Most Common Eating Disorders in Athletes
Key Takeaways
Eating disorders is the more common among athletes than non athletes.
Runners and endurance athletes face especially high risk . This is due to the “lighter is faster” culture and demanding energy needs of the sport.
Both female athletes and male athletes are affected. Although research has historically focused more on women, men face significant risk too.
Warning signs often hide in plain sight. Extra workouts, skipping meals, and obsessing over “clean eating” can all signal something deeper.
Early intervention, compassionate coaching, and professional support from an eating disorder therapist is key. Serendipity Counseling can help prevent long-term damage and guide athletes towards returning stronger.
Eating Disorders in Athletes Today
If you’ve ever hung around runners, you’ve probably heard casual comments about “race weight". Maybe you have watched someone skip the post-run bagels or noticed a teammate adding extra miles after a big meal. Most of the time, it flies under the radar. It's just part of the culture, right?
Here’s the thing. Those pressures around speed, leanness, and “fueling right” can quietly morph into eating disorders. Research shows athletes experience eating disorders at significantly higher rates than non athletes. Runners and other endurance athletes are near the top of the list. At Serendipity Counseling, performance and mental health aren’t opposing forces. They work together. This article will answer which eating disorder behaviors are most common in athletes, why runners are so vulnerable, and how to spot problems early.
Which Eating Disorder Is Most Common in Athletes?
Let’s cut to it. Behaviors like, binge eating are the most common in eating disorders among athletes,. Overall, disordered eating and RED-S are commonly present. But here’s what makes this tricky. Many athletes struggle with eating issues don’t fit neatly into one diagnostic box. They might show mixed symptoms, restriction during the week, binge eating on weekends, compulsive exercise as compensation. The lines blur.
Why Runners and Endurance Athletes Are at Such High Risk
Distance runners face a perfect storm of risk factors for eating disorders. The same goes for swimmers, cyclists, triathletes, and rowers.
That myth gets reinforced everywhere. High school coaches commenting on “leaning out,” college teammates comparing body shape at the starting line, and social media feeds full of lean elite athletes. Studies show three times as many female runners screen positive for eating disorder symptoms, compared to males. Although male athletes are catching up in reported cases. With the stigma again males and mental health, males are less likely to report concerns.
What Drives A Higher Risk In Athletes
High training volumes combined with school or work make inadvertent underfueling easy
Constant body comparisons at race starts, in photos, and online
Uniforms(singlets, shorts, sports bras)that make athletes feel constantly on display
Coach comments about body weight or “cutting seconds by dropping pounds”
Perfectionism and pain tolerance (traits that make great runners) also make it easier to ignore hunger and fatigue
Research consistently shows higher disordered eating rates in endurance sports, aesthetic sports like figure skating and gymnastics, and weight-class sports like wrestling. The very traits that drive athletic performance can become risk factors when turned toward food restriction.
Most Common Eating Disorder Patterns Seen in Athletes
What’s most common in sport isn’t always a neat DSM-5 label. Instead, we see overlapping behaviors. This can look like chronic restriction, binge eating, compensatory behaviors, and underfueling leading to serious health consequences. Each pattern often starts as “trying to be healthy” or “trying to get faster.”
Bulimia Nervosa
Bulimia involves episodes of eating large amounts of food with a sense of loss of control. This is followed by compensatory actions (vomiting, laxatives, fasting, or extra training).
Why does it thrive in sport? The “secret” nature fits with pressure to appear disciplined. Extra workouts are socially acceptable, even praised. Post-race overeating is common and can easily slide into binge-purge cycles.
Concrete examples from running: A runner binges after long-run days, then adds nighttime miles to “offset” it. Another athlete only allows “junk food” after races, feels out of control, and purges later. Body size isn’t a reliable indicator. Many athletes with bulimia are at what appears to be a “normal” body weight.
Anorexia Nervosa and Atypical Anorexia in Athletes
Anorexia nervosa involves intense fear of weight gain and severe restrictive eating. There is often significant weight loss with distorted body image. In athletes, we often see “atypical anorexia”, medically serious restriction without being underweight.
