Responding to eating disorders in sport – UK guidelines

Eating disorders are common in sporting populations. They have an adverse effect on athletic performance and can represent a serious health problem. Many practitioners who work with athletes require guidance on how best to respond to these problems. The purpose of this paper is to present an overview of what can be done to address the problem of eating disorders in a high performance sports environment.

Three clinicians (a psychiatrist, dietitian and psychologist) with many years experience of working in a sports environment were tasked with drafting guidelines relevant to elite sport in consultation with a senior sports physician. The group met on three occasions and corresponded by e‐mail over a 15‐month period. Existing guidelines and literature were reviewed and adapted to the UK high performance sports environment. The guideline was targeted at all practitioners, including coaches, who work in this setting and comments were invited from national sports institutes and governing bodies before the document was finalised.

The guideline summarises current best practice in the prevention of eating disorders in a sports environment. Screening processes are described alongside the necessary response to a positive screen. Advice on accessing therapy and returning to sport during recovery is also provided. Finally guidance is given on how and when to de‐select athletes who are ill.

This paper presents a comprehensive overview of what can be done to address the problem of eating disorders in a high performance sports environment. It provides practical suggestions and guidance on principles rather than a definitive response to every eventuality in an area that is often difficult and complex.