For many children and teens, sports are a core part of their lives. According to the Aspen Institute’s Project Play initiative, 55.4% of kids between the ages of 6 and 17 play organized sports. Team sports are linked to higher self-esteem and lower rates of depression and anxiety, but an overemphasis on athletic performance can lead to anorexia athletica.
What Is Anorexia Athletica?
“Though not an official diagnosis, anorexia athletica is a term used to describe athletes who become preoccupied with weight control or body composition to better perform as an athlete,” said Alli Spotts-De Lazzer, a psychotherapist and eating disorders specialist. Dr. Jessica Lin, a pediatrician at Cincinnati Children’s, explained that the focus on weight control for athletic performance distinguishes anorexia athletica from anorexia nervosa, though symptoms overlap. “With anorexia nervosa, the focus is on body image and thinness, while with anorexia athletica, it is more about athletic performance,” Lin said.
Prevalence Among Young Athletes
Data on anorexia athletica is sparse because it is not a diagnosable condition. However, existing evidence shows elevated risk among youth athletes. A meta-analysis of 21 studies found that elite youth athletes were more likely to engage in disordered eating than non-athletes. A 2023 study reported that 77% of youth athletes surveyed were at risk of developing an eating disorder, with 22% at high risk. Student athletes aged 14–16 faced the highest risk, affecting both boys and girls almost equally.
Why Are Young Athletes at Risk?
“Young athletes are up to three times more likely to struggle with an eating disorder than kids who don’t play sports,” said Barbara Kessel, a child and adolescent psychiatrist at Equip. She described a “perfect storm” of personal drive and intense sports culture. Athletes’ perfectionism can slide into obsessively tracking calories, macros, and weight. Health tracking wearables like Apple Watches and Fitbits, available for about a decade, fuel this obsession. Social media also contributes, as feeds fill with fitness tips often geared toward adults and potentially unsafe for youth. “The tricky part is that coaches and teammates usually praise dedication, missing the fact that it’s turning into an obsession,” Kessel added.
Signs of Anorexia Athletica
Dr. Lorna Richards, a psychiatrist at Central Health London, listed warning signs: restrictive eating, increased exercise, frequent weighing, weight loss or dropping on growth charts, low energy, recurrent injuries, loss of periods, mood changes, irritability, and anxiety. Lin and Spotts-De Lazzer emphasized that children may not realize their behavior is problematic. “Don’t expect them to tell you,” Spotts-De Lazzer said. Red flags include rigid thinking about training and food, such as avoiding team pizza parties.
How Parents Can Help
Parents should broach the topic carefully. Lin recommends starting conversations in relaxed settings like the car, avoiding mealtimes. Kessel suggests opening with observations: “I’ve noticed that you aren’t recovering from practice as you used to.” Guide the child toward a professional evaluation. Educate kids that food fuels activity, and encourage all food groups in moderation. If caught early, treatment involves a registered dietitian and therapist. For progressed cases with physical symptoms, a pediatrician should be involved. “If their heart rate is dangerously low, they have to pause sports until medically cleared,” Kessel said. Richards stressed planning a safe return to sports with coaches.
Encouraging Healthy Sports Participation
To keep sports healthy, ensure the activity remains fun. If it causes negative feelings, a break may be needed. Spotts-De Lazzer advises praising children for qualities unrelated to athletic performance to prevent self-worth from being tied to sports. Focus on effort, teamwork, and enjoyment. Teach that food is fuel for strength and recovery, not a reward to earn or burn off. Remind children that social media health advice is often for adults and may not meet their nutrient needs. A dietitian specializing in adolescent health can provide tailored guidance.
