Preventing eating disorders among young athletes

Introduction 

Adolescence is a pivotal stage marked by increased vulnerability to the development of body image concerns, disordered eating, and eating disorders. For adolescents involved in sport, where they may face pressure to conform to a certain body type to progress and achieve success, the risk may be even more pronounced. 

Consider some of the ideas that can be strongly endorsed in sport culture: 

• athletes should have lean, toned bodies 
• weight loss will improve performance 
• “real” athletes push through pain and injury 
• success requires sacrifices, even if it means enduring physical and emotional suffering 

These ideas, layered on top of the pervasive societal messaging that upholds certain body ideals and ways of eating as the standards to strive for, can stir up body- and eating-related worries in a young athlete that compels them to engage in detrimental behaviours as means to managing those worries. These may include: 

• restricting their food intake,  
• eliminating food groups from their diet,  
• misusing dietary supplements or ergogenic aids,  
• adopting a strict and rigid eating and workout schedule,  
• exercising to compensate for eating, or training while ill or injured 

A young athlete engaging in disordered eating, which can involve negative thoughts, feelings, and behaviours related to food and body weight and shape, is at high risk of developing an eating disorder such as anorexia nervosa, bulimia nervosa, or binge eating disorder. 

While research varies on the prevalence of disordered eating and eating disorders among athletes due to differences in the measurement tools used and the populations studied, it is unclear how common disordered eating and eating disorders are among athletes, particularly among adolescent athletes (Marrows et al., 2023). One study with a large mixed-gender and mixed-sport sample, however, suggests that 33% of elite adolescent athletes exhibit eating disorder pathology (Giel et al., 2016). Various studies also suggest that individuals who participate in sports with an aesthetic component or weight categories are especially likely to engage in eating disorder behaviours (Giel et al., 2016; Walter et al., 2022). 

Preventing eating disorders among young athletes 

Toxic messaging in sport can undermine the physical, mental, and social health benefits of participating for many adolescent athletes. However, instilling the following concepts in young athletes helps them establish solid relationships with food, body, and sport that provide protection against negative messaging to which they may be exposed.     

• Respecting body diversity 
  Bodies naturally come in a wide array of shapes and sizes, and among this range are varying physical abilities. Moreover, all bodies do not have to look or function the same. Just as in other species, body diversity is inherent among humans. Ideally, all humans could feel free to be just as they are, to not have to look a certain way to be respected. Any individual, regardless of what their body looks like or is able to do, could then have the opportunity to live without being burdened by unfair expectations and judgements about their body. 
• Eating for energy and enjoyment
  Adolescents, particularly those involved in sport, have high energy needs. Young athletes who have a positive approach to food eat in attunement with their internal cues, allowing themselves to eat according to their hunger and fullness levels, energy needs, and appetite. Fueling themselves with adequate amounts of food that nourishes them physically and that they enjoy supports them to train and perform to their potential and avoid injury.  
• Their holistic self: Recognizing who they are beyond sport 
  Athletes are more than their sport. They may also be a sibling, a friend, a student, and an employee. It is important for young athletes to be aware of the degree to which they identify as an athlete; to be able to recognize whether “being an athlete” is over-represented among their values, beliefs, and self-perception; and to have self-esteem that is derived from aspects of their lives beyond sport and their performance. 

Athletes who have low self-esteem or whose self-worth is based on their accomplishments in sport are vulnerable to experiencing poor mental health, which may include anxiety, depression, negative body image, and disordered eating. 

In addition to self-esteem, it is important for athletes to be able to exercise self-compassion. In contrast to self-esteem, which is centred around the positive aspects of oneself, the focus of self-compassion is acknowledging one’s flaws and failures with kindness and without judgement. Research findings from Doorley and colleagues (2022) suggest that athletes who are able to engage in self-compassion are less likely to experience a decline in performance following a setback than those who are not. Self-compassion might ultimately contribute to improvements in performance. 

• Their authentic self: Living by their values and advocating for themself 
  Athletes face pressures from coaches, family, peers and social media to look, act train, and perform a certain way, to attain a certain result. These pressures may compel a person to disregard their own needs and values, and engage in actions that do not align with what is truly most important for their well-being. Learning to prioritize their needs and advocate for themselves helps them resist harmful pressures and maintain a healthful, values-based approach to sport and life.     

The role of coaches, parents, and caregivers in preventing eating disorders 

Coaches, parents, and caregivers have vital roles in preventing the development of disordered eating and eating disorders in young athletes. By demonstrating to the young athletes in their lives that they respect bodies of all types, attend to their self-care needs, and have a holistic perspective of the value of sport participation and performance, they serve as positive role models. Actions that cultivate sport environments that promote the well-being of young athletes include:   

• implementing person-oriented over performance-oriented coaching practices 
• focusing on the development of their strength and skills and the enhancement of not only their physical health, but also their mental health 
• refraining from engaging in commentary about body weight, shape, or composition (theirs and yours) 
• enforcing a policy of zero tolerance for appearance-based teasing or bullying  
• seeking education about disordered eating and eating disorders, and learning how to identify early warning signs 
• providing athletes with educational resources that can help them develop knowledge and skills to successfully navigate challenging body image- and food-related issues in the sport setting, such as BodySense 

BodySense  

BodySense is an interactive e-learning course developed by the Canadian Centre for Ethics in Sport (CCES), with contributions from a multidisciplinary advisory group, which included the National Eating Disorder Information Centre (NEDIC).  

While the primary audience is adolescents of all genders in the Train to Train and Train to Compete stages of the Long-Term Development in Sport and Physical Activity framework, young athletes at all levels of sport can benefit from taking BodySense, which is designed to: 

• enhance their awareness of the ways in which societal and media messages about food and bodies influence sport culture;  
• guide them in exploring their relationships with food, their body, and sport participation; 
• introduce a holistic approach to athlete well-being; and 
• foster greater respect and compassion among athletes for their body both within and outside of sport. 

The course consists of 7 modules: 

Interspersed throughout the modules are self-reflection and self-assessment activities, and various tools and links to other resources.  

Conclusion 

Young people can benefit greatly from participation in sport. Adolescent athletes, however, are a particularly at-risk population with respect to the development of disordered eating and eating disorders. By serving as positive role models, fostering safe and supportive sport environments, and providing them with thoughtfully developed educational resources such as BodySense, coaches, parents, and caregivers can help mitigate the risk.