Chapter 12: Preventing and Treating Eating Disorders and Disordered Eating Among Athletes

Athletic participation has many benefits, including improved physical and psychological health among athletes compared to non-athlete peers (Weight et al., 2016), and positive impact on adolescent academic outcomes (Videon, 2002). However, research also suggests that participation in competitive sports can increase the likelihood of developing eating disorders (EDs) and disordered eating behaviors (DEBs; Bratland-Sanda & Sundgot-Borgen, 2013; Chatterton & Petrie, 2013; Greenleaf et al., 2009). By definition, EDs are serious mental illnesses that are characterized by unhealthy eating patterns and weight control behaviors (American Psychiatric Association, 2013), and are associated with psychiatric and medical morbidity (Gibson et al., 2019; Swanson et al., 2011) and elevated mortality (van Eeden et al., 2021). In contrast, DEBs are a collection of abnormal eating patterns that are quite common (Neumark-Sztainer et al., 2006) and although they may pose a threat to physical health, they do not meet the clinical diagnosis of an ED (Thompson & Sherman, 2014). Unique features of both the athlete mindset (e.g., Arthur-Cameselle & Baltzell, 2012; Gorrell & Anderson, 2018) and the sporting environment (e.g., Davis et al., 2018; Scott et al., 2022) can place athletes at greater risk for both EDs and DEBs, and their associated negative physical and psychological consequences (Gibson et al., 2019; Mountjoy et al., 2014). In particular, eating pathology among athletes can lead to a range of serious metabolic and physiologic consequences, including relative energy deficiency in sport (REDS), a condition that results from insufficient caloric intake and energy over-expenditure (Carson et al., 2022; Holtzman et al., 2019; Mountjoy et al., 2014; Torstveit et al., 2019). Given these considerable psychological and physical health risks, continued efforts to better understand and treat EDs and DEBs among athletes within competitive sports is of great importance.