In runners, this might look like gradually cutting whole food groups in the name of “clean eating,” refusing team dinners, skipping recovery nutrition, or training fasted routinely. Short-term impacts hit hard: slower recovery, frequent illnesses, stagnating times despite more effort.
Binge Eating Disorder (BED)
Binge eating disorder involves repeated episodes of eating large amounts with loss of control, without regular purging. Underfueling during the day often sets runners up for nighttime or rest-day binges.
A collegiate runner eats very little during training days, then “loses control” on rest day. An off-season runner swings between rigid restriction and big binges after races. The shame about these episodes pushes athletes into secret eating and isolation.
RED-S and Disordered Eating: The “Invisible” Epidemic in Sport
Relative energy deficiency in sport (RED-S) means not eating enough to cover both training and life needs over weeks to months. It can be intentional (dieting) or completely unintentional (busy schedule, poor nutrition education). It’s incredibly common in high-volume runners, but is not considered an eating disorder.
Health impacts include chronic fatigue, stress fractures, menstrual dysfunction, low testosterone in men, poor sleep, brain fog, and mood swings. RED-S often overlaps with other eating disorders. Many athletes believe they’re “just working hard,” which delays intervention.
Who Is Most at Risk? (Not Just Elite Women)
Let’s bust a myth: eating disorders don’t only affect elite, very thin, female athletes. The reality is more complicated.
Female athletes struggle at high rates. Male athletes in running, wrestling, cycling, and lightweight rowing face significant pressure too. High school and college athletes hit transition points that spike vulnerability. This can look like a new coach, increased risk from higher competition, and moving away from home.
Athletes with perfectionistic personalities, anxiety, trauma history or prior dieting attempts face higher risk. LGBTQ+ athletes and athletes of color are often under-studied but emerging data suggests equal or greater vulnerability. Don’t assume safety based on gender, body appearance, or performance level.
Warning Signs: When “Healthy” Training Crosses the Line
In sport, red flags hide in plain sight. Intense training, discipline, and food focus are normalized. This makes eating disorder behaviors easy to miss.
Physical signs:
Recurring injuries, stress fractures, low bone mineral density, dizziness, menstrual loss, frequent illness
Emotional signs:
Anxiety around team meals, irritability, withdrawal, obsessive focus on macros, declining self esteem
Behavioral signs:
Skipping meals, cutting food groups, secret weighing, body checking, unplanned workouts to “burn off” food
Runner-specific cues:
Panic if a run is shortened or rest day added
Refusing to fuel during long runs despite obvious fatigue
Bragging about running on empty (“I crushed that workout on just coffee”)
Performance changes like sudden drops in times, plateaus despite more effort, and extreme fatigue are often the earliest visible clues for coaches and teammates.
How Eating Disorders Impact Performance and Long-Term Health
Here’s the paradox: many athletes believe eating less will make them faster. Over time, it almost always costs them both athletic performance and health.
Performance impacts:
Reduced speed, power, and endurance from low glycogen and muscle loss. Slower recovery and stalled progress. Poor concentration affecting race pacing and decision-making.
Long-term health consequences:
Bone health suffers and can lead to increased stress fractures, broken bones, early osteoporosis. Hormonal changes include amenorrhea, reproductive health issues, and low testosterone in men. Cardiovascular health and psychological health decline. Mental health risks escalate to depression, anxiety, and obsessive thinking.
Anorexia mortality rates are among the highest of any mental illness. “Toughing it out” isn’t an option when the stakes are this high.
Supporting Athletes: What Coaches, Teammates, and Parents Can Do
The goal is protecting both the athlete and their love of the sport. A compassionate, non-blaming approach makes all the difference in helping athletes.
For coaches:
Focus feedback on effort, tactics, and performance skills, not body weight or body shape
Avoid group weigh-ins or public comments about athletes’ bodies
Bring in sports medicine professionals, sports dietitians, and mental health providers for education
For teammates:
Check in privately if you notice behavior changes
Avoid bragging about extreme dieting, fasting, or “earning food” with miles
Normalize fueling before and after runs; make team meals relaxed
For parents and family members:
Watch for mood changes, food rituals, or overtraining
Keep conversations about food focused on energy, not weight loss or lower body weight
Seek professional support early. Don’t wait until things look “severe”
At Serendipity Counseling, we often collaborate with coaches, families, and medical providers. We work together to build a full treatment team around the whole person.
