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Athletes & Eating Disorders

Impact of Eating Disorders on Athletes

Eating disorders and disordered eating are commonly experienced by female athletes, but sorely under recognized by coaches, teachers, parents, therapists and physicians. I use the term disordered eating to include sub-clinical eating disorders as well as eating disorders which meet full DSM-IV-TR criteria for anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified, and binge-eating disorder.

Characteristics of Eating Disorders in Athletes

There are several core features of the illness of eating disorders, which may be particularly exacerbated in the athletic arena for females.

volleyball-team-1520918_960_720Denial is one core feature of eating disorders and other addictive processes. The fire of denial can be fed by coaches who rely on the exceptional talent and extreme drive for success that many athletes possess to win games, titles, awards, etc. When a female athlete is still winning or competing and ill, it may be easier to deny an active problem with food or eating.

Another character trait that has been shown by clinical research to be present in patients with eating disorders is perfectionism. Competitive athletes rely on precision and “perfect” execution of planned movements, behaviors, training rituals in order to succeed and win.

Competitiveness itself is another trait commonly seen in individuals with eating disorders. Finally, the psychosexual implications of being a female may also contribute to the increased prevalence and risk of disordered eating among female athletes. Most athlete role models are men (with the exception of aesthetic sports such as dance, cheerleading, synchronized swimming). The female athlete may feel more pressure to masculinize her body and become more muscular. She may also seek to avoid menstruation, with its inherent cyclical fluctuations affecting our bodies and moods, since stability, consistency, and control are important for athletic performance and success. The triggering of such traits and their perceived importance in successful athletes are a set-up for female athletes with genetic, familial, psychosocial predispositions for eating disorders.

Early Signs of an Eating Disorder in an Athlete

  • increased concern about body composition, body fat;
  • increased concern about “healthy eating” and rigid behavior around food (eating fat free, not eating certain food groups, eating alone or in isolation);
  • social withdrawal, loss of intimacy or closeness with peers and family members;
  • rapid weight loss or gain; going to the bathroom after meals;
  • unmanageability in other areas of life (school, relationships, substances/intoxication);
  • loss of menses or irregularity of menses.

Tips for women on how to avoid eating disorder behaviors while training:

  • exercise and train with a partner or in groups with other women (avoid isolation and secrecy around exercise and food);
  • replenish fluids and follow a well-balanced food plan (including enough protein, iron, calcium, and fat intake);
  • get guidance and help from a sports nutritionist;
  • contact your physician if you begin to experience menstrual irregularity or lose menses;
  • take 1-2 days off per week;
  • avoid looking at “calories burned” displays on cardio equipment;
  • seek professional help if you start to experience unmanageability in your eating, exercise, or weight and/or body concerns;
  • avoid using diuretics, laxatives, stimulants, steroids for performance or training enhancement;
  • Women with histories of eating disorder: continue to receive maintenance care from a professional; continue to attend support groups for people in recovery from eating disorders.

Tips for coaches and school administration:

  • provide education around prevention and recognition of eating disorders particularly to staff and coaches for female athletes;
  • provide education around prevention and recognition of eating disorders to female athletes;
  • make appropriate treatment recommendations for athletes who are suspected of having an illness;
  • work with treatment team professionals to set clear expectations around necessary recovery parameters to resume or maintain athletic participation;
  • foster a culture of safety around the athlete asking for help and expressing concerns about weight;
  • allow for and enable a female athlete to express when a training schedule feels like too much or feels too intense;
  • be part of the solution, rather than part of the problem (denial, shaming, etc.).

If you think you have an eating disorder, please seek help from a eating disorder treatment professional, school counselor, coach, or parent. A variety of treatment settings are available, from outpatient to residential eating disorder treatment centers, and early intervention is a key factor in reducing the long-term health, athletic, emotional and spiritual consequences of having an eating disorder.

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Athletes & Eating Disorders Articles

  • Running is a way to keep healthy. However, long distance runners are at higher risk of developing an eating disorder. There is a fallacy that many athletes believe and that is lower body weight means better performance. This particular idea has not been proven but it still remains prevalent in endurance running.
  • Being an athlete, particularly those that participate in elite or judged sports, such as gymnastics or distance running, can encompass rigorous physical demands.  As a result, the risk of developing an eating disorder can be more prominent in this population.  For athletes struggling with any form of an eating disorder, the effects are debilitating. With an adequate treatment plan, unfaltering support system, and with the love of the sport, the prognosis for athletes in recovery can be successful. Learn more about the dangers for athletes with eating disorders in this article.
  • In the effort to treat eating disorders, many health professionals utilize Cognitive Behavioral Therapy as well as Dialectical Behavioral Therapy. Yet as treatment programs face increasing competition, clinicians are emphasizing the potential benefits of supplementing such therapeutic mechanisms with alternative approaches. A recent study concerning the effect of yoga on psychological functioning in women with a history of disordered eating reported that modalities, such as yoga, offer potential benefits for improving mood and other psychological states.  Learn more about alternative methods to eating disorder treatment.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on
February 17, 2014
Published on, Source for Information on an Eating Disorder

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{ 6 comments… read them below or add one }

Ldr April 29, 2014 at 10:30 pm

Hello, I am an athlete. I am a binge eater. Need help and want help. Don’t know how to recover from this.
Could you guys help me?
I live overseas, can’t go to The US:/
Thank you very much

Crystal Karges MS, RDN, IBCLC April 30, 2014 at 12:45 am

Hi LDR! Thank you for your comment. We are sorry to hear of your struggle with binge eating and deeply empathize with your pain. We would be happy to direct to you some resources! Where overseas are you located? The BEAT organization in the UK may be able to help get you connected to some resources for recovery and treatment. You can learn more about their organization here: Let us know if we can direct you to sources of help in other locations. Take care!

Lisa August 24, 2014 at 12:05 am

My daughter Leora has told me that she has been binging and throwing up for the last 3 months. She competes in Cross country and track. I would like to get her the help she needs. She said the last time she threw up was last week when she ate to much pizza. We live in West Los Angeles 90035/ Manhattan Beach CA 90266

Sofia December 7, 2014 at 10:17 pm

my doter is professional athlet and she need really help .I interested if you gays can help we live in NJ near Readgwood.

Crystal Karges MS, RDN, IBCLC December 8, 2014 at 1:01 am

Hi Sofia!

Thank you for your comment. Is your daughter in need for resources for treating an eating disorder? You can begin by searching our Treatment Directory on the Eating Disorder Hope Website. The National Eating Disorder Association also has a toll-free hotline that you can contact to find eating disorder treatment resources within your insurance coverage and financial means. Their help hotline is 800-931-2237. We would encourage you to contact them to help you find the treatment facilities you need for eating disorder recovery.

If there is anything further we can do, please let us know!

CNB January 6, 2015 at 7:27 pm

hi, i’m a distance runner,
I recovered anorexia but now I have a severe eating disorder. I justify my binging with the exercise and i have been throwing up again from two months. I have cravings, eat too much more than i need to fuel-up or recover and i have gained 5 kilos. My performance is decreasing (or at least that’s what I’m afraid of) and i am feeling lost. I think I need professional help. I feel fat, slow and insecure; eating helps me relieve pain but then i feel worse. Nobody knows I’m still doing this, they just realize I feel guilty about eating, I don’t know if it would be a good idea to talk about this and worry my family or my coach, because I don’t want to stop running.

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