Table 2

Suggested risk factors for disordered eating and eating disorders in high performance athletes4 10 14 17 18

Biological risk factors
  • Age

  • Stages of growth, development or puberty

  • Genetic risk factors, for example, EDs, addictions in family

  • Precocious growth or development

  • Growth or development that is significantly different from the average

Psychological risk factors
  • Body dissatisfaction, body image distortion

  • Low self-esteem

  • Personality traits, for example, perfectionism

  • Obsessive-compulsive tendencies/traits

  • Neuroticism (depression, anxiety, emotional lability)

  • Harm avoidance

  • Heightened stress reactivity

  • Inflexible, rule-drive, drive for order and symmetry

  • Risk-taking behaviour

Sociocultural risk factors
  • Eating pressures/modelling

  • Peer pressure regarding physical appearance or weight

  • Influence of the media

  • ‘Thin ideal’, ‘muscularity ideal’ or ‘fit ideal’

  • Direct or perceived pressure to modify appearance or weight

  • Weight/appearance-based teasing, bullying

  • Social Isolation

  • Experiences of weight stigma, including in healthcare and within sporting environments

Sport-specific risk factors
  • Transition periods

    • Early start of sport-specific training

    • Making a senior team at a young age

    • Retirement (forced or voluntary)

    • Non-selection or de-selection

    • Injury, illness, surgery, time away from sport and training

  • Changes in weight/body shape following injury/illness

  • Pressures (perceived or real) to change body shape or composition

  • Weight cycling

  • Patterns of restriction or disordered behaviours

  • Coaching behaviour and accepted ‘norms’ within sport

  • Rules and regulations in sports

  • Performance optimisation pressure

  • Use of supplements, and nutritional and ergogenic aids

  • Body composition testing, weighing and measuring

  • Public displays of ‘results’ in common areas, for example, training environment

  • Media and social media pressure (perceived or real) to look a certain way

Gender-based factors
  • Media-driven gender stereotypes

  • Drive for muscularity/leanness/thinness

  • Anabolic-androgenic steroid use

  • Gender diversity

Other risk factors
  • Chronic disease related to caloric utilisation, for example, diabetes, thyroid

  • Co-occurring conditions, for example, coeliac disease, other gastrointestinal conditions


  • History of trauma

  • History of food insecurity

  • Major life transitions, for example, moving away from home, moving between schools, moving overseas