Recognizing Eating Disorders in Athletes

Being an athlete can often come with all kinds of pressure. Pressure to perform the best, pressure to win, and pressure to have your body look a certain way. All of this pressure and emphasis on the body contributes to the disproportionately high rates of eating disorders in athletes. In this blog, we explain the risk factors and warning signs of eating disorders in athletes, as well as the importance of valuing the person over their performance.

Eating Disorder Risk Factors in Athletes

Athletes of all genders can develop eating disorders, though research on transgender athletes and athletes with diagnoses other than anorexia and bulimia is extremely limited. According to the research we do have, the percentage of college athletes at risk for developing anorexia is 35% for females and 10% for males. Meanwhile, bulimia risk is much higher for both, with 58% of females at risk and 38% of males at risk (NEDA).

No one chooses to have an eating disorder. They are complex brain-based illnesses influenced primarily by three types of factors: biological, psychological, and social/environmental.

• Biological
  • Genetics
  • Dieting
  • Puberty
• Psychological
  • Co-occurring illnesses (anxiety, depression, obsessive-compulsive disorder (OCD), or substance abuse)
  • Trauma/abuse
  • Stress
• Social/Environmental
  • Appearance standards
  • Weight-based comments
  • Messages from the media

Sports that emphasize appearance and weight may pose an especially high risk for the development of an eating disorder. These sports include bodybuilding, boxing, wrestling, gymnastics, horseracing, diving, figure skating, dance, track and field, running, and swimming. For athletes in these sports, there is usually immense pressure to meet a weight requirement, fit a stereotypical body size, or have a specific muscle/fat ratio.

Added pressure from coaches, family, and teammates to perform may contribute to extreme levels of perfectionism and competitiveness. When an athlete is rewarded for their competitiveness, losing weight, winning, or making a new record, that praise may trigger, reinforce, or normalize eating disorder thoughts and behaviors.  

Another risk factor for athletes is the high level of exercise often required by their sport. Excessive exercise, or compulsive exercise, can cause health problems such as dehydration, injuries, osteoporosis, or low heart rate, and increase the eating disorder risk.

Noticing the Warning Signs

Athletes may believe their actions and routines are standard for their sports. They may not notice the warning signs because of the normalization of eating disorder behaviors. Therefore, coaches and teammates play an important role in recognizing signs of trouble. It is crucial to notice any of the below behaviors that may develop suddenly or over the course of time.

• Dramatic weight loss or weight gain
• Rapid decline or increase of food intake
• Frequently talking about food, weight, and body size
• Compulsive exercise patterns—never skipping a gym day, working out several times a day, or exercising to “make up” for food consumed
• Negative self-talk and self-perception
• Purging, restricting, binge eating, or compulsive eating
• Abuse of diet pills, laxatives, or diuretics
• Eating in secret, hiding food, and feelings of being out of control when it comes to food
• Denial of food and eating problems
• Exercising when sick or injured
• Great distress when a workout is missed or avoiding events and situations to workout
• Medical complications—menstrual irregularity, dry skin, hair loss, brittle hair, osteoporosis, dental problems, diabetes, heart disease, organ failure, consistent fainting, dizziness, bruising, leg cramps, diarrhea, constipation, chest pain, heartburn, and shortness of breath

Addressing eating disorder concerns and asking if the athlete is struggling can open the door for conversation. Keep all lines of communication open as it may take a few discussions to get the athlete to open up and accept support.

Valuing the Person Over Their Performance

Athletes may feel that their performance is more important than who they are as a person, especially if the validation they receive relates to their sport. Many times, athletes may struggle with their mental health, which may manifest from stress, burnout, depression, and anxiety, to name a few concerns.

It can be difficult for athletes living in a competitive world to feel positive when they are expected to have peak performance and high scores, not make mistakes, be separated from loved ones for long periods of time, or possibly gain sponsorships. A sense of failure may affect the athlete if they feel their performance is not good enough (on or off the field) or they may feel depressed being isolated from their family, friends, or support systems. Athletes and supporters should recognize the effort and remember that the athlete is human, and perfection is not possible. Support the person regardless of the results.

Athletes are portrayed as tough and strong, often not making room for vulnerability and mental health maintenance. As a result, coaches, trainers, or teammates may tell athletes to “toughen up,” not cry, or not show emotion on the field. Athletes should be allowed to experience their feelings, regardless of whether they win or lose. Remember that mental health is just as important as physical health.

Athletes who suffer from eating disorders may need to take a leave of absence to pursue recovery. Even though taking a leave of absence can be devastating to an athlete, time to recover is essential to both mental and physical health. If an athlete breaks a bone, they will take time to get medical assistance and let it heal; mental illnesses (like eating disorders) are serious and deserve care as well. Professional care teams can support the athlete through their recovery and help them reintroduce healthy movement back into their lifestyle. Coaches, supporters, and fans should prioritize the athlete’s overall wellbeing over the sport.

Learn more about eating disorders here. If you know an athlete that shows signs of an eating disorder, ask them to take the assessment or visit The Emily Program online or call 1-888-364-5977. The sooner they reach out, the better the outcome. Recovery is possible.