For many young people, taking part in sports is an important and enriching part of their daily life. Sports can form the basis of friendship groups and social activities, provide enjoyment and relaxation, and promote good mental and physical health.
However, sometimes participating in sports – particularly at a competitive level – also comes with risks. Adolescent athletes are at a higher risk of eating disorders than other young people, particuarly in sports like swimming, combat sports, and gymnastics. As with every young person, eating disorders among athletes are serious mental health conditions that affect their mental and physical health and quality of life.
It’s still not clear exactly what puts adolescent athletes at a higher risk of eating disorders, but experts think that sporting pressures surrounding weight and body shape play a big role. This also means that with changes in attitudes and practices, it should be possible to protect young athletes against eating disorders.
This blog explores how and why eating disorders develop among adolescent athletes – and what steps can be taken to prevent them.
How Common Are Eating Disorders Among Adolescent Athletes?
Eating disorders are relatively common among young people in general. Recent studies suggest that the prevalence of any eating disorder among adolescents is about 5.5%, and girls are more likely to develop eating disorders than boys.
Until now, research into the prevalence of eating disorders among adolescent athletes has certain limitations. For example, studies often only consider elite athletes and not non-elite athletes, meaning they have a small sample size. They may also use different criteria for eating disorders or use tools that aren’t suitable for identifying eating disorders in athletes.
However, despite these limitations, studies show that eating disorders are much higher in female athletes than in the general population. Research has found that the prevalence of eating disorders among athletes is 5-33%, depending on the criteria used. One study found that up to 60% of female athletes showed disordered eating behaviours.
Studies among male athletes have also found that disordered eating behaviours are common in certain sports. These include wrestling, light-weight football, horse racing, bodybuilding, and long-distance running. For example, in a study among wrestlers and rowers, 52% reported engaging in binge eating behaviours and 11% met the criteria for a subclinical eating disorder.
Which Sports Have a High Risk of Eating Disorders?
Any young person can develop an eating disorder, regardless of their background, age, gender, or lifestyle. However, some people, like athletes, are more likely to develop eating disorders, and even within athletes, certain sports come with a higher risk than others.
Sports that have the highest risk or prevalence of eating disorders often put some emphasis on body shape or weight, encouraging disordered eating attitudes and behaviours. For example, sports like wrestling involve weight categories, causing many athletes to engage in unhealthy weight loss behaviours to maintain or reach a certain weight.
Other sports like gymnastics or long-distance running can also idealise a certain body type that may lead to body dissatisfaction, low self-esteem, and disordered eating behaviours.
Some sports with the highest risk of eating disorders include:
- swimming
- gymnastics
- combat sports
- ballet
- wrestling
- bodybuilding
- long-distance running
Why Are Adolescent Athletes at a Higher Risk of Eating Disorders?
There are several factors that might put adolescent athletes at a higher risk of eating disorders than other people. These include practices within sports and the attitudes of coaches and other professionals.
Sporting Practices, Attitudes, and Eating Disorders
Some sports involve certain practices and cultures that may lead to eating disorders. In general, these include sports that involve weight categories (such as boxing or wrestling), aesthetics (such as gymnastics, dancing, or synchronised swimming), or endurance (such as distance running).
These practices may cause young people to focus more on their shape and weight, placing their self-worth in their bodies, rather than other strengths and parts of their identity. Concerns about their bodies may start to feel more important than other aspects of sport, including training, skill, or performance.
Overvaluation of shape and weight is a core characteristic of eating disorders that may lead to body disatisfaction and increasingly restrictive eating behaviours to try and reach a specific body weight that is usually unhealthy or unrealistic. These behaviours may include laxatives, vomiting, and diet restriction.
One study asked female athletes who engaged in dieting to identify the reasons behind their behaviours. Their responses included enhancing performance, improving appearance, and following the recommendations of coaches, parents, or friends.
They also asked those who had developed eating disorders about the causes of their condition. Their answers included
- prolonged periods of dieting or weight fluctuation (37%)
- new coach (30%)
- injury or illness (23%)
- casual comments (19%)
- leaving home or failing at school or work (10%)
- problems in relationships (10%)
- family problems (7%)
- illness or injury to family members (7%)
- death of significant others (4%)
- and sexual abuse (4%)
Athletes who developed eating disorders also started dieting at an earlier age than those without eating disorders and felt like there was a bigger difference between their actual body shape and their ‘ideal’ body. Those who started dieting unsupervised were more likely to develop eating disorders.
