Supporting an Athlete Through an Eating Disorder: A Guide for Coaches, Parents, and Teams

Supporting an athlete who is experiencing an eating disorder is one of the most challenging and important things a coach, parent, or teammate can do. It requires knowledge, patience, appropriate boundaries, and a willingness to act, even when it feels uncomfortable. This blog aims to provide a practical and compassionate guide for those in a position to help.

Recognising an Eating Disorder in an Athlete

Eating disorders in athletes are often missed for longer than they should be, for a few reasons. First, athletic culture can normalise behaviours that, in other contexts, would raise immediate concern: strict control over food, concern about body weight, high levels of exercise, and intense focus on physical appearance.

Second, many athletes appear "high-functioning" i.e. performing well, attending training, maintaining social connections, even as their relationship with food is causing serious harm. Third, the stigma around eating disorders, and around vulnerability more broadly, means that athletes often work very hard to conceal what they are experiencing.

Signs that may indicate an eating disorder (or the beginning of one) include:

• Significant changes in eating habits, food rituals, or food avoidance

• Eating in secret, or avoiding meals and social eating situations

• Excessive or rigid focus on food quality, calories, or body weight

• Distorted or disproportionate distress about weight or body shape

• Declining energy, concentration, and training performance without clear physical explanation

• Repeated injuries, particularly bone stress injuries, that may indicate energy deficiency

• Disappearing to bathrooms after meals

• Noticeable changes in mood, including increased irritability, anxiety, or social withdrawal

• Loss of menstrual cycle in female athletes (amenorrhoea)

These signs do not always point to a clinical eating disorder but they always warrant a caring conversation.

How Coaches Can Help

Coaches occupy a position of enormous influence. Research shows that coach behaviours — particularly body-related comments and performance-linked weight expectations — significantly shape athletes' eating and body image attitudes (Greenleaf et al., 2009). This means coaches have both the capacity to contribute to the problem and a genuine opportunity to be part of the solution.

What to do if you are concerned:

• Approach the athlete privately, away from team settings. Choose a calm, unhurried moment.

• Lead with care, not confrontation: "I've noticed you seem tired lately — how are you going?" is a better entry point than "Are you eating enough?"

• Express concern about the athlete as a person, not just as a performer. Make clear that your interest is in their wellbeing, not their weight or their statistics.

• Listen more than you speak. Resist the urge to problem-solve immediately.

• Avoid making comments about body weight, food choices, or body composition, both with this athlete and with the team more broadly. Research is unambiguous that these comments increase eating disorder risk.

• Refer. Coaches are not therapists, and they should not try to be. Connect the athlete with appropriate professional support: a psychologist, a sports dietitian, a GP, or the club's welfare officer.

What not to do:

• Do not suggest the athlete "just eat more" or tell them they are "too thin" — these comments, however well-intentioned, rarely help and can cause harm.

• Do not make weight or body composition a selection criterion unless it is strictly medically necessary, and even then, involve a full clinical team.

• Do not share information about an athlete's eating disorder with the broader team without the athlete's explicit consent.

Coaches who cooperate with the treatment team, and who adjust training loads and expectations appropriately while an athlete is in recovery, make a significant difference to outcomes.

How Parents Can Help

For parents, discovering or suspecting that their child has an eating disorder is frightening and often accompanied by significant guilt. "Did I do something wrong? Could I have prevented this?" These responses are understandable but what matters most is what happens next.

Immediate priorities:

• Seek professional help as soon as possible. The earlier eating disorders are identified and treated, the better the prognosis. A GP is a good starting point; they can refer to a psychologist, psychiatrist, or eating disorder specialist.

• Avoid making food a battleground at home. Family meals should be as calm and normalised as possible. Power struggles over what or how much is being eaten almost always make things worse.

• Express love and concern consistently and separate these from performance, weight, or food. "I love you, and I'm worried about you" is always the right message.

