Special Populations Affected by Eating Disorders:
Athletes, Males, and Children
While many believe only young, white females are impacted by eating disorders, its important to know that these serious illnesses can occur in people of all ages, genders and sexual orientations, across all socioeconomic groups, and from any cultural background.
Athletes, men, and children have many of the same eating disorder signs and symptoms as women, and may also experience distorted body image. These groups may also be more reluctant to talk about their symptoms, less likely to admit they have a problem, ask for help, or understand the seriousness of what they are experiencing.
If you have concerns about a friend of loved one with a possible eating disorder, please refer to the section, How to Get Help.
Athletes and Eating Disorders
Certain Athletes are Especially Vulnerable to Eating Disorders:
1. Aesthetic sports (e.g. diving, gymnastics, dance)
2. Weight-based sports (e.g. wrestling, rowing)
3. Sports in which lower body fat is associated with higher performance (e.g. cross country, track, swimming, dance)
4. Sports in which strength and size are important (e.g. bodybuilding, football)
Relative Energy Deficiency in Sport
Relative Energy Deficiency in Sport (RED-S) is an updated version of the Female Athlete Triad, which had previously connected menstrual dysfunction in females with disordered eating and osteoporosis. RED-S has adapted this model and expanded on it to include the numerous psychological, physiological, and performance problems including:
Athletes and Eating Disorders
Decreased concentration and coordination
Decreased bone health
Menstrual dysfunction (in females)
RED-S is caused by low nutritional intake in conjunction with athletic activity and exercise, that is, an imbalance in input and output.
Eating Disorder Red Flags in Athletes:
Amenorrhea (loss of menstruation)
Stress fractures, or other injuries that do not heal
Feeling lightheaded or fainting
Chronic fatigue (feeling tired all the time)
Males and Eating Disorders
Prevalence of Eating Disorders in Males
An estimated 10 million males suffer from a clinically significant eating disorder. While this is a smaller prevalence than in females, eating disorders do not discriminate based on gender. Individuals of any or no gender identity can experience an eating disorder in their lifetime. Additionally, sub-clinical eating disorder behaviors such as bingeing, purging, or restriction are nearly as common in males as in females.
Though the prevalence of eating disorders in males varies, the most commonly cited rates:
0.3% for anorexia nervosa (AN) 0.5% for bulimia nervosa (BN) and 2% for binge eating disorder (BED)
Males represent approximately 25% of those with anorexia and bulimia
Participation in sports with specific body ideals
Weight-based sports such as wrestling, football or crew
Image-focused sports such as diving, dance & gymnastics
Identifying as homosexual, bisexual, asexual, or other minority sexual orientation increases the risk of developing an eating disorder
One study of males with eating disorders found that around 50 percent of those diagnosed with anorexia or bulimia identified as a sexual minority.
Many have a co-morbid disorder including major depressive disorder, a personality disorder, or substance abuse.
Depression is seen in 50-70 percent of eating disorder patients
Family history of substance abuse, mood disorders, or eating disorders
Fatigue and low energy
Decreased bone health
Osteopenia / osteoporosis
(leading to injuries or fractures)
Digestive issues, bloating, constipation
Depression and/or anxiety
Possible cardiac problems
Due to the stigma around males with eating disorders, men tend to seek help less than females. As a result, males often have more severe symptoms by the time they reach treatment. Some studies have shown that by the time a man enters treatment, he is more likely to have severe bone damage than a female patient would have, due to nutrition deficits.
Treatment processes tend to be unique for every sufferer and special considerations are often needed for men. Unless they are at an all-male treatment center, many male patients will likely be the only, or one of a few, males in the treatment facility. Because of this, a gender-sensitive approach is important in the treatment center selected. An all-male treatment facility is encouraged whenever possible.
Children and Eating Disorders
How Eating Disorders May Show Up in Children
The average age of onset for an eating disorder is 12 years old. However, disordered eating can develop as early as 4 years old and symptoms may differ in children from those seen in teens and adults, as seen in the list of warning signs below. However, it's important to note that eating disordered behavior in children is NOT a phase and should always be taken seriously.
Early detection of eating disorders is always critical as the consequences of an eating disorder can be permanent, especially in growing kids who miss out on important nutrition during their years of rapid physical and mental development. Hence, the sooner an eating disorder is identified and addressed, the more likely the child will make a full recovery.
It's important to note that eating disorders arise from a complex interplay between genes and environment. Parents and families are NOT to blame, and are almost always the greatest source of support for a child in recovery.
Warning Signs in Children
Anxiety surrounding food, avoidance of food or meals including irritability, crying, fits, tantrums.
Sudden changes in eating habits such as skipping meals, cutting out specific foods or food groups, avoiding foods that used to be favorites, overusing condiments, cutting food into small pieces, and chewing excessively.
A notable increase in exercise or movement. For children, movement and exercise should be for fun, not for burning calories. It's important to note when a child begins to exercise and train outside of scheduled sports, begins to talk about burning calories or fat, exercises in secret, chooses exercises over playing with friends or doing school work.
Concern about body appearance or weight. Children who begin to spend ample time in front of a mirror or looking at their reflection, ask to be weighed or weigh themselves often, ask if they are fat, and/or compares themselves to their friends excessively may be struggling with an eating disorder.
Unexpected weight loss or gain in children and adolescents can also be a red flag. If a child stops growing, falls off their growth chart, or gains weight very rapidly, it's a good idea to assess for an eating disorder.