Reflection
Eating Disorders and Addiction in Athletes: The Obsessive-Compulsive Thread
Elite sport selects for exactly the traits that, taken too far, become an illness: discipline, self-denial, the ability to override the body’s signals and keep going. That is what makes eating disorders and addiction so common, and so easily missed, in athletes and high-level performers. The behaviours do not look like a problem. They look like commitment.
One engine, three expressions
An eating disorder, compulsive exercise and an addiction are not three separate problems that happen to appear together in athletes. They are three expressions of the same underlying difficulty: a nervous system that has learned to manage anxiety, shame and the fear of not being enough from the outside, through a repeated behaviour that soothes and controls. Restricting, training, purging, using: each does the same job. This is why they so often travel together, and why treating one while ignoring the others rarely holds. It is also why the compulsion beneath them all is best understood as exercise addiction when it settles on training, and as an eating disorder when it settles on food.
How it hides in sport
In most settings, obsessive control of food and training would raise concern. In sport it is rewarded. The athlete who trains through injury, eats with rigid rules, and punishes themselves for a missed session is praised for dedication. The disorder is applauded rather than questioned, which is precisely why it can run for years before anyone names it. In men it hides further still, often as muscle dysmorphia, the drive to be ever bigger and leaner that looks like devotion to the gym.
RED-S: when the body starts to fail
One of the clearest signals is Relative Energy Deficiency in Sport, or RED-S: the state that arises when an athlete is not taking in enough energy for their training load. It disrupts hormones, weakens bones, flattens mood, harms sleep and, eventually, damages the very performance the athlete is chasing. RED-S is frequently the physical face of an underlying eating disorder and compulsive exercise, and it is often what finally brings someone to help, when the body stops cooperating.
The identity underneath
For many athletes and performers, the deeper difficulty is that the body and the performance have become the whole self. When so much of your worth is invested in what your body can do or how it looks, controlling it can feel like the only way to hold together. That is also why injury, deselection and the end of a career so often trigger crisis: the structure that held the person is gone. The work is not only with the eating or the training, but with the identity that has been built entirely on them.
Why confidentiality matters here
For a professional athlete or performer, a public association with an eating disorder or addiction can carry real career and reputational cost. That is why confidential, specialist work, conducted privately and where needed online, matters so much for this group, and why so many prefer it to anything on the record.
If this is you, or someone you coach or love
None of this means giving up sport. It means loosening the grip of the compulsion and addressing what drives it, so that training can become a choice again rather than a cage. The work settles the immediate behaviour, understands the anxiety and control beneath it, and repairs the older shame the body has been made to carry. Because the roots are shared, eating disorder, compulsive exercise and addiction are treated together, with the same depth.
Dr Philippe Jacquet is an eating disorder and addiction specialist, Hazelden-trained, with a Doctorate of Professional Practice on male eating disorders and more than 20 years of EMDR experience. If any of this resonates, it can help to talk it through. Arrange a confidential consultation, online or in London. For men specifically, Men Who Heal is his dedicated programme.