Eating Disorders in Female and Male Student Athletes: Warning Signs Parents and Coaches Shouldn’t Ignore

Research shows that up to 45% of female athletes and up to 19% of male athletes struggle with an eating disorder or disordered eating — significantly higher rates than in the general population, according to the National Eating Disorders Association. Yet most of these athletes never ask for help.

Why? Athletes are taught to “be tough.” They power through injuries, push through fatigue, and keep competing. Asking for help can feel like weakness. And when the struggle involves food, the barriers grow even higher: fear of being pulled from competition, fear of gaining weight, fear of losing their “look,” and the shame of the label eating disorder.

In my work as a sports dietitian, I sit with athletes and their families to unpack exactly these fears. What I hear most often is some version of, “I’ll get help after the season ends.” The problem is that athletes usually don’t know what they don’t know — and the consequences of letting an eating disorder run its course through “just one more season” can be severe and lasting.

Eating Disorders Are Serious — and Treatable

Eating disorders are among the deadliest of all mental health conditions. Anorexia nervosa has the highest case mortality rate of any mental illness, and eating disorders as a group are directly responsible for more than 10,000 deaths in the U.S. each year — roughly one every 52 minutes, according to the National Association of Anorexia Nervosa and Associated Disorders.

The most common eating disorders include anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive food intake disorder (ARFID). Their symptoms are distinct but often overlap — and importantly, eating disorders are about far more than food. You can learn more about each diagnosis from the National Institute of Mental Health.

The good news that often gets lost in the statistics: with early intervention and proper support, athletes recover — and many return to their sport stronger than before.

Why Female Athletes Are Most at Risk: Understanding RED-S

Female athletes who train hard without fueling adequately can develop relative energy deficiency in sport (RED-S). RED-S occurs when an athlete doesn’t consume enough energy to support both training demands and normal body function. It can happen unintentionally — but it’s also a common companion to disordered eating.

RED-S can result in:

• Declining performance and increased injury risk from chronic low energy
• Compromised immune function, leading to more frequent illness
• Low estrogen levels, which can disrupt or stop menstrual periods and damage long-term reproductive, bone, brain, and heart health
• Decreased bone mineral density, raising the risk of stress fractures and broken bones
• Gastrointestinal problems such as bloating and constipation
• Greater risk of depression and anxiety

A missing or irregular period is never just “part of being an athlete.” It’s one of the clearest warning signs that the body is under-fueled, and it deserves attention from a physician and a sports dietitian.

Signs of an Eating Disorder in an Athlete

Parents and coaches are often the first to notice something is off. Watch for:

• Weight loss, particularly in teens, whose bodies should still be growing
• Anxiety and perfectionism, including social anxiety or intense worry about being judged or evaluated
• Mood changes, such as increased irritability or a loss of joy in a sport they used to love
• Changes in food habits: cutting out favorite foods or entire food groups, or avoiding meals with family, friends, and teammates
• Training beyond scheduled workouts, even when coaches have built in rest and recovery days

No single sign confirms an eating disorder — but a pattern of these changes is a reason to start a conversation, not to wait and see.

Male Athletes Struggle Too

Eating disorders are often framed as a “female problem,” and that stereotype is costing male athletes their health. In my own practice, I’ve worked with male cross country runners who struggled with under-fueling and disordered eating — and who waited far too long to seek help precisely because they didn’t think this could happen to them.

The research backs up what I’ve seen firsthand. In one study of NCAA Division I distance runners, roughly 14% of male runners screened positive for eating disorder risk, and among collegiate track and cross country men, nearly 20% reported dissatisfaction with their eating patterns. At the elite level, a study of European Cross-Country Championship competitors found that over half of male runners were at risk of low energy availability — the same energy deficit that drives RED-S.

RED-S affects male athletes differently but no less seriously: instead of disrupted menstrual cycles, under-fueled male athletes may experience low testosterone, declining bone density, stress fractures, low mood, and stalled performance. Because males are less likely to be screened and less likely to be diagnosed, their struggles often go unnoticed until an injury forces the issue.

If you’re a male athlete — or the parent or coach of one — the warning signs above apply to you, too.

How to Help an Athlete With Disordered Eating

If you suspect an athlete may be struggling with an eating disorder or disordered eating, the most important thing to understand is this: it is not something a person can simply “get over.” Losing your cycle as a competitive female athlete is not normal! Learn more here how to regain your cycle.

