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Young athletes and eating disorders: what to know | Ask the Pediatrician

How to recognize and avoid this potential downside of kids' sports.

Sports are a wonderful way for children and adolescents to learn teamwork, set goals and boost confidence. Most importantly, sports are a way for kids to connect, stay strong and make friends.

I am a huge fan of sports for kids, but sometimes kids (and coaches) can become too focused on performance or weight. Let’s talk about kids and sports and how to get the benefits without tipping toward excessive stress and eating disorders.

What is an eating disorder?

Eating disorders are complex mental health disorders that are seen in both females and males. Simply put, patients with eating disorders have an unhealthy focus on food, weight and body image. Common eating disorders include anorexia nervosa and bulimia. Patients with anorexia nervosa often severely restrict their caloric intake due to an intense fear of weight gain. Patients with bulimia nervosa, on the other hand, tend to binge eat and purge or use diuretics or laxatives. Excessive exercise, beyond what is recommended for sport, can also be related to purging.

In general, people with eating disorders are in denial and deeply believe that they are making healthy choices. The irony is that athletes who lose an excessive amount of weight ultimately are less likely to achieve peak performance. They experience fatigue, muscle breakdown, dangerously low heart rates and brain fog. They are also much more likely to have fractures, injuries and electrolyte derangements. Unfortunately, chronic malnutrition has severe health consequences and can be fatal.

Sports culture of performance and competition can mask some of the symptoms of this mental illness. Eating disorders can be difficult to identify so awareness, understanding of the risk factors, prevention and early treatment is critical.


The link between eating disorders and sports

Eating disorders tend to affect female athletes more often than male athletes, but both can be impacted. Some sports are more weight sensitive than others, meaning that there is an intense focus on the athlete’s weight. Whether it is an endurance sport such as long-distance running, a weight category sport such as boxing or wrestling, or an aesthetic sport such as gymnastics or diving, intense focus on an adolescent’s weight is a risk factor for eating disorders. In fact, research has found that serious athletes and all three of these types of sports (endurance, aesthetic and those with weight categories) have increased prevalence of eating disorders.

Some sports have a culture of fasting or dehydration and frequent weight checks prior to competitions. Additionally, young athletes are congratulated on meeting weight goals. The message teens hear is disordered eating is part of athletic routine. Unfortunately, this is a set-up for perseveration, or contined involuntary repetition of a thought or behavior, on weight and eating disorders.

Eating disorder risk factors

Certain behaviors or beliefs can increase the risk that a young athlete will develop an eating disorder. Stay in the know so you can understand how athleticism and performance are being discussed. Risk factors associated with increased risk of eating disorder include the following:

  • Coaches who focus on competition and success rather than sportsmanship.
  • Athletes with low self-esteem.
  • Belief in the mistaken idea that being thinner improves athleticism.
  • Family pressure to be thin.
  • Family member with eating disorder.
  • Dieting constantly.

eating disorders

Preventing eating disorders

Prevention is key — not just for our own kids but for all the kids on the team. Let’s help our kids enjoy sports and have a healthy attitude toward food. As parents and caregivers, we can support our athletes by encouraging their motivation rather than emphasizing looks or weight.

  • Encourage young athletes to grown in their sport in healthy ways including strength and mindset.
  • Work with coaches to encourage motivation and positivity, rather than body shape and weight.
  • Stay in the loop. Is the team promoting healthy beliefs about weight, body image and health?
  • Are the coaches trained to spot eating disorders?
  • Advise against frequent weigh-ins.

Early intervention

If you think your child may have an eating disorder, start with unconditional love and support. Let them know you love them for who they are, not how they look or if they win. Visit your provider to talk about further evaluation and treatment.


More from Dr. Block and Kaiser Permanente in Seattle’s Child:

What is my kid’s poop telling me?

Pediatrician’s tips for dealing with picky eaters

Do toddlers need “toddler milk”? Here’s what a doctor says

Tips for talking to kids about tough topics

About the Author

Susanna Block

Dr. Susanna Block, MD, MPH, is a pediatrician with Kaiser Permanente in Seattle and lives with her family in Queen Anne.