Disordered eating in student-athletes includes a wide range of eating concerns. These range from the student-athlete who inadvertently is not eating enough to fuel their body for sport simply out of not realizing how high their caloric needs are, all the way to the extreme of a full blown eating disorder and associated complications. Eating disorders include anorexia nervosa (being significantly underweight with distorted body image and intense fear of gaining weight) and bulimia nervosa (recurrent episodes of binging--rapidly eating very large amounts of food well beyond the point of comforably full and in a manner that feels out of control--and purging--self-induced vomiting, laxative or diuretic use, excessive exercise beyond that recommended by coaches in order to compensate for food eaten, or times of fasting to compensate for binges). Student-athletes may underfuel because of wanting to try to achieve a competitive advantage in sport, meet appearance standards for sport or for society, or for other reasons. Ultimately, underfueling is not a sustainable way to achieve success in sport, and athletic performance will suffer if disordered eating continues. Student-athletes may find themselves on a slippery slope in which a desire to “eat healthy” turns into food restriction and rigid dieting in the hopes of improving athletic performance.
Note that some people reference the term “Female Athlete Triad”, which is becoming outdated. However, the idea still applies that the three elements of the Triad, disordered eating, menstrual cycle changes, and lowered bone mineral density, can occur in athletes who are not eating enough calories to fuel their activity levels.
A newer term being used is RED-S (Relative Energy Deficiency in Sport). The International Olympic Committee has used the “RED-S” terminology since 2014. This term is preferred over Female Athlete Triad in recognition of the fact that student-athletes across genders can suffer from inadequate intake, disordered eating, or full-blown eating disorders (though it is a more common problem in females). Additionally, the RED-S term conveys that there are more than just three issues when it comes to underfueling in sport.