Coaches, Trainers and Fitness Instructors

Athletes and Eating Disorders

Athletes are at a higher risk of developing an eating disorder than non-athletes. Studies show that approximately 20% of female athletes have eating disorders (compared to 5% of non-athletes). Rates are higher in aesthetic sports (gymnastics, figure skating), weight classes (rowing), and sports where a low body mass is seen as an advantage (cross-country or cycling).

Athletes who severely manipulate their dietary intake or engage in purging are at risk of cardiac arrhythmia. The mortality rate for eating disorders is the highest of any mental illness. So it’s critical that coaches, instructors, and trainers be adequately trained to recognize the warning signs of eating disorders, understand the risks involved, use pre-screening tools and validated protocols to ensure the athlete is healthy enough to train, engage in conversations with their athletes when they have concerns, work cooperatively with treatment professionals and parents to support recovery and examine coaching language and materials to ensure the promotion of health and proper nutrition to support peak performance.

Where to Start

The HAES Files: An Open Letter to Fitness Professionals

  • Information about weight-based discrimination and internalized weight bias.
  • Includes both fictional and real-world accounts of people experiencing weight-based discrimination.

For Athletes and Coaches – Eating Disorders Center for Treatment and Research

  • Eating disorder signs and symptoms specific to an athletic setting.
  • Medical consequences of disordered eating in athletes.

NEDA Coach and Athletic Trainer Toolkit

  • The National Eating Disorder Association (NEDA) provides a downloadable toolkit for staff who work in gyms, school settings, outside athletic groups, dance studios, etc. who would like to know how to support athletes who may be affected by eating disorders.

What Gyms Can Do if They Think Someone Has an Eating Disorder? (USA) 

  • Contains more graphic imagery from a personal account of someone struggling with an eating disorder while also attending the gym.
  • Tips for trainers on how to spot and talk about disordered eating/eating disorders with their clients.
Some highlights from the article above:
  • Pre-participation Physical Examination (PPE): developed by several US sports organizations has questions aimed at disordered eating behaviours and also looks at the consequences of eating disorders, including stress fractures, mood disturbance, and substance abuse.

Mindful Movement and Recovery for Compulsive Over-Exercise

  • Information about compulsive over-exercising and the importance of mindful movement.

Mental Health Resources – Canadian Centre for Mental Health and Sport

  • A list of mental health resources and organizations
  • USports Guidelines
  • NCAA Guidelines

Canadian Sport Psychology Association

  • The Canadian Sport Psychology Association (CSPA) is an organization devoted to applied sport psychology. Has a list of consultants.

What is Orthorexia: Symptoms, Complications and Causes

  • An article by Eating Disorder Hope on Orthorexia

NEDA: Orthorexia

  • Warning signs and symptoms
  • Health consequences
  • Treatment

InsideOut: Fitness Australia Recommendations for Eating Disorders

  • Five recommendations for the identification and support of people with eating disorders in the fitness industry

Studies and Articles

  • Study of fitness instructors’ knowledge about eating disorders. Done in Alberta.

Hopeful, Hungry and Chasing a Lie. ​

  • Brutally honest article about long-distance runners and the risks they take by restricting in order to shave seconds off their time. Written by a professional runner.

Disordered eating behavior among group fitness instructors: a health-threatening secret?

  • Study from Norway on disordered eating among fitness instructors.

Psychology Today article: Lessons from a Marathon Runner in Recovery

  • An article by Gia Marson, Ed. D on eating disorders in athletes.

Defining compulsive exercise in eating disorders: acknowledging the exercise paradox and exercise obsessions

  • A scholarly article in the Journal of Eating Disorders defining compulsive exercise

Responses of fitness center employees to cases of suspected eating disorders or excessive exercise

  • A scholarly article in the Journal of Eating Disorders looking to determine whether gym employees report incidences of eating disorders and exercise issues

My fitness pal usage in men: Associations with eating disorder symptoms and psychosocial impairment

  • Some have raised concerns of calorie-counting apps potential to precipitate, intensify, or maintain eating disorder symptoms, this study looks at that

Objectifying fitness: a content and thematic analysis of #fitspiration images on social media

  • The study examines the nature of images and text contained within #fitspiration posts on social media

Digital pruning: agency and social media use as a personal political project among female weightlifters in recovery from eating disorders

  • This article traces the ways in which women who are in recovery from eating disorders and engaged in weightlifting strategically navigate their social media ‘worlds’

Protect me from my selfie: Examining the association between photo-based social media behaviors and self-reported eating disorders in adolescence

  • This study examined whether social media behaviours were associated with higher odds of meeting criteria for an eating disorder and whether gender moderated these relationships.

Perspectives of Canadian fitness professionals on exercise and possible anorexia nervosa

  • The purpose of the study was to examine Alberta fitness professionals’ experiences with clients suspected of having anorexia nervosa, and their views on related ethical issues

Instagram use is linked to increased symptoms of orthorexia nervosa

  • The study investigate links between social media use, in particularly Instagram and orthorexia nervosa symptoms

Exercising for weight and shape reasons vs. health control reasons: The impact on eating disturbance and psychological functioning

  • The aim of this study was to determine the prevalence and correlates of exercise motivated by health and weight/shape reasons

Weight Bias: A Primer for the Fitness Industry 

  • Looking to increase awareness among fitness professionals about weight bias and its consequences, and to outline strategies for increasing sensitivity and preventing bias with overweight and obese populations

Female athletes and eating problems: a meta-analysis

  • The relationship between athletic participation and eating problems is examined using meta-analysis

Absence of menstruation in female athletes: why they do not seek help

  • This study looks to gain more insight into the reasons why female athletes do not seek help when experiencing amenorrhea and how care for these women could be improved

Fitness Australia Guidelines: Identifying and Managing Members with Eating Disorders and/or Problems with Excessive Exercise

  • This policy has been designed to assist managers, personal trainers and instructors to work effectively with gym members who are at risk of developing (or who have developed) an eating disorder or exercise disorder, in order to sensitively and appropriately address issues of health and safety

In Obesity Research, Fatphobia Is Always the X Factor

  • An opinion piece on fatphobia in obesity research