Eating disorders in athletes: effects, treatment and prevention
Pressure on weight and shape pushes some athletes into disordered eating, from dieting to anorexia or bulimia. It weakens performance and health; early detection and a team approach work best.
Types of eating disorders
| Type | Main features | Warning signs in athletes |
|---|---|---|
| Anorexia nervosa | Severe food restriction, intense fear of weight gain, distorted body image, low body weight | Rapid weight loss, skipping team meals, extra secret training, feeling cold, missed periods |
| Bulimia nervosa | Repeated binges followed by purging: vomiting, laxatives, diuretics, fasting or excess exercise; weight often normal | Going to the toilet right after meals, swollen cheeks, damaged tooth enamel, sore knuckles |
| Binge-eating disorder | Repeated binges with loss of control, without purging | Secret eating, distress, weight gain |
| Disordered eating ('anorexia athletica') | Restrictive eating and over-training that do not meet full criteria | Rigid food rules, constant calorie counting, anxiety about missing training |
| Muscle dysmorphia | A body-image disorder: feeling too small or weak, mostly in men | Over-training, heavy supplement use, steroid misuse |
Effects on sports performance and health
| Effect | Why it happens |
|---|---|
| Lower endurance | Low glycogen, dehydration, anaemia |
| Less strength and power | Muscle protein is broken down for energy |
| Poor concentration and coordination | Low blood glucose and electrolyte imbalance |
| Stress fractures and injuries | Low bone density (triad, RED-S) |
| Slow recovery, frequent illness | Too little energy, protein and micronutrients |
| Heart rhythm problems | Low potassium from vomiting or laxatives; very low heart rate |
| Depression and anxiety | Part of the illness; worsened by poor performance |
Treatment
- 1Identify early and speak to the athlete privately, with concern, not blame.
- 2Medical check: weight, heart rate, blood pressure, electrolytes, ECG, bone density; decide whether training must stop.
- 3★Build a team: physician, psychologist or psychiatrist (for example cognitive behaviour therapy; family-based therapy for teenagers), sports dietitian, coach and family.
- 4Nutrition rehabilitation: regular meals and snacks, energy raised step by step, weight and periods restored, calcium and vitamin D; severe cases need hospital care because of refeeding risks.
- 5Return to sport in stages, with agreed eating and health goals in writing.
- 6Follow up for months to catch relapse.
★ one-way, controls the pace
Prevention
- Educate athletes, coaches and parents about fuelling for performance and the risks of under-eating.
- Stop public weigh-ins and remarks about body size; measure body composition only when needed, privately.
- Screen at pre-season medicals with simple questionnaires and a menstrual history.
- Build a team culture of eating together and enjoying food.
- Give athletes access to a sports dietitian; train coaches to spot early signs.
- In weight-class sports, discourage rapid weight cutting before weigh-ins.
The dietitian's job is to rebuild regular eating without fear: three meals and two or three snacks, using foods the athlete accepts (idli, curd rice, fruit, milk), slowly raising energy. Weight comments from coaches or teammates must stop; the plan talks about fuelling for performance, not the scale.
2 marks: “What is bulimia nervosa?” Repeated binge eating followed by purging (vomiting, laxatives, diuretics, fasting or excess exercise); body weight is often normal.
5 marks: “Write a note on eating disorders among athletes.” Types, high-risk sports, warning signs, and the main effects on health and performance.
10 marks: “Discuss eating disorders in athletes: their effect on sports performance, treatment and prevention.” Spectrum and types, risk sports, effects table, treatment steps with the team, and prevention measures.
Treat with a team of four: Doctor, Psychologist, Dietitian, Coach: 'Don't Punish, Do Care'.