• Involve the athlete in their own care where possible. Recovery is more sustainable when the person experiencing the eating disorder has some sense of agency in the process. I understand this is not always possible and it can get really difficult to enforce treatment.

Recovery from an eating disorder is rarely linear. There will be setbacks. Parents who can hold steady — staying connected, staying patient, continuing to seek support — provide a crucial stabilising presence. Family therapy is often a valuable component of eating disorder treatment, particularly for younger athletes.

The Role of a Multidisciplinary Team

Eating disorders are complex conditions that sit at the intersection of psychology, nutrition, medicine, and social context. Effective treatment almost always requires a multidisciplinary team, not because any single professional cannot do their job well, but because the different dimensions of the condition require different kinds of expertise working in a coordinated way (Bray et al., 2024).

A typical treatment team for an athlete with an eating disorder might include:

• A psychologist or psychiatrist to address the cognitive, emotional, and behavioural patterns underlying the eating disorder

• A sports dietitian to provide evidence-based nutritional guidance and support the restoration of adequate fuelling

• A GP or sports physician to monitor physical health, bone density, hormonal function, and any medical complications

• A coach or performance team representative who is informed and cooperative with the recovery process

Communication and trust between these professionals, and between the professionals and the athlete, is as important as any individual's skill. A fragmented care team is significantly less effective than a coordinated one.

What Recovery Looks Like

Recovery from an eating disorder is possible. This is worth saying clearly, because athletes, and those who love them, often arrive at this space with a deep sense of hopelessness. Research consistently shows that with appropriate treatment, most people recover meaningfully from eating disorders, including those that have been present for a long time (Fichter et al., 2017).

Recovery is not the same as perfection. It does not mean never having a difficult moment with food, or achieving some ideal body state. It means developing a relationship with food and body that is flexible, compassionate, and consistent with a full, meaningful life, including, often, continued participation in sport at whatever level the athlete chooses.

For athletes, recovery can include a return to training and competition, though this needs to be managed carefully, with clear guidance from the treatment team about what is safe and when. Sport can be a meaningful part of recovery for many athletes, offering structure, community, identity, and genuine enjoyment. But it needs to be sport on healthy terms, not the resumption of a relationship with performance that contributes to the eating disorder.

A Final Word

Eating disorders in athletes are serious, common, and treatable. The most important thing any coach, parent, or teammate can do is to pay attention, to care enough to act, and to connect athletes with the professional support they deserve.

You do not need to have all the answers. You need to be the person who helps them find someone who can contribute to the care together, as a team.

References

• Bray, B., et al. (2024). The imperative of collaboration: Lived experience perspectives on team approaches in outpatient eating disorder treatment. International Journal of Eating Disorders. https://doi.org/10.1002/eat.24084

• Fichter, M. M., Quadflieg, N., Crosby, R. D., & Koch, S. (2017). Long-term outcome of anorexia nervosa: Results from a large clinical longitudinal study. International Journal of Eating Disorders, 50(9), 1018–1030. https://doi.org/10.1002/eat.22736

• Greenleaf, C., Petrie, T. A., Carter, J., & Reel, J. J. (2009). Female collegiate athletes: Prevalence of eating disorders and disordered eating behaviours. Journal of American College Health, 57(5), 489–495.

• Mountjoy, M., Sundgot-Borgen, J., Burke, L., et al. (2023). 2023 IOC consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine, 57, 1073–1097. https://doi.org/10.1136/bjsports-2023-106994

• National Eating Disorders Association (NEDA) (2024). Supporting athletes in eating disorder recovery. https://www.nationaleatingdisorders.org/supporting-athletes-eating-disorder-recovery-through-change/

• Stice, E., Shaw, H., & Marti, C. N. (2007). A meta-analytic review of eating disorder prevention programs: Encouraging findings. Annual Review of Clinical Psychology, 3, 207–231. https://doi.org/10.1146/annurev.clinpsy.3.022806.091447

This blog was drafted with assistance from Claude, an AI assistant. All content has been reviewed, edited, and approved by the author.