Athletes & Eating Disorders
Eating disorders may be particularly hard to detect among athletes due in part to secretiveness, stigma, and symptom presentation. Characteristics and personality traits among athletes tend to also be common among those with eating disorders. This includes being achievement-oriented (or as most of us know it, perfectionism), sensitive to consequences, high attention to detail, and high pain tolerance. Unfortunately, athletes may be less likely to seek treatment for an eating disorder due to stigma, accessibility, and sport‐specific barriers.
With the support of our friends from Athlete EDGE® at EDCare, we hope this page will answer your questions and connect you with resources related to eating disorders in athletes.
Eating Disorders in Athletes: Common Questions
Short Answer: Preoccupation with weight and body composition, changes in weight, fatigue, injuries, amenorrhea, secretive eating, mood swings, and performance decline can signal eating disorders in athletes.
Athletes with eating disorders often show both physical and behavioral warning signs. Common physical signs can include sudden weight changes, frequent injuries, fatigue, dizziness, and irregular menstrual cycles in females. Behavioral signs might include skipping meals, obsessive calorie counting, rigid food rules, or avoiding team meals. Reduced motivation and changes in mood, such as increased irritability, depression, or anxiety, can also be red flags.
Identifying these signs early is important because athletes are often praised for discipline and physical fitness, which can make disordered behaviors harder to recognize.
Short Answer: Perfectionism, pressure to perform, body image concerns, low sense of self outside of sport, and sport-specific appearance demands can increase an athlete’s risk.
Athletes face several unique risk factors for developing eating disorders. These include:
- Sport-specific pressure: Sports that encourage athletes to maintain a certain body size, weight and/or appearance, such as gymnastics, wrestling, martial arts, swimming, rowing, figure skating, running, and more.
- Perfectionism: Many athletes strive for perfection, but this mindset can lead to disordered behaviors, all-or-nothing thinking, and a tendency to tie self-worth to achievements and external approval.
- Cultural and coach influence: Pressure from coaches, parents, teammates, or the media, especially around performance, weight, or body size, can contribute to disordered eating and harmful body image beliefs.
- Body dissatisfaction: Constant exposure to idealized athletic bodies can lead to negative body image and internalized pressure to lose weight or change one’s body image.
- Overtraining and food restriction: Trying to improve performance through training while restricting food can spiral into disordered eating.
These factors, combined with a culture that rewards thinness and performance, can make athletes uniquely vulnerable.
Identifying these signs early is important because athletes are often praised for discipline and physical fitness, which can make disordered behaviors harder to recognize.
Short Answer: Athlete treatment often involves sport-specific nutrition, a sport informed therapist, guidance from an eating disorder-informed mental performance coach, adjustments to training, coordination with coaches and athletic staff, and return-to-sport planning when appropriate.
Treatment for eating disorders in athletes differs from standard care because it must address the unique physical and psychological demands of sport. While traditional eating disorder treatment focuses on medical stabilization, psychological support, and nutritional rehabilitation, athlete-specific treatment goes a step further. It takes into account the athlete’s training schedule, performance goals, injury risk, and deep connection between sport and identity.
This kind of care often includes a multidisciplinary team familiar with athletic culture, such as sport-informed therapists, eating disorder-informed mental performance coaches, and dietitians who specialize in fueling for sport. It may also involve collaboration with coaches and athletic trainers, adjusted training plans, and thoughtful return-to-sport strategies to ensure both physical safety and long-term recovery.
If you or someone you care about is seeking treatment, don’t hesitate to ask questions. It’s important to understand how a program tailors care specifically for athletes. Ask how the treatment team integrates sport into recovery, whether staff have experience working with athletes, and how your goals as an athlete will be respected while prioritizing recovery. You deserve a treatment plan that fully understands your experience and supports both recovery and your relationship with sport.
Key differences include:
- Specialized Nutrition Plans: Treatment often involves sports dietitians who understand energy needs for specific sports.
- Return-to-Sport Protocols: Medical and psychological readiness is assessed before resuming competition or training.
- Team Collaboration: Treatment teams often include athletic trainers, coaches, and sport informed therapists, sports dietitians, mental performance coaches, and sports medicine physicians.
- Identity Work: Many athletes struggle with tying self-worth to performance, so therapy includes identity exploration beyond sport.
- Monitoring Energy Availability: Reducing training or adjusting food intake is done carefully to avoid further harm.
This specialized approach ensures that athletes can recover safely while maintaining long-term physical and mental health.
Short Answer: Female athletes often focus on thinness and may experience amenorrhea; male athletes may seek muscularity, leanness, and are more likely to hide symptoms due to stigma.
Eating disorders can present differently in male and female athletes due to societal and sport-related expectations. Female athletes often face pressure to be thin, especially in sports like figure skating, running, or ballet, leading to restrictive eating and/or purging. Men, on the other hand, may focus on achieving a lean but muscular physique, leading to behaviors such as excessive exercise, use of supplements, or bingeing followed by guilt and/or purging.
Male athletes are more likely to be underdiagnosed because their symptoms may not match traditional eating disorder criteria. Social stigma, which frames eating disorders as a “female problem,” often delays diagnosis in males, who may hide symptoms to maintain a tough, masculine image.
