Athletes and Eating Disorders: Understanding the Risks

A few weeks ago, a girlfriend from college invited me to go sailing on her boat on the San Francisco Bay with some other women. I eagerly accepted. The day was resplendent and the company was equally sunny. Lots of laughs – until one mom mentioned that her daughter was repeating her sophomore year of high school and I asked why. “Bulimia,” she said. Her daughter, an athlete, first became too weak to play the sport she loved. Then, her eating disorder led to her missing so much school that the family finally pulled her from school and sent her to a rehab facility in another state. She’s doing better now, back in school, but she’s a year behind.

I was flabbergasted and incredibly sad for the woman and her family. But the true pervasiveness of these illnesses among young athletes really hit home when a 12-year-old neighbor was hospitalized for an eating disorder. Upon her return to her soccer team, the parent of another player suggested that simply making the girl eat snacks with her teammates would cure her illness and make her realize ‘eating is ok’.

Nothing could be further from the truth, but it made me realize how little sports parents, myself included, understand eating disorders—and, unfortunately, how much they are growing in popularity in the adolescent and pre-teen demographic, especially high-achieving, intelligent, driven adolescent athletes.

According to Dr. Neal Anzai, Medical Director of the Center for Anorexia and Bulimia at Alta Bates Summit Medical Center in Berkeley, California, “The increased focus on being thin and eating healthy in our society clearly has a hand in the rise in eating disorders, which are nearly 10 times as prevalent today as they have ever been.

What I thought was a problem among older teens and college-age students has truly stretched its ugly tentacles down to pre-teens and middle-schoolers. While the first semester of college is the most common life stage in which an eating disorder can develop—the fear of the “Freshman 15”—adolescence is right up there with the transition to college.

The numbers are mind-boggling: according to a 1999 study by Craig Johnson, chief clinical officer of the Eating Recovery Center in Denver, Colorado, at least one in every three female college athletes shows symptoms of some form of eating disorder. And over 50 percent of teenage girls and nearly 33 percent of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives, according to a 2005 study conducted by NeumarkSztainer.

If those statistics aren’t jaw-dropping enough for you, try this: Almost half of all 9- to 11- year-old girls are ‘sometimes’ or ‘very often’ on diets (Gustafson-Larson & Terry). Yes, you read that correctly: half of all 3rd, 4th and 5th grade girls are on a diet.

While eating disorders are dangerous for anyone at any age, adding that factor to the already high activity levels of athletes can make them more prone to serious injury—not to mention the long-term effects, which can include osteoporosis, organ malfunction, and digestive problems, just to mention a few.

For athletes with eating disorders, Dr. Anzai notes, there is a “dissonance between what the body needs in terms of muscle and fat to be good at his or her chosen sport and what the athlete thinks is the ‘ideal’ or ‘perfect’ body.” For example, many female soccer players “hate having ‘thunder thighs’”, but it’s the muscular thighs that enable them to strike the ball hard and run for long periods of time. Runners, male and female, need muscular legs as well, but they strive to be thin for aerodynamic reasons, which can often work at cross-purposes.

Don’t assume your child is “too young”, “too thin”, or “not a girl” to be affected. Bulimia and anorexia are not age- or gender-specific, and they’re really not about food – they’re about control. The anorexic tends to say to himself or herself, “If I eat, I will be out of control,” and is able to restrict and control his or her eating, while the bulimic, who, personality-wise is not quite as disciplined as the anorexic, says, “I am a failure because I couldn’t control my eating,” which leads to the cycle of binging and purging.

Whether you have a young athlete at home or an older teen or twenty-something away at college here, according to Dr. Neal Anzai, are some of the warning signs to look for if your child has an eating disorder:

  1. Noticeable or dramatic weight loss
  2. Picky eating or resisting food in general
  3. For girls, the loss or absence of a menstrual cycle
  4. Obsessive/compulsive behavior in schoolwork and other activities
  5. Over-concern about food and body image
  6. Awkward behavior or disappearance at mealtime
  7. Excessive exercise, even outdoors in poor winter weather conditions

While you, as a sports parent, may be tempted to turn a blind eye to an eating disorder to avoid inhibiting your child’s athletic progress, you can cause irreparable long-term harm to your child if you don’t take it seriously.


Emily Cohen is a freelance writer living in Berkeley, California. An avid tennis player and swimmer, Emily has a son who plays high school baseball and a daughter who plays on a Class I soccer team and middle school volleyball team. She has been a team manager for a number of her children’s sports teams. You can find Emily’s bi-weekly blog about team management and youth sports parenting here at Check out the rest of Emily’s work at or contact her at [email protected]

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