Getting Help: Treatment and Recovery for Athletes
Athletes can recover from eating disorders and still have a healthy relationship with sport. This includes often times coming back stronger and smarter about training. Eating disorder recovery is possible.
Common elements of treatment:
Medical evaluation to check vitals, bone health, and RED-S signs
Work with an eating disorder therapist experienced in working with athletes (CBT, DBT, RO-DBT, or Family-Based Treatment)
Nutrition support from a sports-savvy dietitian providing preventative support and rebuilding adequate fueling
Sometimes training is modified or paused for safety. Other times, careful supported participation continues alongside recovery work. Early intervention improves outcomes dramatically.
Taking The First Step
At Serendipity Counseling, we emphasize whole-person care, not just “fixing food". We address perfectionism, identity beyond sport, and building coping skills. Our approach as an eating disorder therapist is collaborative and non-shaming, respecting the athlete’s goals. To get started, here are the first steps!
Schedule a free consultation call to see if we are a good fit.
Set up your first session and start diving into how food is impacting your performance.
Start seeing how food freedom feels!
Serendipity offers in-person and virtual eating disorder therapy in NJ. If you are not from New Jersey, do not worry! We also offer virtual therapy in PA, MD, FL, AZ and VT.
If you’re unsure whether your habits are “just dedication” or something more, reach out. Future research continues to show that a “better safe than sorry” check-in with a professional prevents serious harm.
FAQ
These questions come up often at Serendipity Counseling and cover concerns not fully addressed above.
Can I still call myself an “athlete” if I take time off to recover?
Absolutely. Time away from organized sports for eating disorder recovery isn’t failure. It’s part of long-term athletic development. Many runners return after a break with better sports performance once they’re fully fueled. Think of recovery as a training block focused on your brain and body’s foundation. Most athletes who invest in recovery build self esteem and come back with personal bests.
How do I know if my “race weight” goal has gone too far?
Watch for constant anxiety about food or the scale, needing to lose “just a little more” repeatedly, or performance dropping despite lower weight. If body image concerns dominate your thinking during regular exercise, that’s a signal. Shift focus to performance markers, such as times, energy, enjoyment, instead of the scale. Seek professional guidance if weight goals feel obsessive or scary to release.
Are male athletes really at risk, or is this mostly a women’s issue?
Male athletes absolutely experience eating disorders, even if they’re less likely to discuss it due to stigma. High-risk groups include runners, wrestlers, lightweight rowers, cyclists, and bodybuilders. Cultural messages telling men to “tough it out” delay help-seeking. Men deserve the same care they’d seek for a physical injury.
Is it possible to prevent eating disorders in young runners?
Prevention isn’t perfect, but early dialogue lowers risk and speeds help-seeking. Start conversations about fueling for strength, not restricting food for thinness. Set team norms discouraging body talk. Educate parents and coaches on low energy availability in sport and warning signs. Providing preventative support in youth athletics makes a real difference.
How can I bring this up with my coach without sounding dramatic?
Try something simple: “Coach, I’ve been struggling with energy levels and want to talk about fueling. Can we chat?” You can also ask an athletic trainer, parent, or counselor to join the conversation if that feels safer. Advocating for your health shows maturity and commitment to the sport, not drama. Coaches who care about athletic competition want their athletes healthy and sustainable.
About the Author: A Specialist for Eating Disorders in Athletes
Kate Ringwood is a licensed professional counselor in the state of New Jersey. She also sees clients virtually in PA, MD, FL, VT and AZ, helping guide many athletes towards food freedom. Kate’s background getting her Master’s degree in Mental Health Counseling at John Hopkins University and her Bachelor’s in Culinary Nutrition from Johnson and Wales University, shows the wide professional support she can offer. From her love of nutrition and food, to her history in athletes since the age of 5, Kate is well-rounded in her knowledge of the presence of eating disorders in sports. Kate offers a gentle and genuine, yet straightforward approach to helping you finally feel free from the anxiety of food and performance.
