Female Athlete "Triad: a risk of eating disease

Women participating in appearance-based and endurance sports are at risk of developing an eating disorder. A study of college-age female athletes found that 15% of swimmers, 62% of gymnasts, and 32% of all varsity athletes exhibited disordered eating patterns. Estimates of eating disorders for college women not involved in competitive sports are much lower.

In addition to disordered eating, college women athletes tend to experience irregular menstruation more frequently than other college women. Disordered eating, particularly food restriction and stress, can precipitate this, causing women to have less dense and weaker bones than normal because of lower estrogen concentrations in the blood. Some of these young women have bones equivalent to those of 50- to 60-year-olds, making them overly susceptible to bone and stress fractures during both sports and general activities. Much of the bone loss is irreversible.

The American College of Sports Medicine (ACSM) has named the syndrome female athlete triad because it consists of three parts: disordered eating, lack of menstrual periods, and osteoporosis. The ACSM has issued a call to teachers, coaches, health professionals, and parents to educate female athletes about the triad and its health consequences.

Many coaches/trainers and even some health professionals wrongly believe that loss of menstrual periods is a normal consequence of a high level of physical activity. However, this loss of menstrual periods has negative consequences on the body, such as fragile bones, as just mentioned. Correcting menstrual irregularities by increasing caloric intake should help normalize hormone levels and increase bone mineral density. During therapy, a physician may prescribe a multivitamin and mineral supplement as well as calcium supplements as needed to maintain an intake of 1200-1500 milligrams, as mentioned for treatment of anorexia nervosa in the answer to the Real Life Scenario.


Those exhibiting symptoms should seek treatment from a multidisciplinary team of health professionals. Involving the coach or trainer in therapy is usually a key factor in the success of the treatment plan. Suggestions for treatment are as follows

• Reduce preoccupation with food, weight, and body fat.
• Gradually increase meals and snacks to an appropriate amount.
• Achieve an appropriate weight-for-height.
• Establish regular menstrual periods.
• Decrease training time and/or intensity by 10% to 20%