Sports Nutrition How Eating Disorders Develop in Athletes By Elizabeth Quinn, MS Elizabeth Quinn, MS Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. Learn about our editorial process Updated on June 09, 2021 Medically reviewed Verywell Fit articles are reviewed by board-certified physicians and nutrition and exercise healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, Ph.D., FTOS, is a licensed psychologist, clinical assistant professor, speaker, and wellness expert specializing in weight management and eating behaviors. Learn about our Medical Review Board Print Robert Decelis Ltd / Getty Images Athletes tend to be highly competitive and disciplined individuals who go to great lengths to excel in their sports. This personality type combined with the expectations of teammates and coaches as well as spectators may make them at a higher risk of developing an eating disorder than the average person. Athletes who compete in sports that emphasize appearance or require speed, lightness, agility, and quickness are at higher risk for developing an eating disorder than are non-athletes or athletes in sports that require muscle mass and bulk. Disordered Eating: What It Is and How it Differs From Eating Disorders Which Athletes Are Most at Risk for Eating Disorders? Eating disorders are most common in athletes that participate in the following sports: Ballet and other danceFigure skatingGymnasticsRunningSwimmingRowingHorse racingWrestling Which Eating Disorders are Most Common in Athletes? Both men and women are susceptible to eating disorders, although a greater percent of eating disorders are found in women. The two most common eating disorders found in athletes are: Anorexia Nervosa Bulimia Compulsive exercise is also problematic. It is not a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) but can be a symptom of an eating disorder. The real threat to an athlete with an eating disorder is the extreme stress placed upon the body. The very practice of self-starvation, purging, or obsessive exercise has a detrimental effect on performance. The process of bingeing and purging results in loss of fluid and low potassium levels, which can cause extreme weakness, as well as dangerous and sometimes lethal heart rhythms. The Female Athlete Triad Women athletes with eating disorders often fit into a condition called the female athlete triad, a combination of: Low energy availability Menstrual irregularities, such as amenorrhea Weak bones (increased risk of stress fractures and osteoporosis) This attempt to reduce body fat by extreme measures not only leads to decreased exercise performance but can lead to severe health complications. Nutrient deficiencies and fluid/electrolyte imbalance from low food intake can lead to increased risk of fractures, illness, loss of reproductive function, and serious medical conditions such as dehydration, and starvation. Medical complications of this triad involve almost every body function and include the cardiovascular, endocrine, reproductive, skeletal, gastrointestinal, renal, and central nervous systems. Many athletes mistakenly think they're not at risk for osteoporosis because they exercise and exercise is known to strengthen bones. However, research shows that exercise alone does not prevent bone loss. Irreversible bone loss starts within six months to two years of the loss of menses. Another negative consequence of eating disorders is the close association with depression. Identifying athletes with an eating disorder is not easy. They are often secretive or blame their eating and exercise regimen on their training goals. More patients are identified by perceptive coaches, teammates, friends or family members who notice an athlete losing weight, exercising beyond their normal training regimen or becoming overly preoccupied with food and weight. Warning Signs of an Eating Disorder Preoccupation with food, weight, and appearanceRepeatedly expressed concerns about gaining weightIncreasing criticism of one's bodyFrequent eating aloneUse of laxativesTrips to the bathroom during or following mealsContinuous drinking of diet soda or waterCompulsive, excessive exerciseComplaining of always being coldDenies being hungryCooks meals for others while not eatingEating too little, training too hardUnderweight or notable weight lossStress fractures or overuse injuries Getting Help for an Eating Disorder Eating disorders in an athlete are serious and can become life-threatening if left untreated. Identifying the type of eating disorder and getting help sooner rather than later is essential for the best outcome. 9 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. Milano W, Milano L, Capasso A. Eating disorders in athletes: from risk management to therapy. Endocr Metab Immune Disord Drug Targets. 2020;20(1):2-14. doi:10.2174/1871530319666190418121446 Mancine RP, Gusfa DW, Moshrefi A, Kennedy SF. Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type - a systematic review. J Eat Disord. 2020;8:47. doi:10.1186/s40337-020-00323-2 Barron L, Ward W. Prevention of hypokalaemia in bulimia nervosa. J Eat Disord. 2015;3(S1):O61. doi:10.1186/2050-2974-3-S1-O61 Nazem TG, Ackerman KE. The female athlete triad. Sports Health. 2012;4(4):302-311. doi:10.1177/1941738112439685 Kueper J, Beyth S, Liebergall M, Kaplan L, Schroeder JE. Evidence for the adverse effect of starvation on bone quality: a review of the literature. International Journal of Endocrinology. 2015;2015:1-7. doi:10.1155/2015/628740 Silvestris E, Lovero D, Palmirotta R. Nutrition and female fertility: an interdependent correlation. Front Endocrinol (Lausanne). 2019;10:346. doi:10.3389/fendo.2019.00346 Keller U. Nutritional laboratory markers in malnutrition. J Clin Med. 2019;8(6). doi:10.3390/jcm8060775 Benedetti MG, Furlini G, Zati A, Letizia Mauro G. The effectiveness of physical exercise on bone density in osteoporotic patients. Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531 Ji M-X, Yu Q. Primary osteoporosis in postmenopausal women. Chronic Dis Transl Med. 2015;1(1):9-13. doi:10.1016/j.cdtm.2015.02.006 Additional Reading National Association of Anorexia Nervosa and Associated Disorders. Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED). Athletes With Eating Disorders. By Elizabeth Quinn, MS Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit