Losing weight (or maintaining optimal body weight) is one of the main reasons most of us exercise, so you might be surprised I often recommend eating more. For many athletes, though, eating disorders or milder forms of disordered eating can adversely affect performance and health.

Inadequate caloric intake can predispose to both menstrual irregularities and bone disorders in female athletes. Many athletes frequently consume less than the optimal number of calories. It has been shown that up to 70% of elite athletes in sports with weight classes try to lose weight and have some form of disordered eating before competitions (true for male and female athletes).

Among female athletes, disordered eating is particularly common. Different studies show eating disorders to be present in 16% to 47% of female athletes compared to generally less than 10% of non-athletes.

Young runners can present with stress fractures and eating disorders.

Also read:
Female athlete triad
Tips for eating well on the road

Females who compete in sports that involve judging, those that emphasize aesthetics or leanness, or those where low body weight and appearance are important appear to be at more risk. Gymnastics, dance, figure skating and cheerleading are some of the sports that would meet these criteria. Also females in individual sports or who experience tremendous pressure to excel might be more at risk.

Disordered eating can lead to abnormal menstrual periods or absence of them, which can subsequently cause osteopenia or osteoporosis. The relationship between inadequate nutrition, hormonal imbalance and bone density is far beyond the scope of this guide, but parents should consider all of these issues if their daughter develops a stress fracture. Often these issues require a multidisciplinary approach with a sports medicine orthopaedic surgeon, nutritionist, psychiatrist or therapist, along with the coach and parents. Ensuring adequate caloric intake for training is a good first step towards prevention.