Eating Disorders in Athletes
Athletes of all ages and performance levels are at an increased risk for developing eating disorders, and face unique challenges in treatment and recovery. However, it’s 100% possible for all athletes to fully recover from an eating disorder and enjoy a long career in their sport.
You might already be aware that there are higher rates of eating disorders in “weight-sensitive” sports like ballet, wrestling, and running. However, recent research shows that athletes participating in all types of sports have a higher risk of developing an eating disorder than non-athletes.
Despite this increased risk, athletes are actually less likely to be diagnosed than their non-athlete counterparts. This is because eating disorder behaviors—like excessive exercise, restrictive diets, or obsession with weight—are often normalized or even celebrated in athletic circles. In some cases, disordered eating or exercise behaviors might even be prescribed as part of a training program.
Facts and statistics about eating disorders in athletes:
- Athletes have 2 to 3 times the risk of developing an eating disorder as compared to their non-athlete peers.¹
- Over one-third of female Division 1 NCAA athletes reported attitudes and symptoms that put them at risk for anorexia.²
- Youth athletes with disordered eating are twice as likely to sustain a sports-related injury.³
- A study of elite and pre-elite female athletes found that 80% had symptoms of relative energy deficiency in sport (RED-S), which is a group of symptoms that occur when calorie intake is too low to meet demands of training and daily living.⁴
- Studies have shown that roughly half of adolescent athletes, across genders and sports, suffer from inadequate calorie intake, or 'low energy availability' (LEA).⁵
Common questions about eating disorders in athletes
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Understanding relative energy deficiency in sport (RED-S) in athletes
Relative energy deficiency in sport (RED-S) is a serious condition that’s common in both athletes and people struggling with eating disorders. Put simply, RED-S is when a person doesn’t eat enough to refuel and renourish their body after physical activity. This can happen when an athlete doesn’t adequately increase their caloric intake to match their training intensity, or when someone with an eating disorder continues to exercise compulsively despite restriction.
RED-S can have serious complications, including:
- Delayed or stunted growth
- Poor bone health
- Impaired immune system
- Metabolic issues
- Gastrointestinal issues
- Low heart rate
- Anxiety
- Depression
- Inability to focus
- Disrupted hormones
There’s a lot of overlap between RED-S, eating disorders, and disordered eating, but it’s important to note that not everyone with RED-S has an eating disorder, and not everyone with an eating disorder experiences RED-S. Learn more about RED-S on our blog.
How Equip supports athletes with eating disorders
We know that athletes are especially vulnerable to developing eating disorders, and that the risks, triggers, and consequences are different in athletes vs. non-athletes. We also know that inadequate nutrition adversely affects not only overall health and well-being, but also muscle strength and endurance, coordination, response time and power output—all of which hinder performance. Equip provides the specialized support and resources necessary to give athletes the best chance at full recovery and longevity in their sport.
Sports experts
Athletes require a support team with both expertise in eating disorders and a thorough understanding of the athlete mindset, team dynamics, the culture of competitive sports, and sports-specific nutrition requirements.
We have many former athletes, researchers, and subject matter experts on our team who understand the complex interplay between athletics and disordered eating struggles. We also offer an abundance of resources developed by experts in sports psychology and sports nutrition, and have an ongoing partnership with American soccer champion and Equip investor, Alex Morgan.
Inclusion of physical activity
There is no evidence that supports full abstinence from activity during eating disorder treatment, and there’s a well-established connection between dysfunctional exercise and eating disorder relapse. Because of both these factors, we think it’s important to help patients return to or develop a healthy relationship with exercise while in treatment.
There’s a growing body of evidence showing that engaging in closely monitored, nutritionally supported physical activity while undergoing treatment may improve eating disorder symptoms, treatment response, and long-term prognosis. Equip works with each athlete’s support network to help them safely navigate recovery and their return to sport.
Research-backed exercise protocol
We developed Equip’s Staged Approach for Exercise Reintroduction (SAFER) Protocol based on the Safe Exercise at Every Stage (SEES) guidelines. The SEES guidelines, created by leading experts in eating disorders, sports nutrition, and psychology, were designed to assist clinicians through the process of reintroducing activity across all stages of eating disorder treatment.
Ongoing research
As evidence of our deep commitment to providing cutting-edge eating disorder treatment for athletes, our Research and Development Team conducts ongoing research to ensure that the treatment and resources we provide are data-informed and based on best practices.
We also offer the following resources and services for our athletes and their families:
- Sport-specific nutrition education
- Expert guidance around navigating shifts in nutrition requirements as patients go through the renourishment process and change their training volume
- Therapeutic support around challenging the athletic aesthetic myth, respecting and listening to your body, advocating for your recovery, redefining your relationship with exercise, and other common psychological struggles
- Injury prevention education
- Monthly athlete education groups and process groups for patients and their support system, led by people with expertise in eating disorders and athletics
- Close collaboration with the athlete’s “village,” which may include their training team and coaches, student health and counseling personnel, and others, in addition to family
Worried that you or an athlete in your life may have an eating disorder?
Talk with our team today.Proven results for
eating disorder patients
After completing treatment
improve to subclinical levels of eating disorder symptoms
improve to subclinical levels of anxiety
Our patients are getting better
After the first 8 weeks of treatment, Equip patients are well on their way to recovery
1lb
Average weekly weight gain for those who need it
8 in 10
Patients report a decrease in eating disorder behaviors
74%
Of patients report improvements with depression or anxiety
Dive DeeperLearn about the nuances of eating disorders, treatment, life in recovery, and more on our blog.
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References
1. Magee, Meghan K., et al. “Body Composition, Energy Availability, Risk of Eating Disorder, and Sport Nutrition Knowledge in Young Athletes.” Nutrients, vol. 15, no. 6, Mar. 2023, p. 1502. Crossref, https://doi.org/10.3390/nu15061502.
2. Johnson, C et al. “Athletes and eating disorders: the National Collegiate Athletic Association study.” The International journal of eating disorders vol. 26,2 (1999): 179-88. doi:10.1002/(sici)1098-108x(199909)26:2<179::aid-eat7>3.0.co;2-z
3. Thein-Nissenbaum, J. M., Rauh, M. J., Carr, K. E., Loud, K. J., & McGuine, T. A. (2011). Associations between disordered eating, menstrual dysfunction, and musculoskeletal injury among high school athletes. The Journal of orthopedic and sports physical therapy, 41(2), 60–69.
4. Mountjoy M, Sundgot-Borgen JK, Burke LM, et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update British Journal of Sports Medicine 2018;52:687-697.
5. T Magee, M. K., et al. (2023). Body Composition, Energy Availability, Risk of Eating Disorder, and Sport Nutrition Knowledge in Young Athletes. Nutrients, 15(6), 1502.
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