon.

While participation in sports and engaging in regular physical activity, such as running, has many numerous health benefits, there are concerns about certain sports that make an individual more susceptible to developing an eating disorder.

Long Distance Runners are Vulnerable to Eating Disorders

People who participate in long-distance running are among those athletes who are more vulnerable to developing an eating disorder. Long distance running, or endurance running, can be classified as a form of continuous running over distances of at least 3.1 miles [1].

The most common types of long distance running include:

  • Cross country running
  • Track running
  • Road running

Training for long distance running events, such as a cross-country race or a marathon, often involves rigorous training schedules and activities.

A Potential Breeding Ground for Eating Disorders

Long distance running is often connected with a stigma that lower body weight will have a positive effect on sporting performance, such as by enhancing speed on a course or in a race. While research has not supported this theory, this myth strongly circulates among long distance runners, from the high school level athlete to the Olympian.

The pressure of sports performance and competition involved with long distance running can be a breeding ground for eating disorders. If other factors are involved, such as social pressures, low body image/self-esteem, or biological susceptibility, the risk for developing an eating disorder can be increased.

Research has shown that both female and male athletes are at greatest risk for developing an eating disorder in sports where leanness confers a competitive advantage, such as long distance running [2].

Rationalizing the Weight-Loss

Long distance athletes who fall into the trap of thinking that weight loss will aid performance, may be encouraged to further perpetuate weight loss, engaging in disordered eating behaviors, such as restriction certain foods, extreme exercise, fasting, or purging.

Woman runner with Exercise CompulsionThese behaviors can quickly spiral out of control, progressing rapidly to an eating disorder such as Anorexia or Bulimia.

Long distance running is unique in the sense that it is a sport performed in isolation.

Performance is completely hinged on the individual that is running, thus increasing the demands and drive for perfectionism that an athlete may experience.

The nature of long distance running is one that can become completely agreeable with an eating disorder; however, this can be missed among coaches and parents, as behaviors may be mistaken for the demand of the sport.

The Role of Parents, Coaches and Loved Ones

Early intervention can play a tremendous role in recovery, preventing an athlete from experiencing many of the dangerous consequences that result from having an eating disorder. If you are a parent, coach, or loved one of a long distance athlete, it is important to be aware of these risk factors, which may indicate early signs of an eating disorder.

Signs to Look For:

  • Increased isolation
  • More frequent occurrences of injuries, such as sprains or muscle strains
  • Decreased concentration, coordination, and energy
  • Increased fatigue, low energy
  • Decreased social interaction with coaches and teammates
  • Preoccupation with food
  • Physical complaints, such as light-headedness, muscle aches, dizziness
  • Prolonging training beyond what is required for sport
  • Continued training, even when sick or injured

Because eating disorders among athletes and long-distance runners can result in dangerous consequences to both health and performance, early identification and diagnosis is crucial for appropriate intervention. The Preparticipation Physical Examination (PPE) monograph is a questionnaire screening tool used to identify potential disordered eating behaviors among athletes.

Use of a questionnaire like this among sports medicine providers and coaches can be an important tool in evaluating disordered eating and diagnosing eating disorders when interacting with athletes and active persons.

A Proper Balance of Nutrition, Rest and Exercise is Best

These warning signs are red flags that may reveal that an athlete is struggling. For an athlete with early indicators of an eating disorder, long distance running may serve as the ideal portal from which the disease can continue to develop. While with any sport, there is the potential for positive benefits, there also exist extreme measures, which can lead to a vicious cycle of an eating disorder.

Women runningRunning great distances, whether as a recreational activity or a competitive sport, can be a beneficial outlet for channeling physical and emotional energy. It is also an activity that requires a proper balance of moderation, rest, and nutrition in order for those benefits to be reaped.

If an eating disorder is identified in a long-distance runner, specialized care should be sought with an experienced multidisciplinary team, including a physician, mental health professional, athletic trainer, and dietitian. Sports medicine physicians can help determine the best course of action for an athlete, such as if a temporary break is needed for adequate healing and treatment and/or clearance for a return to long-distance running.


Jacquelyn EkernAbout the authors: Jacquelyn Ekern, MS, LPC founded Eating Disorder Hope in 2005, driven by a profound desire to help those struggling with anorexia, bulimia and binge-eating disorder. This passion resulted from her battle with, and recovery from, an eating disorder. As president, Jacquelyn manages Ekern Enterprises, Inc. and the Eating Disorder Hope website. In addition, she is a fully licensed therapist with a closed private counseling practice specializing in the treatment of eating disorders.

Jacquelyn has a Bachelor of Science in Human Services degree from The University of Phoenix and a Masters degree in Counseling/Psychology, from Capella University. She has extensive experience in the eating disorder field including advanced education in psychology, participation and contributions to additional eating disorder groups, symposiums, and professional associations. She is a member of the National Eating Disorder Association (NEDA), Academy of Eating Disorders (AED), the Eating Disorders Coalition (EDC) and the International Association of Eating Disorder Professionals (iaedp).

Jacquelyn enjoys art, working out, walking her golden retriever “Cowgirl”, reading, painting and time with family.
Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without support from our generous sponsors.

Crystal Headshot 2Crystal Karges, MS, RDN, IBCLC is a Contributing Writer for Eating Disorder Hope.

Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing,

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH and nutrition private practice.


[1] Grine, Frederick E. et al (October 2006). The First Humans – Origin and Early Evolution of the Genus Homo. Stonybrook University. Retrieved on 2013-04-11.
[2]: Sundgot-Borgen J, et al. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med 2004;14:25–32.
[3]: Bernhardt DT, et al. American Academy of Family Physicians, American Academy of Pediatrics. PPE: preparticipation physical evaluation. 4th edn. Elk Grove Village, IL: American Academy of Pediatrics, 2010.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on June 14, 2017.
Edited And Updated By: Crystal Karges, MS, RDN, IBCLC.
Reviewed By: Jacquelyn Ekern, MS, LPC on June 14, 2017.
Published on

Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without the support from our generous sponsors.