Both genders face sport-related triggers, such as pressure from coaches or weigh-ins, and females may be more influenced by aesthetic expectations, while males may face more demands for strength and power, particularly in sports like wrestling, football, hockey, or bodybuilding.
Recognizing these differences is essential to provide appropriate support and avoid missing warning signs.
Short Answer: Yes. Aesthetic or weight-class sports like gymnastics, figure skating, ballet, martial arts, wrestling, or swimming often face higher risks of developing an eating disorder.
Certain types of athletes are more susceptible to eating disorders based on the nature of their sport, competitive level, and demographic factors. Sports that emphasize leanness or low body weight, such as gymnastics, figure skating, ballet, diving, running, and equestrianism, can carry a greater risk. In aesthetic sports, where performance is partially judged on physical appearance, athletes face intense pressure to maintain a specific physique. Weight-class sports, like wrestling, martial arts, or rowing, require frequent weigh-ins, encouraging restrictive eating or rapid weight-cutting practices that can spiral into eating disorders.
Athletes across many sports are particularly vulnerable to eating disorders, not only due to pressures around body size, but also due to broader societal expectations tied to appearance, gender, and attractiveness. Female athletes often face unrealistic ideals related to thinness, femininity, and how they’re expected to present themselves both in and out of their sport. Male athletes, too, are increasingly affected by harmful standards around leanness, muscularity, and traditional notions of masculinity. These expectations can create intense pressure to meet a specific “physical ideal.”
High-level or elite athletes face amplified risks due to greater performance demands and scrutiny from coaches, judges, or media. Adolescents are also at higher risk, as puberty brings body changes that may clash with sport-specific body ideals, exacerbating body image concerns. Psychological traits like perfectionism, common in competitive athletes, can further elevate vulnerability to eating disorders.
For all athletes, these appearance-driven demands can contribute to body dissatisfaction, unbalanced behaviors, and a heightened risk of developing eating disorders. Preventative efforts should target high-risk sports with education on nutrition and body image, while creating environments that prioritize mental and physical health over aesthetics.
Short Answer: Under-fueling frequently leads to fatigue, poor recovery, injuries, hormone imbalances, decline in performance, and long-term health problems.
When athletes do not get enough energy to support both their training and basic body functions, it can cause Relative Energy Deficiency in Sport (REDs). This condition has serious consequences including the following:
Short-term impacts include:
- Decreased performance
- Slower recovery
- Increased risk of injuries and illness
- Mood changes and difficulty concentrating
Long-term impacts can be even more serious:
- Loss of bone density, increasing risk for fractures or early osteoporosis
- Irregular or absent menstrual cycles in females
- Hormonal disruptions in males and females
- Heart issues, digestive problems, and weakened immunity
Mental health may also decline, causing higher rates of depression, anxiety, and burnout. Recognizing and treating under-fueling early is critical not just for athletic performance, but for the athlete’s whole body health and long-term well-being.
Additional Resource Hubs for YOU!
Whether you are an athlete living with an eating disorder or caring for someone is, ANAD is here for you. We’ve developed specific pages with additional resources and information for you to identify warning signs, start conversations, prepare for appointments, and find treatment options in your area.
Click below to explore resources curated just for you.
Eating Disorder Treatment Programs for Athletes
Athlete EDGE at EDCare
Providing intensive, compassionate care from professionals who understand the world of sport and the challenges athletes face.
AthleatMD
A fully virtual, multi-state medical and nutrition practice, led by nationally-recognized clinical experts for athletes across all sports and skill levels who need additional support with sports nutrition, disordered eating & eating disorders, and/or relative energy deficiency in sport (REDs).
Lane 9 Project Clinician Directory
Lane 9 has built a directory filled with providers across the US (and abroad!) who specialize in female athlete care.
Opal Food + Body Wisdom
Opal provides eating disorder treatment in Seattle for adults of all genders ages 16+. We offer partial hospitalization, intensive outpatient and traditional outpatient programming.
ANAD Support Group for Athletes
In addition to our weekly supports, ANAD now hosts a weekly support group for athletes throughout the year. Learn more and register now at anad.org/groups.
Past Event Recordings
Athlete Blogs & Stories of Hope
Recommended Books by Athletes
References
Martinsen, M., & Sundgot-Borgen, J. (2013). Higher Prevalence of Eating Disorders among Adolescent Elite Athletes than Controls. Medicine & Science in Sports & Exercise, 45(6), 1188-1197. doi:10.1249/MSS.0b013e318281a939
Thiemann, P., Legenbauer, T., Vocks, S., Platen, P., Auyeung, B., & Herpertz, S. (2015). Eating disorders and their putative risk factors among female German professional athletes. European Eating Disorders Review, 23(4), 269-276. https://doi.org/10.1002/erv.2353
Galli, N., Reel, J. J., Petrie, T., Greenleaf, C., & Carter, J. (2011). Preliminary development of the weight pressures in sport scale for male athletes. Journal of Sport Behavior, 34(1), 47-68. https://psycnet.apa.org/record/2011-03281-003
Sundgot-Borgen, J., & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25-32. https://doi.org/10.1097/00042752-200401000-00005
Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S) British Journal of Sports Medicine 2014; 48:491-497. https://doi.org/10.1136/bjsports-2014-09350