Signs and Symptoms

Are Elite Male Athletes at Increased Risk for Eating Disorders? - Ellie Herman

Thankfully, health and recovery from eating disorders are possible. Of course, it depends on a combination of factors including the support of coaches, teams, families, medical and mental health professionals. Learn more about the signs of compulsive exercise and eating disorders in athletes.

He looked at the delicious Thai dish I made for dinner. He hesitated, seeing that the meal included an ingredient that he had labeled as “fatty.”

He pinched his stomach and fearfully said, “I can’t eat that. I didn’t run today, and I know I gained a pound since yesterday!“

He then anxiously left for home to make a meal he felt more comfortable with. He believed he needed his lean, “good and safe” foods necessary for his training.

… He wanted food that wouldn’t make him fat

It was months before I put the puzzle together, but it seems so clear now:

  • He was a competitive athlete.
  • His obsession with his diet interfered with his personal life.
  • He had a strong fear of becoming fat.

… I was dating a guy with an eating disorder 

Twenty million American women and ten million men currently suffer from a clinically significant eating disorder or have symptoms that don’t meet full diagnostic criteria (Wade et al., 2011). If you find this fact surprising, I get it — so did I.

I often wondered, post-break-up, “How did I not see his eating disorder more clearly?” Easy: It was disguised and even rewarded since he was a marathoner and an Iron Man triathlete. He didn't display the more common signs of anorexia, for example. His disordered eating was masked by the social acceptability of manipulating food to change his body composition, in order to gain a competitive advantage.

Surprising facts about endurance athletics

Many sports use short bursts of energy (think: sprinters), but endurance athletics requires longevity. Put simply, if you have to eat food to finish a race, it’s probably an endurance sport like distance running, cycling, and some triathlons.

To be an “elite” endurance athlete, you must rank within the top 10 to 15 percent of the competition. The next level of competition from here is competing at the world level.

Some elite endurance athletes say that this culture offers mixed messaging: Athletes should live healthy and normal lives — but they must also do what they have to, in order to win. Consider these quotes from some of the group’s most competitive athletes:

  • “You’re willing to do anything to lose time. Saving four to six seconds could make a difference of how you place, or if you win money.” Regarding the omission of food groups like gluten, dairy, and alcohol, “I don’t think it’s a disorder to not do those things, I think it’s smart and healthy.” — Brett Rindt, age 34, Pro 1-2 level cyclist
  • “It’s a whole lot easier to change your weight than [it is] to change your power in order to climb hills. I would guess most elite endurance athletes have some form of an eating disorder. We weigh ourselves every day.”—Kyle Thomas, age 33, Pro 1-2 level cyclist.
  • “I’m 6’3”, 195 lbs. I’d have to lose 20 to 30 pounds to be in the range of a world class Iron Man. I have no interest in doing that. For me, it’s about maintaining my weight and finishing.”—Jon Slinger, age 35, triathlete.

Can a quest for winning become unhealthy?

Endurance athletic culture is centered upon discipline regarding training regimens, weight, sleep and food. For these men, their eating and weighing habits aren’t necessarily about a certain body image — rather, they are about performance. While eating disorder professionals have different criterion for “red flags”, the athletes shared the following turning points in which they noticed unhealthy habits:

  • Over training
  • An increase in injuries
  • Continual food group restriction post-race day
  • Continual focus on weight loss post-race day
  • Feeling guilty about food choices
  • Focusing so much on healthy” food that it was limiting happiness

Endurance athletics: A risk for eating disorders

Male athletes develop eating disorders for the same reasons other male and female non-athletes do, and these behaviors are not caused by participation in a particular sport (Currie, 2010).

Participation in endurance sports is a risk factor, not a cause of, an eating disorder.

This risk factor for developing an eating disorder, particularly affects men with an underlying genetic predisposition influenced by biological, psychological and social factors (Thompson and Sherman, 2010).

Compare it to the genetic vulnerability a person may have when alcoholism runs in their family. Consuming alcohol creates a higher risk of developing the disorder, just as engaging in diet manipulation and intensive exercise is a risk factor for someone who is vulnerable to eating disorders.

Eating disorders often go unnoticed in sports; endurance athletics will continue to be a risk factor for many men

“To be elite or at world level — you have to have intense focus. Eating disorders for these athletes is often misguided focus — intense focus, detail, excellence and perfection. But when that becomes misdirected, ‘eating well’ doesn’t equal success — it equals disordered eating,” says Danny Gerow, age 25.

Gerow was an elite cyclist who competed at the world level in Belgium and went on to coach cycling at the collegiate level. Gerow saw athletes struggling with obsessive thoughts around food and training. These habits are fear-based — a fear of eating too much or too little, and a fear about how this might affect performance. Gerow urges the community to look beyond eating disordered behaviors to understand the function of the disorder:

“There’s a lot of people to be helped and freed… if the athlete has disordered eating, it’s the outward expression of something inward gone awry.”

Thankfully, health and recovery from eating disorders are possible. Of course, it depends on a combination of factors — including the support of coaches, teams, families, medical and mental health professionals.

Learn more about the signs of compulsive exercise and eating disorders in athletes

Ellie Herman, MA, LPC, NCC is an Alumni Coordinator for Eating Recovery Center.


  • Currie, A. (2010). Sport and eating disorders—Understanding and managing the risks. Asian Journal of Sports Medicine, 1(2), 63-68.
  • Thompson, R.A., & and Sherman, R. T. (1993). Helping athletes with eating disorders. Champaign, IL: Human Kinetics Publishers.
  • Wade, T. D., Keski-Rahkonen, A., & Hudson, J.I. (2011). Epidemiology of eating disorders. In M. Tsuang, M. Tohen & P. B. Jones (Eds.) Textbook in psychiatric epidemiology (3rd ed., pp. 343-360). New York, NY: Wiley.
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