There’s a particular kind of eating disorder that hides in plain sight, and it hides best in sport and perfectionism.
Because in sport, the early behaviours don’t look like illness. They look like commitment. The athlete who’s tracking everything, who’s first to arrive and last to leave, who turns down the cake because there’s a meet on Saturday, that athlete gets praised. Coaches hold them up as an example. Teammates are told to be more like them. Parents feel a complicated mix of worry and pride and often can’t work out which one they’re allowed to say out loud.
By the time anyone uses the words “eating disorder,” a young person may have spent months or years being reinforced for the exact patterns that are hurting them. It’s one of the reasons athletes so often reach treatment later in the course of an illness than anyone would want.
Sport doesn’t cause eating disorders. It camouflages them.
The distinction matters, because parents often arrive carrying a suspicion that if they’d only pulled their kid out of the sport sooner, none of this would have happened.
That’s not how it works. Eating disorders are complex and arise from a tangle of genetic, psychological and environmental threads. Sport is not the villain. For many young people sport is the best thing in their life, the community, the structure, the identity, the one place they feel competent and receive the reassurance they need to keep that inner critic voice at bay.
But sport does two things that make disordered eating harder to catch.
The first is that it normalises restriction and monitoring. In an environment where everyone is already discussing fuelling, recovery, weight classes, body composition and what they did or didn’t eat before training, a young person’s disordered relationship with food doesn’t stand out. It blends in.
The second is that it supplies a socially sanctioned explanation. Restriction in sport almost always has a reason available that sounds like training rather than illness, which gives everyone around the athlete a reason not to ask the next question. Even doctors and medical professionals can confuse medical fragility and serious risk caused from malnourishment with athlete vitals.
What tends to get noticed first… and it usually isn’t food
Parents often expect the first sign to appear at the dinner table. In athletes, it more often shows up on the field first.
🤍 Performance going backwards despite training harder. Doing more and getting less. This is often what finally gets a coach’s attention, because it’s the thing sport measures.
🤍 Injuries that keep coming, or that don’t heal. A body without enough energy to run its basic systems starts taking that energy from somewhere, and tissue repair is an early casualty.
🤍 Concentration, coordination and decision-making slipping. Missed cues. Slower reads. A player who used to see the whole field and now doesn’t.
🤍 Mood changes that are getting worse rather than better. Irritability, flatness, pulling away from teammates. Often written off as the stress of a competitive season.
🤍 Rigidity that has stopped being useful. Not the good structure of a training plan, but a rule set that has grown teeth, where breaking a rule causes real distress, and where the rules keep multiplying.
A related picture worth knowing about is Relative Energy Deficiency in Sport (RED-S), a sports-medicine syndrome describing what happens when an athlete’s available energy doesn’t cover both training and the basic business of being a body. It affects hormonal, cardiovascular, immune and psychological systems. RED-S and eating disorders overlap but are not the same thing: either can occur without the other, and a sports-medicine clinician may assess for it alongside, not instead of, a mental health assessment.
We want to be careful with a list like this, because it can send a worried parent hunting for evidence, and that isn’t the goal. Not every injured or frustrated athlete has an eating disorder. What we’d say is this: if you read that list and felt something drop in your stomach, that reaction is information. It’s worth a conversation with someone who knows both of these worlds.
Why “just eat more” doesn’t land
Most parents try it, often for a long time before they call anyone.
It doesn’t work, and the reason isn’t that the athlete is being stubborn or that the parent said it wrong. An eating disorder isn’t a decision that can be reversed with better reasoning, and it isn’t a diet that got out of hand. It’s a way of managing feelings that has become load-bearing, and the more anxious or overwhelmed a young person is, the more tightly they tend to hold on.
There’s also a difficult loop underneath it. An undernourished brain tends to be a more rigid, more anxious, more black-and-white brain. So the very thing that would help a young person think flexibly about food is the thing the illness is preventing. It is very hard to reason someone out of this while the fuel that makes reasoning possible is missing.
This is also why willpower framing does damage. When a young athlete is told they just need to be stronger about this, they hear one more performance to fail at. And these are young people who are extremely good at pushing through, that’s part of what made them good at their sport. Pushing through is the problem here, not the solution.
Parents are not the problem. In this work, they’re central to it.
There’s an old idea, still circulating, that eating disorders are caused by families and that treatment means getting the young person away from their parents. It caused enormous harm and it does not reflect where the evidence has landed or what we know to be true at Healing Recovery Centre.
Family Based Therapy (FBT) has the strongest evidence base of any outpatient approach for adolescent anorexia nervosa. Emotion Focused Family Therapy (EFFT) is a caregiver-focused approach, increasingly used alongside it, that works on parents’ confidence and their capacity to support their child through emotional distress. Both put parents at the centre rather than out of the room.
For many parents this is the first relief in a long time: not being managed, not being investigated, not being sent to the waiting area. Being given something to do, and being supported to do it.
It isn’t easy work. Sitting with your child through a hard meal, holding a boundary while they’re distressed with you, staying steady when they say the thing designed to make you back off — that asks a great deal of a parent. But it asks for something you already have, rather than something you’d have to become.