Eating Disorders in Athletes
Behind the smiles of some athletes who return home decorated with Olympic medals is a struggle that has overshadowed their quest for gold.
Olympic glory has come at the cost of their physical and mental health as they struggle with disordered eating and body image. In recent memory, more have spoken out about their struggles.
Gracie Gold, US figure skater, took a break from the 2017-2018 competitive season to seek inpatient treatment for an eating disorder.
That same year, fellow skater Yulia Lipnitskaia of Russia retired from the sport due to her struggle with anorexia.
Australian cricket captain Meg Lanning retired for the same reasons.
Other elite athletes have also come forward, including US figure skater Nancy Kerrigan, Australian sprinter Jana Pittman, Australian swimmer Alicia Coutts. Men, too, struggle with depression, anxiety, body image, and disordered eating, including US swimmer Michael Phelps and US snowboarder Shaun White.
Yet one need not be considered elite to struggle in similar ways.
Research indicates that athletes are at higher risk for developing eating disorders than non-athletes. A 2024 data review found that 19.23% of athletes self-reported an eating disorder.
According to Kendra Becker, a clinical psychologist with the Women’s Sports Medicine Program at Mass General Brigham the rate of eating disorders among female athletes can be as high as 42% and “up to 70% of female athletes may engage in behaviors that can develop into an eating disorder, such as restricting food and trying to lose weight.”
A 2020 review of studies cited in the Journal of Eating Disorders demonstrated increased disordered eating among all athletes, with a higher risk attributed to so-called “lean” sports, including aesthetic sports (gymnastics, artistic swimming, figure skating, and dancing), endurance sports (track, cycling, swimming) and weight-dependent sports (wrestling, judo, karate). Such sports involve judgment of the body alongside technique and performance (aesthetic); belief that leanness increases performance (endurance); and require athletes to meet certain weight standards to compete (weight-dependent).
There are several unique factors that contribute to eating disorders among athletes:
Pressure to Maintain a Specific Body Weight or Shape: Many sports require athletes to maintain a certain weight or physique to enhance performance or meet aesthetic standards. For example, runners may be pressured to stay lean to improve speed, while gymnasts may feel compelled to maintain a petite frame to perform certain maneuvers. Wrestlers and boxers are required to publicly weigh in before competitions to ensure they still meet their class standards.
Perfectionism and High Achievement Standards: Those who compete as athletes are often driven to excel and achieve perfection. This mindset can extend beyond their performance to their body image, leading to obsessive thoughts about weight and appearance, creating apt conditions for increased anxiety, depression, fear of failure, and shame and blame that trap them in cycles of disordered behaviors.
Cultural and Societal Influences: Diet culture messaging laden with fat phobia lifts up certain body types as ideal - specifically thin, lean, and toned bodies - and equates ideal bodies with success and attractiveness. Athletes are subjected to these influences as much as non-athletes, yet they are also involved in competition where appearance is judged alongside skill and technique. Aesthetic sports (gymnastics, artistic swimming, figure skating, and dancing), endurance sports (track, cycling, swimming) and weight-dependent sports (wrestling, judo, karate) increase risk.
Coaching and Team Culture: Coaches and teammates are significant players in the life of an athlete. Coaches offer guidance, challenge, and support, thus their attitudes toward weight and performance can impact an athlete's relationship with body and food. Those who emphasize weight loss and/or critique an athlete’s body can inadvertently contribute to the development of unhealthy behaviors. Such attitudes can be further emphasized by team culture that prioritizes appearance or weight over health, creating an ethos of disordered attitudes and behaviors toward food and body.
The consequences of eating disorders for athletes are severe, affecting both their physical health and athletic performance.
Physically, eating disorders can lead to malnutrition, electrolyte imbalances, cardiovascular issues, and decreased bone density, increasing the risk of injury.
Psychologically, these disorders are associated with anxiety, depression, and impaired cognitive function, which can diminish an athlete’s ability to concentrate and perform under pressure.
Moreover, the obsession with food and body image can consume an athlete’s thoughts, leading to social isolation and withdrawal from relationships and activities outside of their sport. The stress of maintaining disordered eating habits can also contribute to burnout and a premature end to an athlete’s career.
Given the serious impact of eating disorders, prevention and early intervention are crucial.
Education is a key component of prevention, with coaches, trainers, and athletes themselves needing to be aware of the signs and symptoms of eating disorders.
Promoting a healthy body image, emphasizing performance over appearance, and fostering a supportive team environment can help reduce the risk.
For athletes who develop eating disorders, early treatment that employs a multidisciplinary approach, including medical, nutritional, and psychological support, is essential for healing and recovery. Coaches and athletic organizations should also be involved in the treatment process, working to create an environment that supports the athlete’s recovery and ensures their well-being.
As for Olympians, alongside those who have shared their struggles are others who seek to promote health and body acceptance.
Ilona Maher, member of the 2024 US Women’s Rugby Team, has engaged nearly four million followers on Instagram, saying: “All body types matter, all body types are worthy, all body types are beautiful and can do amazing things. Truly see yourself in these [Olympic] athletes and know that you can do it, too.”
Athletes of all sizes compete at the Olympic level and influential voices like Maher’s invite us to see this wide range of representation. Maher is stepping into other spheres as well, challenging conventional stereotypes about women’s bodies in the world of fashion and on the latest season of Dancing With the Stars. Such voices can further contribute to a supportive athletic community.
Eating disorders among athletes are a serious and often hidden issue that can have devastating consequences.
The unique pressures faced by athletes, combined with societal and cultural influences, contribute to the development of these disorders. Understanding the factors that lead to eating disorders in athletes and implementing strategies for prevention and treatment are critical steps in protecting the health and careers of those affected.
By fostering a culture that prioritizes health and well-being over appearance and performance, the sports community can help athletes thrive both in their sport and in their lives.
If you’re in need of body image or disordered eating support, I hope you reach out as you’re ready. You deserve to feel better.
🧡,
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