Attitudes of Coaches and Social Pressures
Many young athletes refer to the attitudes of coaches or comments from others as reasons for the development of eating disorders. Harmful attitudes of coaches, professionals, and others involved in sports can create environments with an especially high risk of eating disorders.
For example, some coaches may emphasise body weight and shape as an important part of sporting performance or directly pressure young people to change their body weight. They may also encourage disordered eating behaviours.
As awareness about eating disorders among athletes has increased, steps have been taken to identify and prevent pressures that encourage disordered eating within sports teams and promote positive eating cultures and body positivity. In some cases, this may include removing coaches and other professionals from positions or holding individuals accountable for ‘casual comments’. However, many adolescent athletes continue to be exposed to these behaviours and attitudes.
What Are the Consequences of Disordered Eating Behaviours Among Adolescent Athletes?
Eating disorders have serious consequences for young people’s mental and physical health and, without effective treatment and support, can be fatal. Some of the effects of eating disorders on adolescents include:
- fatigue
- slow heart rate
- low blood pressure
- heart failure
- osteoporosis (decreasing bone density)
- muscle loss and weakness
- stopping of menstruation
- dehydration
- anxiety and depression
Adolescent athletes with eating disorders are at risk of developing these health problems, as with any other young person. There are also some consequences that are more specific or relevant to adolescents taking part in competitive sports.
Relative Energy Deficiency in Sport (REDs)
Relative energy deficiency in sports is a common problem among athletes where a combination of exercise and insufficient nutritional intake results in low energy availability. This, in turn, leads to a variety of health problems, including:
- menstrual dysfunction (in females)
- anemia
- depression
- excessive fatigue
- decrease in muscle health
- weak immune system
Athletes with REDs not only experience serious health problems but also suffer consequences for their athletic performance. Their condition affects their ability to train consistently, develop strength, and perform to their potential.
Bone Density, Injury, and Recovery
Adolescence is a key period for the development of bone density. Among female athletes, 95% of mineral bone density is developed in their adolescent years, with the greatest increase occurring between the ages of 11 and 14. If a young person doesn’t take in enough nutrients during this time, there can be irreversible decreases in bone density.
This leaves young athletes at risk of osteoporosis, both during adolescence and later in life. It also makes them more susceptible to injuries, such as stress fractures and broken bones. In general, high school athletes who show disordered eating behaviours take longer to recover from injury than those who don’t.
Preventing and Treating Eating Disorders Among Adolescent Athletes
Eating disorders are common among adolescent athletes. However, certain steps can help prevent the development of the disorders and create healthy sporting cultures and environments.
This includes educating athletes, coaches, and others involved in sports about eating disorders and introducing mechanisms to quickly identify problematic behaviours. It also involves implementing healthy weight practices in sports and, in some cases, modifying rules and regulations.
Experts emphasise the importance of the involvement of coaches in recognising and managing eating disorders among athletes. Research also suggests that school-based programs can play a key role in preventing the development of eating disorders and symptoms.
Treating Eating Disorders Among Adolescents
Eating disorders are serious mental health disorders that require professional treatment and support. However, with the right care, young people can recover from eating disorders, no matter how serious the condition.
Eating disorder treatment for adolescents can involve a variety of different evidence-based therapies. Young people may receive inpatient (residential) care or outpatient care, depending on their needs, or move between different levels of care.
Some evidence-based treatment approaches for young people include:
- Family-based therapy (FBT)
- Enhanced cognitive-behavioural therapy (CBT)
- Integrated trauma therapy
The Wave Clinic: Specialist Residential Care for Eating Disorders
The Wave Clinic is a specialist residential space in Malaysia, dedicated to teenagers and young adults. Our programs combine exceptional clinical care with education, community responsibility, and enriching experiences, supporting young people to plan and build the futures they dream of.
We understand recovery as a process of building: building identities, skills, and resilience. We support young people to leave our centre with self-confidence, stability, and direction, giving them the strength they need to navigate future challenges.
We recognise that experiences of trauma often shape the way young people think and behave later on in life. Our programs sensitively address trauma from the start of treatment, addressing the underlying causes of disordered eating and encouraging healing of the entire person.
The Wave Clinic is a Global Centre of Excellence for the treatment of eating disorders. We offer unequaled qualifications, experience, and expertise, with the necessary medical facliities to keep every young person safe. If you’re interested in our programs, get in touch today.
