Disordered Eating In Elite Athletes Leads to More Injuries and Worse Performance
12-month study links bad habits to lost training days.
Elite athletes chasing leanness through disordered eating face a harsh reality: aside from inviting a calamity of health problems, it doesn’t improve performance and instead predicts more injuries and missed training time, according to a new longitudinal study. Researchers tracked 178 pros (mostly Australian and US, 72% female, average age 24) over 12 months, finding baseline disordered eating scores strongly linked to poorer self-reported competition results and significantly more days sidelined by injury at 6 months, even after controlling for priors and gender. These findings are a stark reminder for many, while a wake-up call to some coaches and parents, urging all teams to screen early to reduce risks.
Aim
Researchers aimed to test if disordered eating at baseline predicts changes in self-reported performance or days missed from training/competition due to injury over 6 and 12 months in elite athletes (national, international, pro, or NCAA D1 level). They hypothesised it would lead to drops in performance and rises in injury-related absences, countering the myth that getting leaner via these behaviours improves results.
Methods
The study surveyed 178 current elite athletes (72% female, average age 24, from Australia/US, mix of lean and non-lean sports) at baseline (March-Sept 2023), 6 months (N=110), and 12 months (N=91). Disordered eating was measured via the 17-item Athletic Disordered Eating (ADE) scale (score 0-68, higher = worse; baseline mean 33). Performance was a 0-100 average of satisfaction in training/competition. Injury was days missed in the prior 6 months (0 to 22+). Analyses used regressions controlling for gender and priors, plus multilevel models, with multiple imputation for dropouts.
Results
Greater baseline disordered eating predicted more days missed due to injury over the next 6 months, even after adjusting—those with higher ADE averaged 37 vs 29 for the no-miss group. It was linked to poorer performance across all points, but didn’t predict performance changes over time. No reverse effect: prior injuries didn’t spike disordered eating.
Practical Takeaways
Disordered eating disguised as discipline doesn’t sharpen your edge. Screen for it early to avoid injury, downtime and stagnant progress. Coaches and teams: prioritise consistent training over leanness myths, as player absences hurt more than any “benefit.” Elite lifters or athletes: if your eating feels off (e.g., constant restriction, missing foodgroups or macronutrients), consult a medical professional. In the end, proper, individualised fueling results in athletes having more energy to train and play, better mental health, and fewer setbacks mean making real progress.
Key Takeaways
Disordered eating offers zero performance upside and ramps up injury absences, hitting male/female elites alike across sports. It’s a risk pathway, not a strategy. Broad screening and strong education and support from experts early on across all avenues is the slow path to getting us there.
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Reference
Fatt, S.J., Hay, P., George, E. et al. A longitudinal investigation of performance and injury outcomes associated with disordered eating in elite athletes. Sports Med - Open 11, 122 (2025). https://doi.org/10.1186/s40798-025-00927-5
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