Demystifying Eating Disorders in Athletes with Dr. Katherine Hill

Whether you’re an athlete, coach, or parent, the topic of eating disorders in athletes presents a critical concern.

As an athlete, these disorders can greatly hinder performance and potentially end a career prematurely. From a coach or parent’s perspective, helping an athlete manage this condition is of paramount importance.

Understanding eating disorders and their impact on performance is a vital step in creating a healthier athletic community and a strong recovery. No one knows this better than Dr. Katherine Hill, a board-certified pediatrician and Vice President of Medical Affairs at Equip Health. She’s also a former collegiate swimmer who has conducted extensive research on eating disorders in athletes.

Dr. Hill appeared on a recent episode of Equipped to Recover on The Recovery Warrior Shows podcast channel, to use her personal experience and professional knowledge to guide us through the ins and outs of eating disorders in athletes, and explore the best ways to both help and prevent eating disorders in sports.

Eating Disorders in Athletics: Dr. Katherine Hill’s Story

It was during her time on the university swim team that Dr. Katherine Hill discovered the insidious world of eating disorders among athletes. It started when she noticed a troubling pattern – many of her teammates were engrossed in detrimental dietary habits, compulsive workouts, and an unhealthy obsession with their body image.

Adding to their plight was the widespread misconception that losing menstrual cycles was evidence of hard work and peak performance. However, Katherine’s medical education suggested a different story.

Intrigued, she delved deeper into the issue, eager to challenge the common belief that only ‘thin’ sports athletes were susceptible. Her findings were surprising – even swimmers, perceived as maintaining a ‘normal’ weight range, were at risk.

This significant revelation sparked her dedication to shedding light on this issue and offering assistance to athletes caught in the grip of these harmful disorders.

Below are 3 important topics Dr. Hill covered on eating disorders and athletics on Equipped to Recover:

  • Prevalence of Eating Disorders in Sports
  • Recognizing Signs of a Struggling Athlete
  • Helping a Struggling Athlete

Prevalence of Eating Disorders in Sports

On screen or in sports magazines, athletes appear to be the epitome of physical health and fitness. Yet, behind the scenes, a surprising number may quietly battle eating disorders.

Their high-pressure environments, combined with scrutiny of their bodies, can create a higher risk of developing these difficult conditions. Regardless of the sport, athletes can find themselves in a situation where they end up using food and their diets in a way that can harm their health, performance, and life overall.

Eating disorders are surprisingly common among athletes. In fact, specific studies suggest that athletes are at a higher risk of developing an eating disorder than non-athletes [1]. The risk applies to any sport and gender, challenging the prevailing belief that eating disorders are exclusive to young, thin, white women in weight-centric sports.

No matter what sport you may be involved in, there is a risk there.

Dr. Katherine Hill

Dr. Hill discussed the concerning rate of eating disorders among athletes, and emphasized that eating disorders are not only reserved for endurance sports, or sports where slimness offers a perceived advantage.

Additionally, male athletes in sports like baseball can exhibit higher rates of eating disorders than their female counterparts, dismantling the stereotypes typically associated with these conditions.

Recognizing Signs of a Struggling Athlete

Recognizing early signs is vital to help athletes who may be battling an eating disorder. Addressing concerns early on, demonstrating empathy, and facilitating open dialogues can motivate athletes to seek help.

Like all eating disorders, you can’t tell if an athlete is struggling based on appearance alone. Dr. Katherine Hill suggests keeping an eye out for behaviors, patterns, and attitudes that may point to an underlying eating disorder.

Some examples she gives of potential disordered behaviors in an athlete are:

  • A fixation on body size and weight
  • Cutting out food groups
  • Exercising outside of regular practice time
  • Emotional and psychological changes
  • Absence of menstrual periods

It’s important to recognize that a dedication to a sport and workout regimen can cross over into harmful eating disorder territory, especially in the face of the high caloric needs required to participate in sports.

As Dr. Hill puts it, the root of most eating disorders in athletics stems from the high energy requirements of sports, which can create a caloric deficit and a serious medical condition known as REDS – Relative Energy Deficiency in Sport.

An extreme caloric deficit can be either intentional as a result of an eating disorder, or unintentional as a result of a lack of education on the true caloric needs of participating in sports. This energy shortage can be the springboard to malnourishment and its ensuing medical consequences, extending from physical changes to emotional and psychological ones.

Complications of REDS include: changes in heart rate, blood pressure, body temperature, and GI tract function, which can impact athletic performance and overall health. [2]

If you recognize this signs in yourself, or any athlete you know, keep reading to discover the best ways Dr. Hill suggests to help.

Helping a Struggling Athlete

Eating disorders in athletes can have serious health consequences, potentially impacting not only their athletics career but their life off the field.

One important way to help struggling athletes is to maintain an open dialogue to educate them about caloric needs and the potential risks of underfueling. Remember eating disorders can affect athletes across ALL sports, and not just those traditionally associated with thinness or appearance.

Knowledge is a powerful tool in helping to improve and prevent eating disorders in athletes. Fostering a supportive and open environment where issues can be discussed openly and honestly is paramount to promote early intervention and treatment.

If you want to reach out to someone directly who you think may be struggling, Dr. Hill suggests to first keep in mind that different people are at different stages of recognizing and accepting if they have an eating disorder. Therefore, she recommends broaching the subject privately and one-on-one.

It’s always good to speak to someone one on one and address some of the things that you’ve seen

She recommends sharing judgment free and neutral objective observations, followed by open ended questions. For example you may say “I’ve noticed you’ve cut out several food groups” or “I’ve noticed that you’re exercising after practices. What’s going on with that?”

Recognize that some people may not be ready to talk about it and deflect the conversation. Others may be open to discuss their struggle.

If they choose to open up, Dr. Hill stresses the importance of asking for their permission to talk to a coach or parent on their behalf to facilitate further help and treatment.

Recovery Is Possible

An athlete struggling with an eating disorder can heal from their illness, and return to their sport healthy and with renewed strength.

Dr. Katherine Hill suggests recognizing and treating these disorders with the same seriousness and care as you would any other sports injury.

Eating disorders are treatable just like any other injury. With proper treatment you can get back to playing.

The role of a supportive environment and proper nutrition stands out as key factors in this recovery process. So, let’s continue to learn, support, and promote healthy practices in athletics, ensuring that our athletes perform their best while also maintaining their physical and mental health.

Take a listen to Dr. Katherine Hill’s interview for more invaluable insights on eating disorders in athletes.

Click here to learn more about Equip.

Connect with Equip & Dr. Katherine Hill


[1]  Conviser, J. H., Schlitzer Tierney, A., Nickols, R. (2018). Assessment of Athletes with eating disorders: essentials for best practice. Journal of Clinical Sports Psychology, 12.


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