Emerging concerns over disordered eating and mental health risks among elite youth athletes

Recent research highlights rising rates of eating disorders and mental health issues among young athletes, with sport culture and societal pressures amplifying risks for both girls and boys, prompting calls for increased awareness and professional support.

Problems with food can erode a young athlete’s performance long before there is an obvious physical crisis. A 2023 scoping review of elite athletes aged 12 to 18 found that, where clinical interviews were used, eating disorders appeared at higher rates than in the general youth population, and the review also linked disordered eating with anxiety and depression. That helps explain why specialists say these struggles do not merely affect body weight or recovery, but also concentration, confidence and a young person’s sense of self in sport. (pubmed.ncbi.nlm.nih.gov)

Adee Levinstein, the eating-disorders dietitian quoted by Youth Sports Psychology, said young athletes are trying to make sense of messages about food, training, appearance and performance “from all directions”. The US Anti-Doping Agency says the mental-health relationship with relative energy deficiency in sport, or RED-S, is “complex and bidirectional”: pressure over results and appearance can push athletes towards restrictive eating or compulsive exercise, while perfectionistic traits can make some young competitors especially vulnerable. USADA also warns that weight alone is not a reliable guide to whether an athlete is adequately fuelled. (youthsportspsychology.com)

The wider sporting culture can sharpen those pressures. Reporting in The Guardian, Megan Maurice described how former Australia cricketer Sarah Coyte developed anorexia nervosa after escalating concerns about food and training, while psychologist Sue Byrne of the University of Western Australia said elite athletes are a higher-risk group because they face greater pressure to fit a particular body shape and often have perfectionist tendencies. Coyte said “Skinfolds were always a big trigger for me”, and The Guardian reported that some skinfold testing and weight checks had become optional by the time she returned to cricket two years after her first retirement. (theguardian.com)

In judged sports, the scrutiny can start early and attach itself to almost every part of a child’s identity. Time reported this year that the American figure skater Amber Glenn grew up in a system where “everything about them” could be assessed, from body shape to costume to style, and where girls were steered towards the image of a “perfect ice princess without a single flaw”. Glenn told the magazine that the sacrifice required from her family made success feel non-negotiable, and Time said she developed an eating disorder as her anxiety worsened. “I was miserable,” she said. (time.com)

These risks are not confined to girls. The Washington Post reported that clinicians believe boys are frequently underdiagnosed, even as body-image pressure pushes them to be “stronger, leaner, taller”. Stuart Murray, who directs the eating disorders programme at the Keck School of Medicine of the University of Southern California, said the more common presentation in boys is “muscularity-oriented”: trying to stay very lean while also gaining muscle. That can look deceptively like ordinary dedication, the Post noted, especially when it shows up as extra gym sessions, rigid high-protein eating and constant dissatisfaction with appearance. (washingtonpost.com)

Part of what makes the problem hard to spot is that athletes are often praised for behaviours that would worry adults in another setting. The National Eating Disorders Association says body awareness is essential in sport, because athletes rely on close attention to energy, movement and recovery. But the organisation says that same heightened attunement can turn into relentless self-surveillance when an eating disorder is present, fuelling distress and destructive behaviour that eventually harms health, enjoyment and performance. (nationaleatingdisorders.org)

That is why experts urge parents and coaches to look past simple ideas about discipline or clean eating. USADA says some low energy availability is unintentional and may be improved with better sports-nutrition education, but deliberate restriction or excessive training often calls for a registered dietitian and a mental-health professional. The Washington Post’s reporting suggests another reason for caution: obsessive exercise, rigid food rules and body dissatisfaction can be missed precisely because they resemble accepted fitness habits in competitive sport. (usada.org)

The research base is still incomplete. The review indexed by PubMed found that the field has focused heavily on girls, European samples and cross-sectional studies, even though the evidence already suggests elite youth athletes are a population at risk. Taken together with accounts from Coyte, Glenn and the boys highlighted by The Washington Post, the message is that eating problems in sport should not be treated as a private lapse in willpower. They are often shaped by systems that reward thinness, control and silence, even while claiming to pursue health. (pubmed.ncbi.nlm.nih.gov)