What I’ve Learned About Eating Disorders in Sport — A View From All Sides

Within sport and fitness I’ve experienced eating disorders from multiple positions. I’ve been a coached athlete with an active eating disorder, from which I have subsequently fully recovered. I’ve been a coach & personal trainer with clients who’ve confided about having an eating disorder, and now I’m an eating disorder therapist supporting athletes and fitness professionals.

I also provide CPD on eating disorders to coaches and have gotten to know their worries and concerns alongside their desire to understand and know how to best support their athletes.

I’ve been reflecting recently on what I’ve learned from this multi-layered perspective that I couldn’t necessarily have seen from one role alone.

Here are my reflections:

Eating disorders in athletes often hide in plain sight.

In sport and fitness environments, behaviours that would raise concern elsewhere are frequently normalised or even praised. What looks like highly controlled eating can be framed as being “nutritionally disciplined” or “doing things properly”. Compulsive exercise can look like commitment. Ignoring injury, fatigue, or illness can look like mental toughness. For many athletes, the eating disorder doesn’t feel like a problem — it feels like the very thing that helps them succeed. This is one of the reasons eating disorders in sport can be so easily missed, and also so easily misunderstood.

Eating disorders feed on low self-esteem.

Not on a desire to be lean, successful, or high performing — although those may be the thoughts most often voiced — but on a deeper belief of not being good enough. Sport can temporarily soothe this by offering structure, identity, and a sense of worth. At the same time, it can also amplify self-criticism and conditional self-value. From the outside, this can look like motivation and drive. From the inside, it often feels like pressure, fear of failing, and never quite measuring up.

The line between being a dedicated athlete and an eating-disordered athlete is often self-esteem, not behaviour.

Two athletes can appear to follow the same training plan, eat similarly, and show the same level of commitment. The difference lies in the internal experience. One is driven by curiosity, ambition, and self-respect. The other is driven by fear, self-punishment, and a belief that rest or nourishment must be earned. This distinction is subtle, but crucial — and it’s why eating disorders in sport can be so easily missed. We don’t know what we are not seeing – behaviours that may be kept secret and feelings that are buried down. External validation of “discipline” or “commitment” can, for some, further reinforce the belief that this way of being is necessary or expected and keep an eating disorder going.

Fear plays a powerful role in keeping eating disorders hidden.

Athletes are often afraid of losing their identity, their performance, or their place in their sport. At the same time, coaches and support staff may feel afraid of saying the wrong thing, overstepping boundaries, or opening up something they don’t feel equipped to handle. When fear exists on both sides, silence can grow — and the athlete can become increasingly isolated at the very moment they most need connection.

Coaches can be a significant steadying presence.

Coaches are often the first to notice subtle shifts: increased rigidity, changes in routine or personality, anxiety around rest days, withdrawal, or escalating training despite injury or fatigue. Supporting an athlete doesn’t mean diagnosing or becoming a therapist. It means being curious, naming concerns gently, and helping the athlete stay connected to appropriate support rather than alone with the problem.

Even when they are not directly involved in an athlete’s treatment or recovery, coaches often represent stability, familiarity, and continuity. A coach who notices, who checks in, and who responds with calm rather than alarm can make an enormous difference. You don’t need to have the right words or the perfect response — being a consistent, supportive presence matters more than most coaches realise.

The moment an athlete speaks up is often when they feel at their most vulnerable.

Disclosure rarely comes from confidence. It usually comes from fear, exhaustion, or a sense of things beginning to unravel. How that moment is handled — the tone used, the response given, and the next steps offered — can shape whether the athlete feels supported or further exposed. Knowing how to listen, stay within scope of practice, and signpost appropriately can meaningfully influence what happens next.

Recovery and sport CAN co-exist — but the relationship has to change.

Recovery is rarely about stopping everything forever. More often, it’s about adjusting training, shifting the underlying relationship with food, body, and movement, and redefining the role that sport and exercise plays in a person’s life. That process is far more possible when athletes feel understood, and when coaches are equipped to support change without inadvertently reinforcing harmful patterns.

In my role now as a therapist supporting athletes through recovery, I recognise how influential everyday interactions can be. Recovery usually requires a support team. Working alongside an eating-disorder-informed coach — particularly one the athlete trusts — can positively support recovery. Most coaches step into their role because they care deeply about helping people develop, grow, and reach their potential. The coach–athlete relationship — how safe, steady, and human it feels — can make a meaningful difference