AASP Blog

Updated January 8, 2021 (originally published July 31, 2014) by Dana K. Voelker, West Virginia University; Jenny Conviser, ASCEND Consultation in Health Care, LLC; Hayley Perelman, Yale University School of Medicine; and Caitlyn Hauff, University of South Alabama on behalf of the AASP Eating Disorders Special Interest Group.

Disordered eating encompasses a range of problematic eating attitudes and behaviors that adversely impact health and performance. Signs and symptoms are physical (e.g., fatigue, extreme weight fluctuation), emotional (e.g., fear of fat or weight gain, body shame), psychological (e.g., preoccupation with food, perceived body flaws), and behavioral (e.g., restrictive dieting, binge eating, excessive exercise, abuse of laxatives, diet pills, or diuretics). Scientific and anecdotal evidence indicates disordered eating can affect any athlete in any sport. By understanding the basics of this phenomenon, including how and why disordered eating occurs, healthcare professionals, sport administrators, coaches, and athletes can prioritize prevention and early intervention.

How and Why Does Disordered Eating Occur Among Athletes?

Disordered eating among athletes is a complex phenomenon involving a range of biological (e.g., heritable characteristics), psychological (e.g., perfectionism, anxiety), and environmental factors (e.g., peer modeling, weight stigma). Of crucial and immediate concern to sport stakeholders, research shows that pressures from the sport environment to change or maintain body weight, shape, size, or appearance may incite, or exacerbate, disordered eating. The following table outlines several sources of these pressures, all of which serve to perpetuate popular, but misguided, body ideals promised to ensure performance success. These pressures are in addition to the broader sociocultural biases, stigmas, and stereotypes that promote narrow definitions of beauty and standards for success.

Body Pressures in the Athletic Environment

How Can Disordered Eating Among Athletes Be Prevented?

Sport communities play a key role in the prevention and early intervention of disordered eating among athletes. Healthcare professionals, sport administrators, coaches, and athletes may consider the following reflective questions and strategies. 

Awareness

Consider your influence on others in your sport community. Are you a positive role model for healthy nutrition, exercise habits, and body image? What messages, both intentionally and unintentionally, do you send about weight, appearance, and food? Practicing healthy habits of your own can set a good example for others around you. Athletes often cite their disordered eating began, or was reinforced, after bearing witness to belittling or comparative comments from coaches, teammates, or athletic support personnel about body weight, shape, size, or appearance. Even comments intended to be helpful (e.g., “Losing some weight will make you faster;” “If you become more like them, you’ll compete better”) may be perceived as harmful (e.g., “They think I’m fat and not good enough”) and trigger disordered eating. Help athletes feel comfortable in their own skin by avoiding body comparisons and showing them how to appreciate their body’s individuality, health, and function above and beyond what it looks like.

Education

Consider your understanding of disordered eating. How well do you know the signs and symptoms? Is there a referral protocol in place if those signs and symptoms are detected?  Disordered eating can easily develop into a clinical eating disorder and must be recognized and referred early to the appropriate licensed professionals (e.g., psychologist/professional counselor, physician). Research suggests that many members of the sport community, such as coaches, have inadequate knowledge of disordered eating, which serves as a significant barrier to early detection and referral. Fortunately, credible resources and scientifically-informed best practices (see sample Resources below) are available and should be leveraged to promote athletes’ health, wellness, and safety. When the sport community is equipped with the proper knowledge and tools to quickly detect and effectively refer, they significantly mitigate risk of harm.

Culture

Consider the sport culture you help to cultivate and grow. Would you describe your athletic department, club, or team as body-accepting? Do you reinforce a health-first focus and prohibit unhealthy weight control practices, like public weigh-ins, body teasing, and food shaming? Athletes deserve the benefits their sport offers. Maximizing these benefits means using sport as an opportunity to show athletes how to fuel, enjoy, care for, and take pride in their bodies while appreciating themselves unconditionally. Working together to promote a healthy body culture in which body diversity is embraced, 

Resources

• National Eating Disorders Association – Tool Kits
  http://www.nationaleatingdisorders.org/toolkits
• National Institute of Mental Health – Eating Disorder
  http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml
• The Victory Program at McCallum Place
  http://www.thevictoryprogram.com/
• AASP Eating Disorders Special Interest Group – Mission and Resources
  https://appliedsportpsych.org/about/special-interest-groups/eating-disorders/

See also:

Conviser, J. H., Schlitizer Tierney, A., & Nickols, R. (2018). Assessment of athletes with eating disorders: Essentials for best practice. Journal of Clinical Sport Psychology, 12, 4, 480-494.  https://doi.org/10.1123/jcsp.2018-0012

Reel, J. J., Conviser, J., & Tierney, A. (in press, 2021). Disordered eating and body image problems: Assessment and treatment of athletes and performance populations. In The Routledge Handbook of Clinical Sport Psychology. Routledge.

Voelker, D. K. & Schroeder, L. (2018). More than just a coach: Developing awareness of eating disorders and body image concerns in sport. In R. Thelwell & M. Dicks (Eds.), Professional Advances in Sports Coaching – Research and Practice (pp. 210-227). London: Routledge. 

Voelker, D. K., & Galli, N. (2019). Eating disorders in competitive sport and dance. In M. H. Anshel, T. A. Petrie, & J. A. Steinfeldt (Eds.), APA handbooks in psychology series. APA handbook of sport and exercise psychology, Vol. 1. Sport psychology (p. 585–599). American Psychological Association. https://doi.org/10.1037/0000123-029