The Reality of Eating Disorders and Orthorexia in Athletes

Picture this: you’re at the top of your sport: focused, disciplined, and fueled by ambition. But beneath the highlight reels and medals, many athletes are secretly navigating pressures that extend far beyond competition. Eating disorders in athletes aren’t just about food; they’re about identity, performance, and the weight of expectation. What looks on the outside like calorie counts, meal restrictions, or obsessive routines is rarely about the food itself. It’s about the deep need for control in a world where so much feels uncontrollable, whether that’s an upcoming race, the judgment of coaches, or the constant comparison to teammates. It’s about tying worth to performance, believing that discipline equals value, and fearing that falling short in body or ability means falling short as a person.

How Common Is It, Really?

Research shows this isn’t rare or “just in your head.” A landmark review by Bratland-Sanda & Sundgot-Borgen (2013) found that up to 45% of female athletes and up to 19% of male athletes experience disordered eating symptoms, which are rates far higher than the general population.

Sports culture amplifies risk. A 2024 meta-analysis confirmed that aesthetic and weight-sensitive sports, like gymnastics, distance running, dance, and wrestling, carry the highest prevalence. Among NCAA Division I athletes, 38% were found to be at risk for an eating disorder, with even higher percentages at risk for low energy availability by not eating enough to support both daily life and training demands (PMC).

Pressures Only Athletes Know

The unique demands of sport culture create a perfect storm:

Performance over health. 

“Pushing through” fatigue or ignoring hunger is often praised as discipline.

Body ideals. 

Leanness, thinness, or muscularity may be directly tied to selection, scholarships, or playing time.

Control disguised as success. Restrictive eating, calorie counting, or compulsive training can feel like control…until they start controlling you.

Not Just a “Girl Thing”

While women are statistically more affected, men are often overlooked in this conversation.

Cycling and endurance sports have shown that as many as 17% of male athletes are at risk for disordered eating (Cycling Weekly).

Men may struggle differently: leaning into compulsive training or restrictive eating tied to performance, sometimes hidden under the pressure to “tough it out.”

Stigma makes men less likely to seek help, meaning the real numbers may be even higher.

The Invisible Toll

Eating disorders don’t always look like what you see in movies. Signs can be subtle:

• Constant fatigue or lack of recovery despite training less.

• Repeated stress fractures or injuries.

• Loss of menstrual cycles in women (amenorrhea affects up to 69% in some sports Wikipedia).

• Low mood, heightened anxiety, or obsessive focus on food and exercise.

The most conflicting part is that you don’t have to look underweight to be suffering significantly. Eating disorders can live in strong, high-performing bodies.

One Way This Presents? Orthorexia: When “Healthy” Goes Too Far

One lesser-known but increasingly recognized issue in athletes is orthorexia nervosa, also known as an unhealthy obsession with eating only foods considered “pure” or “clean.” Unlike anorexia or bulimia, orthorexia isn’t about thinness or weight loss alone, but control and perfectionism expressed through food choices.

At first, it can look like dedication: avoiding processed foods, sticking to strict “fueling” regimens, or eliminating entire food groups. But in athletes, this fixation can:

• Lead to social isolation (skipping meals with teammates for fear of “impure” foods).

• Result in nutritional deficiencies (cutting out essential carbs, fats, or proteins).

• Mask itself as discipline: coaches, peers, and even athletes themselves might see it as commitment rather than a red flag (Journal of Eating Disorders).

Orthorexia often starts with good intentions by wanting to perform at your best, but can spiral into rigidity that harms both physical performance and mental health. Recognizing that flexibility and balance are just as important as fueling is key to recovery.

The Way Forward

The encouraging news: healing is possible, and you don’t have to lose your identity as an athlete to find balance again.

• Early screening (tools like EDSA or LEAF-Q) can flag risks before they spiral.

• Holistic treatment (therapy, sports dietitians, medical monitoring, and supportive coaching) helps address both the mental and physical sides.

• Reframing success by learning that strength and longevity in sport come not from restriction, but from fueling body and mind.

Most importantly: you are more than your performance metrics.

Journal Prompts for Reflection

If you’re an athlete (or coach, or supporter), here are some prompts to help you pause and reflect:

• When I think about food, do I feel freedom, or fear?

• How do I define success in my sport? What would it mean to redefine it in a way that honors my well-being too?

• Are there moments I’ve pushed through fatigue or hunger when my body was begging me to stop? What would compassion look like in those moments?

• When I look in the mirror, what do I notice first: appearance, or strength? How might I shift that focus?

• What role models in my sport inspire me beyond their performance—because of their courage, vulnerability, or balance?

• If I were supporting a teammate struggling with these pressures, what words would I want them to hear? How can I turn those words inward?

• Do I ever avoid foods because they feel “bad” or “impure”? What might balance look like if I allowed for flexibility?

  
  

Eating disorders in athletes are a reflection of how deeply sport culture can entangle body, identity, and worth. Orthorexia shows us how even “healthy choices” can be taken to extremes, especially when performance is on the line.

Speaking up, reaching for support, and reframing the relationship with food and performance is not the end of being an athlete.

It’s the beginning of becoming one who thrives both on and off the field.

Resources & Support

National Eating Disorders Association (NEDA) 

Offers a confidential helpline, screening tools, and resources for individuals and families navigating eating disorders.Website: https://www.nationaleatingdisorders.orgHelpline: 1-800-931-2237

The Alliance for Eating Disorders Awareness (The Alliance) 

Provides education, referrals, and free weekly support groups (including virtual options) for those struggling with eating disorders, including athletes.Website: https://www.allianceforeatingdisorders.com