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.
- Over one-third of female Division 1 NCAA athletes reported attitudes and symptoms that put them at risk for anorexia.
- Youth athletes with disordered eating are twice as likely to sustain a sports-related injury.
- 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.
- Studies have shown that roughly half of adolescent athletes, across genders and sports, suffer from inadequate calorie intake, or 'low energy availability' (LEA).
Many eating disorder red flags are considered normal or even praised in athletic circles, This includes disordered behaviors like restrictive eating, excessive exercise, and frequent weight checks, as well as physical symptoms like irregular or delayed periods, overuse injuries, and slowed heart rate.
On top of all the above, athletes might also be disincentivized, either explicitly or implicitly, from seeking help when they’re struggling. They may be held back by shame or a sense of loyalty or obligation to their coach and teammates, or they may simply be unaware that their food- and body-related thoughts are disordered. Treatment accessibility is also an issue for many, as getting treatment for their eating disorder might mean being removed from their sport and losing life-altering opportunities like a sponsorship or scholarship.
At Equip, we believe that engagement in sports can be an integral part of treatment and an important asset for patients’ recovery. We share patients’ passion for their sport and support their goal of returning to competition.
We look at many different factors—including medical safety, emotional wellness, and recovery progress—to help determine how and when sports fit into a patient’s recovery journey. Once a patient has received both medical and behavioral clearance, the provider team and family work together to gradually reintroduce physical activity in a way that's both safe and sustainable.
This might mean starting with lower-intensity movement like yoga or walks, which can gradually be ramped up. Given this approach, athletes may not be able to continue participating in their sport at first, but with patience and dedication to recovery, they can return to it stronger than ever.
If you’re worried about an athlete in your life, the best first step is often just to have a conversation. Find a quiet moment to talk one-on-one, and approach them from a place of curiosity, using “I” statements. Avoid making accusations or assumptions. It might be helpful to share specific examples around your concerns (for instance, “I felt concerned when you kept training even though you were injured and in pain.”).
Parents and family members can best help their loved ones by connecting them with specialized medical, psychological, and nutritional support. Support groups, expert guidance, and other resources designed specifically for athletes with eating disorders can help them feel less alone and ensure the best possible outcome and a safe return to their sport.
Athletes face a variety of unique risk factors. For one, the same temperament traits that often lead athletes to excel are independent risk factors for developing an eating disorder. These traits include:
- Competitiveness
- Perfectionism
- Extreme focus on performance
- The grit required to push through discomfort
- The drive to continually improve performance
In athletic communities, there’s also an ever-present focus on achieving and maintaining a certain physique in order to achieve optimal performance. This is known as the “athletic aesthetic” myth, and it places undue pressure on athletes to meet unrealistic shape-, weight-, and diet-related expectations, which can fuel an eating disorder.
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 up 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:
- Athletes have 2 to 3 times the risk of developing an eating disorder as compared to their non-athlete peers.
- Over one-third of female Division 1 NCAA athletes reported attitudes and symptoms that put them at risk for anorexia.
- Youth athletes with disordered eating are twice as likely to sustain a sports-related injury.
- 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.
- Studies have shown that roughly half of adolescent athletes, across genders and sports, suffer from inadequate calorie intake, or 'low energy availability' (LEA).
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 and 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. The virtual nature of our program is ideal for athletes with busy schedules, frequent travel, or heightened concerns around privacy. 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 is actively conducting ongoing research to ensure that the treatment and resources we provide are data-informed and based on best practices. …and much more In addition to all of the above, we 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.
