Athletes and eating disorders: know the warning signs

Whether you’re a coach or parent, there’s a good chance you’ll run into one or more children under your supervision who develop an eating disorder as they go through puberty and pursue competitive sports.

You don’t need to be a trained dietitian or psychologist to spot some of the more common signs of eating problems.

Expert dietitian Page Love gives parents some helpful advice for spotting these problems before it’s too late to address them.

Who Is at Risk?

Post-pubescent girls

Teen girls are the biggest group to develop eating disorders, but boys in some sports (such as wrestling and cross-country) also develop rapid weight-loss problems.

Kids under stress

“With children who have a body-image or weight focus, there are usually underlying psychological stressors,” says Love, president of the nonprofit Eating Disorders Information Network and owner of NutriFit Sport Therapy. “Maybe a family member has an illness, the parents are going through a divorce or the child is struggling in school.” Love points out that children from families with a history of alcoholism and those with physical abuse issues are can be more prone to developing eating disorders.

High-performing, perfectionistic children

“Good students put a lot of pressure on themselves and have higher anxiety,” says Love. “They tend to be perfectionists. The ‘good-student’ personality characteristic can be a sign that a child is at higher risk for an eating disorder."

Sports with the highest instances of eating disorders include cross-country running, swimming, gymnastics, figure skating and wrestling.

These are known as “thinness-demand” sports because the body type of the most successful performers are usually low fat. Atlanta-area cross-country coaches surveyed in 2007 said eating disorders were “running rampant” among their female team members.

What Are Sports-Related Causes?

After children reach puberty, their bodies change. Girls begin to produce and store more fat that’s needed for adult female biological functions. Girls can mistakenly take this as a sign that they are simply putting on weight.

“When kids first go through pubertal changes and the body starts changing, particularly for young women, that's a little scary," says Love. “For example, with cross-country, girls are super-fast before they hit puberty; almost as fast as boys. Then they hit puberty, start developing and their body fat goes up. Girls may be uncomfortable with this change, fear it will slow them down, and may want to lose the weight. Unfortunately, they misperceive that more body fat means they are slower. In reality, it might be that they’re getting stronger.”

Anorexia vs. Bulimia

Anorexia can be described as restrictive eating that leads to not getting enough energy to meet health needs, causing malnutrition issues. Bulimia refers to eating large amounts of food, then immediately getting rid of that food through compensating techniques, such as self-induced vomiting (binging and purging). Eating disorders usually start with anorexia, says Love, a member of the clinical staff of the Atlanta Center for Eating Disorders.

After a certain point, a person who doesn’t eat enough becomes famished and may start binging on large quantities of food, especially after a hard physical activity like sports. When the child binges, she might feel guilty or panic about weight gain and may want to purge or compensate to get rid of the meal she just ate. Some people with eating disorders resort to using laxatives.

What Are Signs to Look For?

Love says to look for the following signs* that a child might have an eating disorder.

  • Dramatic change in body weight that's visually apparent
  • A girl has stopped menstruating
  • A child disappears after team meals or needs to rush to the bathroom after eating
  • Bruised knuckles (from self-induced vomiting)
  • Bloodshot eyes
  • Decreased athletic performance
  • Increased fatigue, lack of enthusiasm or low participation in group activities
  • Inability to recover after workouts and games
  • Not eating or snacking with the team
  • Self-deprecating remarks (e.g., “I’m so fat.”)
  • Wearing baggy clothes, frequently looking in the mirror
  • Performing eating rituals or eating only low-fat, low-calorie foods
  • Overdoing workouts and training
  • Constipation, stomach pains
  • Dehydration and dry skin
  • Feeling physically cold

*List compiled from Page Love and

What to Do if You Suspect an Eating Disorder?

If you are a coach of a player you think might have an eating disorder, don’t try to make a diagnosis or handle the problem yourself, advises Love. "A coach would be smart to talk to the parents and child at the same time to encourage a medical assessment. That would also decrease liability for the coach, school or organization by making sure it's even safe for the athlete to be competing in the sport."

Love suggests not weighing young athletes because weight swings occur for a number of reasons at that age. If you plan to measure body mass composition, don’t make any information public and think about not even sharing the results with your players. This will prevent kids from comparing their weight and body mass to their peers.

Parents and coaches should avoid making weight loss a personality issue at first, suggests Love. “Stay performance focused when talking to a young athlete. You can say things like, ‘You looked fatigued,’ or ‘You’re not moving as quickly as you did before.’ Ask open-ended questions like ‘Is everything OK at home or school?’ to find out if there are any stressors.”

What are your thoughts? Let us know in the comment section below or on our Facebook page

RELATED: Anorexia in boys: recognizing the connection to youth sports

RELATED: 27 warning signs your athlete may have an eating disorder

More Resources

Eating Disorders in Sports

Eating Disorders in Athletes

Steve Milano

Steve Milano has been writing and lecturing on youth sports for more than 25 years. He ... View Full Bio

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