What parents should know about eating disorders in teen athletes

Teen athletes are facing more pressure than ever, with increased pressure to land college scholarships and specialize in one sport earlier. With higher stakes, it is no surprise that teen athletes may start looking for any way to enhance their performance, including trying to change their body through diet or increased exercise. But the line between just trying to improve one’s performance and disordered behaviors can become blurry quickly. This article discusses signs

and symptoms of disordered eating and eating disorders in teen athletes, athlete-specific risk factors, and next steps to consider if you are worried your child may be struggling.

Eating Disorders vs. Disordered Eating in Athletes

Eating behaviors exist on a spectrum, with clinical eating disorders on one end (anorexia, bulimia, binge eating disorder, etc.) and disordered eating on the other. Disordered eating behaviors may not meet the full criteria for an eating disorder, but can still pose risks to a child’s physical, mental, and social well-being. These include behaviors such as weighing oneself constantly, restricting certain food groups, or over-exercising. Disordered eating behaviors significantly increase the risk of developing a clinical eating disorder in the future. 1 The risk for disordered eating is higher in athletes than non-athletes, with up to 19% of male athletes and 45% of female athletes struggling with disordered eating or an eating disorder. 2 There is no single “cause” of an eating disorder, but rather a combination of factors that can interact with each other to increase risk.

Athlete Specific Risk Factors

Emphasis on Appearance: Many sports put an emphasis on maintaining a certain appearance or body type, such as long-distance running, cheerleading, figure skating, and gymnastics. Additionally, sports such as wrestling with weight classes can lead athletes to use unhealthy tactics to manipulate their weight. Athletes participating in sports that emphasize appearance

have a higher risk of developing disordered eating habits. 2

Team Culture: Coaches or teammates may worsen this emphasis on appearance through

directing athletes to avoid certain foods, comparing athletes’ bodies to one another, or encouraging one another to lose weight. Research shows that pressure from peers, coaches, and family to meet the ideal body type of one’s sport increases the risk of disordered eating in teen athletes. 1 Additionally, emphasis on winning and success above all else may lead athletes to feel

pressured to meet their coaches’ expectations, no matter the cost.

High Achievers: High-performing athletes already tend to be competitive, perfectionistic, and goal-oriented. While this may lead to success on the field, when applied to eating behaviors or weight-loss goals, it can contribute to an increased risk of obsessive or rigid rules around food and exercise, and an even more heightened drive for weight-loss if athletes believe it can help them gain a competitive advantage. 3

Signs and Symptoms

What starts as a well-intentioned desire to gain a competitive edge can, for some young athletes, become the start of a more disordered relationship to food and exercise. Here are some psychological, behavioral, and physical signs that indicate further intervention may be needed.

Psychological:

 Increased anxiety, irritability, or low mood

 Often thinking about food or body throughout the day

 Difficulty concentrating

 Labeling foods as “good” or “bad” and experiencing anxiety when eating a “bad” food

Behavioral:

 Skipping meals or social events where food is present

 Going to the bathroom immediately after meals

 Suddenly cutting out food groups or drastic dietary changes

 Spending more time training or getting in extra workouts between practices

 Skipping rest days or refusing to take a day off from exercise

Physical:

 Weight fluctuations (Note: Despite what the media portrays, only about 6% of individuals with an eating disorder are underweight. Weight alone does not indicate the severity of disordered eating. A teen can be at a “normal” weight and still be experiencing all the medical and psychological consequences of an eating disorder) 5

 Decreased performance in sport, including decreased endurance, muscle strength, and coordination and increased fatigue

 Frequent illnesses or infections

 For female athletes, loss of menstrual cycle

I’m noticing these signs and symptoms in my child… Now what? 4

Here are some strategies for approaching the conversation, as well as information on next steps.

 Approach the conversation calmly and without judgment. Your child may be more prone to shutting down if they sense you are coming at them with anger or judgment. Take a few deep breaths and keep your body language and tone relaxed when beginning this conversation.

 Begin with observations about their mood or behaviors that you have noticed and invite a discussion. Ex: “I’ve noticed you haven’t been joining us for family meals and have seemed even more tired after practices. Is there anything you want to talk about?” Do not accuse them or attempt to label what you have seen. You can also normalize tough feelings about body image and food. For example, “I know a lot of people your age start worry about how they look. I just wanted to check in- how has your body image been lately?” It may take several invitations and attempts to get your teen to open up. Don’t get discouraged if they shut you down the first few times.

 Your teen shared that they have been struggling. Now what? The best care for eating disorders and disordered eating involves multiple types of providers. Getting in with their pediatrician can be a good start to ensure there are no acute medical complications (eating disorders can present with changes in heart rate, blood pressure, and lab abnormalities that sometimes require more immediate intervention). They can continue to provide medical monitoring as needed. From there, other team members that are typically involved include:

o A therapist to work through underlying beliefs about food and body image, build healthy coping skills, and process the difficult emotions that can come up throughout the recovery process.

o A dietitian to create a meal plan and provide nutritional guidance to your teen. Bonus if they are experienced in working with both athletes and eating disorders, as athletes have additional nutritional needs to support their activity.

o A psychiatric provider to consider if medication may help ease anxiety

throughout the recovery process, as well as to treat underlying anxiety or mood concerns that may be present.

Throughout this process, it’s important to remind your teen that their health always comes before their performance in sport, and often the healthiest version of them is going to be the most successful. True athletic success is built on fuel, proper recovery, and mental well-being, and pursuing recovery now will allow them to continue to compete in their sport in a sustainable

way.

References

1. Franzoni, A., Antonietti, J.-P., Munsch, S., & Messerli-Bürgy, N. (2026). Psychosocial correlates of disordered eating among adolescent athletes: A cross-sectional study. Journal of Eating Disorders, 14(1). https://doi.org/10.1186/s40337-025-01500-x 

2. Walter, N., Heinen, T., & Elbe, A.-M. (2022). Factors associated with disordered eating and eating disorder symptoms in adolescent elite athletes. Sports Psychiatry, 1(2), 47–56. https://doi.org/10.1024/2674-0052/a000012 

3. Rosinska, M., Soós, D., Gálvez Solé, L., Ibáñez-Caparrós, A., Thiel, A., Zipfel, S., Giel, K. E., Granero, R., Sánchez, I., Pászthy, B., Jiménez-Murcia, S., & Fernández-Aranda, F. (2025). Athletes with eating disorders: Clinical-psychopathological features and gender differences. Journal of Eating Disorders, 13(1). https://doi.org/10.1186/s40337-025-01221-1 

4. Monte Nido. (2025, August 19). Tips for Parents When Talking to Children About Eating Disorders. How to Talk to Your Teen About Their Eating Disorder | Monte Nido. https://www.montenido.com/blog/tips-for-parents-when-talking-to-children-about-eating-disorders 

5. Flament, M. F., Henderson, K., Buchholz, A., Obeid, N., Nguyen, H. N. T., Birmingham, M., & Goldfield, G. (2015). Weight status and DSM-5 diagnoses of eating disorders in adolescents from the community. Journal of the American Academy of Child & Adolescent Psychiatry, 54(5). https://doi.org/10.1016/j.jaac.2015.01.020