Sports Nutrition Anorexia Symptoms and Complications in Athletes Certain athletes are more prone to eating disorders By Elizabeth Quinn Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. Learn about our editorial process Elizabeth Quinn Reviewed by Reviewed by Rachel Goldman, PhD, FTOS on November 13, 2020 facebook twitter linkedin instagram Rachel Goldman, PhD, FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in weight management and eating behaviors. Learn about our Review Board Rachel Goldman, PhD, FTOS Updated on November 17, 2020 Print Table of Contents View All Table of Contents Overview Research Health Complications Signs and Symptoms Heightened Risk for Girls Treatment and Getting Help Athletes benefit from self-motivation and discipline. But unfortunately, those traits—the same ones that can help someone become a great athlete—can also put them at greater risk for anorexia nervosa (often simply called anorexia) and other eating disorders. Overview People with anorexia tend to have a profoundly distorted body image and believe they are overweight, even when in reality they're extremely thin and/or undernourished. A person with anorexia may lose 15% to 70% of their normal body weight by severely restricting their food intake and/or exercising excessively. Athletes with anorexia are often dedicated to strict training and dietary guidelines. Heavily structured and controlled exercise and eating patterns make it relatively easy for them to hide—and not recognize they have—an eating disorder. Training schedules, competition, discipline, and/or travel become reasons for not eating. These explanations often mask unhealthy behavior from loved ones and coaches. The Basics of a Healthy, Balanced Diet Research Anorexia nervosa is an often undiagnosed, easily missed, and misunderstood mental health condition. According to the National Association of Anorexia Nervosa and Associated Disorders, approximately 9% of Americans will have an eating disorder in their lifetimes. Women are about three times more likely than men to develop anorexia. However, men with this condition are more likely to die from it. Mortality Rates Overall, opioid addiction is the only mental health condition with a higher mortality rate, and adolescents and young adults are at heightened risk of both suicide and death from physical complications of anorexia. In fact, studies show that young people from ages 15 to 24 who have anorexia are 10 times as likely to die as their peers who do not have anorexia. Impact on People of Color It's important to note that many people of color with eating disorders don't get diagnosed or have access to the treatment and support they need. In fact, research shows that people of color who have eating disorders are half as likely to get treatment, and their medical providers are less likely to screen them for these conditions. Heightened Risk for Athletes Two research studies found that adolescent athletes are at high risk for anorexia and other eating disorders, especially if they are female. However, adolescent boys and young men also are at risk. Initially, extreme weight reduction may seem to improve their athletic performance, but over time, continued starvation can lead to a variety of physical and mental health problems. as well as negatively impact athletic performance. Studies have found that around 14% of young female athletes and 3% of young male athletes showed signs of having an eating disorder, most often anorexia. Additionally, those with anorexia often have comorbid mental health issues. Some of the most frequent conditions that occur alongside anorexia are obsessive-compulsive disorder, depression, anxiety disorders, attention deficit hyperactivity disorder, and autism spectrum disorder. People with anorexia have a heightened risk of suicidal ideation and suicide as well. If you or your loved one are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see our National Helpline Database. Are There Gender Differences in Suicide and Suicidal Behaviors? Health Complications Anorexia poses life-threatening complications for athletes, including: Abnormal heart rhythms (arrhythmias and bradycardia, which is a slow heart rate)Amenorrhea (interruption or absence of the menstrual cycle)Brain damageDehydrationElectrolyte imbalancesInfertilityLow blood pressureHeart damageMalnutritionMultiorgan failureOsteoporosis (brittle bones and decreased bone mass)Sleep disorders Signs and Symptoms Common symptoms of anorexia may include the following: Avoiding activities that involve foodBrittle hair and nailsConstipationDry skin and yellowish skin toneExcessive, persistent thinking about food, calories, and body weightExcessive weight lossFeeling cold (body temperature may be slightly low)Growth of lanugo (fine hair) all over the bodyInappropriate use of laxatives, enemas, or diuretics in order to lose weightLethargyMood swings or depressionWearing layered clothing (to hide weight loss and for warmth) Signs of Eating Disorders in Exercisers Heightened Risk for Girls The American College of Sports Medicine and the American College of Obstetricians and Gynecologists report that there are three related health problems, collectively referred to as the "Female Athlete Triad," that are often found in girls and young women who participate intensely in sports. This triad consists of the following: Irregular or missing periodsLow energy (with or without an eating disorder)Weak bones, which leads to an increased risk of stress fractures and osteoporosis Young women who attempt to reduce body fat by extreme measures are at high risk for eventual poor performance in exercise and sports, along with severe health complications caused by the development of eating disorders. Nutrient deficiencies and fluid/electrolyte imbalance from low food intake can lead to increased risk of fractures, illness, loss of fertility, and serious medical conditions such as dehydration and starvation. The medical complications of this triad involve almost every body function and include the cardiovascular, endocrine, reproductive, skeletal, gastrointestinal, renal, and central nervous systems. Additionally, the risk of developing comorbid mental health conditions is high as well. Treatment and Getting Help The good news is that there are effective treatments for anorexia. Common treatment options include individual, family, and/or group therapy, medications, nutritional counseling, and hospitalization. Any comorbid conditions should be treated as well. Early interventions tend to result in better treatment efficacy and quicker recovery. Additionally, early diagnosis is key to prevent the potential physical damage that can develop as a result of anorexia's typical progression. A Word From Verywell Eating disorders in an athlete are serious and can become life-threatening if left untreated. Anorexia is a serious health concern that generally requires someone close to the athlete—a coach, teammate, or family member—to recognize the warning signs and encourage the person with anorexia to seek professional help. Identifying the eating disorder is essential to get the right help. How Excessive Weight Loss Affects Female Bodybuilders' Bodies Was this page helpful? Thanks for your feedback! Get nutrition tips and advice to make healthy eating easier. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Association of Anorexia Nervosa and Associated Disorders. Eating disorder statistics. National Eating Disorders Association. Statistics and research on eating disorders. Mclester CN, Hardin R, Hoppe S. Susceptibility to eating disorders among collegiate female student-athletes. J Athl Train. 2014;49(3):406-10. doi:10.4085/1062-6050-49.2.16 ACOG Committee on Adolescent Health Care. Committee opinion No.702: Female athlete triad. Obstet Gynecol. 2017;129(6):e160-e167. doi:10.1097/aog.0000000000002113 Additional Reading Martinsen M, Sundgot-borgen J. Higher prevalence of eating disorders among adolescent elite athletes than controls. Med Sci Sports Exerc. 2013;45(6):1188-97. doi:10.1249/MSS.0b013e318281a939 National Eating Disorders Collaboration. Comorbidity. National Institute of Mental Health. Eating disorders: About more than food. Revised 2018. National Institute of Mental Health. Eating disorders. Revised 2018.