June 23, 2025
Playing sports has a ton of benefits during adolescence. It can boost self-esteem, provide socialization opportunities and improve physical fitness. But for some teens — especially those who play at an elite level — sports can be a source of pressure and lead to changes in eating patterns and behaviors that may become problematic.
“Elite athletes often have a desire to be the best in their chosen sport — it’s what makes them great and drives them to excel. But that mentality can also affect how they view their body, weight and interaction with food,” says Lucy Lot, MD, an MU Health Care pediatrician and adolescent medicine physician. “Even if your teen doesn’t compete at an elite level, the culture around some sports is traditionally weight-focused.”
Some teen athletes are more likely than others to develop eating issues. According to research, eating disorders are more common among elite youth athletes compared to the general population. The athletes at highest risk include:
- Athletes who play sports that value leanness or require weigh-ins
- Athletes with a higher body mass index (BMI)
- Females
“It’s cause for concern any time a teenager develops maladaptive behaviors with food intake and weight control, such as taking diet or water pills, restricting food intake, binge eating or exercising beyond what’s required for chosen sport,” Dr. Lot says. “However, eating issues are not as easy to spot as some might think, especially at the outset.”
Here’s what you need to know:
How Eating Disorders Affect Teen Athletes
Teens who have eating disorders — regardless of whether they are athletes — will experience a lot of mental and physical effects. Their unhealthy eating patterns can result in inadequate nutrition and affect hormonal function.
Athletes who don’t fuel their bodies properly may develop relative energy deficiency in sports (RED-S), formerly called female athlete triad. This syndrome, which affects males and females, is marked by hormonal changes and impacts several body systems and functions.
Teen athletes affected by RED-S may experience symptoms that affect their health and athletic performance, including:
- Decreased muscle mass, causing slower recovery, coordination issues and decreased performance
- Mental health changes, including depression, anxiety and increased irritability
- Fatigue and dizziness, associated with poor nutrition
- Low testosterone in males
- Menstrual issues in women, including irregular periods or absence of menstruation
- Weakened bones, which increases the risk of a sports-related injury
"The health effects of eating issues, and how long those effects last, depend on the severity of the condition,” Dr. Lot says. “Eating disorders impact athletic performance in ways young athletes can’t imagine. For example, eating disorder can cause the heart to lose up to 25% of its muscle mass, leaving it unable to effectively pump much needed blood to support physical activity.”
Signs of Eating Disorders in Teens
Don’t assume that because your teen athlete is a healthy weight that they don’t have problem eating, says Dr. Lot. While your child may not have a specified eating disorder, they may have disordered eating — unhealthy eating patterns that can be a precursor to an eating disorder.
It can be challenging to notice signs of disordered eating when your teenager is independent and eating alone or out with friends. Changes in weight is one of the easiest sign to notice, but it’s not necessarily the earliest. Parents should also watch for:
- Eating in secret or refusing to join the family for meals
- Hyperfocus on weight that may include comments about weight, meticulously counting calories and tracking every bite eaten
- Menstrual changes in females
- Mood changes such as increased anger, irritability or sadness
- Poor endurance if endurance has not been a problem previously
- Sensitivity to cold, and suddenly having cold hands and feet
- Skipping meals, often followed by eating large portions or binging
“The good news is that with early recognition and intervention, your teen can go from disordered eating back to a healthy relationship with food and weight before it evolves into an eating disorder,” Dr. Lot says. “It is critical to recognize the signs early.”
How to Help Your Teen Athlete Eat Healthy
Modeling healthy eating behavior is the best way to promote healthy eating habits in children. However, athletes can have different nutritional needs depending on the intensity and duration of their daily physical activity.
To help your athlete meet those needs and ensure they are eating healthy, Dr. Lot recommends:
- Discuss nutrition: Make sure your teen understands the value of fueling their body with macronutrients, vitamins and minerals. Encourage them to take a nutrition class at school if possible.
- Engage your child’s pediatrician: Contact your pediatrician before your child’s appointment so they can discuss diet and nutrition with your teen.
- Consider speaking with a sports dietitian: Especially for high level athletes needing significant dietary adjustment during sport season. These nutrition experts can analyze your teen’s energy intake and expenditure. They can then use that information to coach you and your child and recommend a balanced and healthy eating plan.
- Focus conversations with your teen around health: If you have concerns about your child’s eating habits, try not to focus on their weight. Instead, ask how they are feeling, talk about any changes you’ve seen in their mood, attitudes, relationships or performance. Seek to understand what is going on and offer dietary and health advice.
- Have regular touchpoints and meals together: Intentionally connecting with your child daily, including during some mealtimes, makes it more likely that you’ll recognize an emerging concern before it becomes a problem.
“Remind your teen that just because someone is a social media influencer or working in a health store does not make them experts on nutrition,” Dr. Lot adds. “If your teen has questions on how to fuel their body, a health care professional is always the best source of information.”
What to Do If You Suspect Your Teen Athlete Has an Abnormal Relationship with Food
If you are worried about your child’s eating behavior, start with an open and honest discussion. Have the conversation during a relaxed time, when your teen is less likely to be defensive and not needing to rush off somewhere. Let your child know that your concerns are less about weight and more about their health, happiness and general well-being. And if you think it would be helpful, consider sharing any personal experience with disordered eating and the journey you had to a healthier relationship with food.
If the signs of disordered eating are persistent or getting worse, or you’re concerned about an eating disorder, Dr. Lot says your child’s primary care provider should be your first call.
“Don’t wait to engage a medical professional if you sense something is off with your child’s eating pattern or nutrition,” Dr. Lot says. “Children and teens who have healthy a relationship with food are more likely to continue the trend into adulthood.”
Next Steps and Useful Resources
- Want to discuss more with a doctor? Find one for your child today.