Eating disorders are not a choice, a phase, or a sign of vanity.They often develop as a response to:

• Trauma or unresolved stress
• A desire for control in an overwhelming environment
• Anxiety, perfectionism, or other mental health challenges

Eating disorders are complex conditions involving neurological, genetic, and personality factors that researchers are still working to fully understand. For this reason, athletes need compassion, patience, and support — not criticism, pressure, or judgment.

Take the Focus Off Weight and Body Shape

I encourage ALL parents, coaches, and teammates to take the focus off of weight and body shape. Create an environment where athletes can love the skin they’re in, without shame or fear. Athletes’ bodies are amazing — especially female athletes’ bodies, which can run, jump, sprint, change direction on a dime, birth babies, and demonstrate incredible resilience. Celebrate what a body can do, not what it looks like.

Lead With Care, Not Performance

Encourage the athlete you care about to seek help by reminding them that their health comes first. Sport will always be there — but without health, participation and longevity are not possible.

Approach the conversation with empathy and reassurance. Focus on who they are as a person, not what they do as an athlete. For families and faith-based communities, it can be especially powerful to remind athletes that their identity is not rooted in sport or performance, but in Jesus Christ.

A supportive conversation may sound like:

“I’m worried about you — not because of how you’re performing, but because I care about you as a person. You don’t seem like your usual healthy, happy self, and I wanted to check in. That’s what people who care about you do. I want you to stay well enough to do the things you love, now and in the future.”

These conversations are not about forcing change. They are about opening the door to support and trust.

Professional Support Matters

My team and I work with male and female athletes who have struggled with food, body image, and fueling across a wide range of sports, including cross country and track, dance, gymnastics, wrestling, swimming, soccer, and lacrosse.

Through education, coaching, and consistent support, we help athletes rebuild a healthy relationship with food and their bodies. Healing is not a quick process — it often takes years, not months, and requires the right resources and a safe, supportive environment.

In some cases, athletes need a higher level of care. During our screening process, we may refer individuals to inpatient treatment or additional providers when more support is needed. Ethical care means recognizing when an athlete needs more than we can provide alone.

It is critical to work with a Registered Dietitian who understands sports, adolescence, and eating disorders — and who can support both the athlete and the parent, coach, or guardian walking alongside them. 

Fuel the Athlete, Not the Fear

One of the most powerful protective factors against disordered eating is education: athletes who understand why and how to fuel are less vulnerable to the myths that under-fueling improves performance.

That’s exactly why I created my Female Athlete Fueling Guide — a practical resource for athletes and parents that covers building a performance plate, fueling around training, and supporting long-term health. Download the Female Athlete Fueling Guide here.

(And parents of male athletes: the fueling principles inside apply to your runners, too.)

More Free Resources for Athletes and Parents

• Gentle nutrition tips
• Food freedom
• Picky eating tips
• Tips for fueling the female athlete
• Iron deficiency and how to correct it
• Tips for getting your period back
• Menstrual cycle nutrition
• Fueling the high school dance athlete and cheerleader

How Our 12 Week Student Athlete Fueling System Can Help

If you are a parent, coach, or athlete who feels overwhelmed, unsure where to start, or afraid of saying the wrong thing, our sports nutrition membership was created to support you.

Inside the membership, you’ll find:

• Athlete-centered education that removes fear and misinformation
• Practical guidance for meals, snacks, and fueling without extremes
• Supportive frameworks that prioritize health, performance, and long-term well-being
• A compassionate, informed approach rooted in both science and real-life application

You do not have to navigate this alone. Early education and support can make a lasting difference — not just in performance, but in an athlete’s health, confidence, and future. If you’re looking for guidance you can trust, we would be honored to support you and your athlete inside the Nutrition with Wendi Fueling System.

FAQ

How common are eating disorders in female athletes? Studies estimate that between 6% and 45% of female athletes experience an eating disorder or disordered eating, with the highest rates in “lean” sports like cross country, gymnastics, and swimming.

Can an athlete keep competing during eating disorder recovery? Sometimes, yes — it depends on medical status and the guidance of the treatment team. Early intervention makes continued participation far more likely.

Is a lost period normal for female athletes? No. A missing or irregular period is a red flag for RED-S and should be evaluated by a physician and sports dietitian.

If you’re an athlete or parent navigating these concerns, you don’t have to figure it out alone. Please reach out to schedule a consultation.