Female Athlete Triad

Three high school girls at locker In 1992, the American College of Sports Medicine first recognized that girls and women in sports were particularly susceptible to three interrelated conditions – disordered eating, menstrual irregularity, and osteoporosis – that have come to be known as the "female athlete triad."


Contrary to popular belief, eating disorders are not limited to classic eating disorders (anorexia and bulimia), but occur on a spectrum ranging from calorie, protein and/or fat restriction and weight control measures (diet pills, laxatives, excessive, compulsive exercise in addition to normal training regimen, self-induced vomiting) to full-blown anorexia and bulimia.


Anorexia is a condition in which a girl's diet does not allow her to maintain her weight within 15% of the mean for girls her age and height. (Remember: daily requirements for calories, carbohydrates, and protein are greater for athletes).

  • Warning Signs: 
    • Sudden weight loss or gain
    • Distorted body image
    • Obsession with weighing oneself;
    • Avoidance of social eating (i.e. a girl who likes to eat alone);
    • Preoccupation with food and dieting/unreasonable fear of being fat (girls on severe diets in one Australian study were 18 times more likely to develop an eating disorder; moderate dieters were 5 times more likely than those who did not diet; Harvard researcher says 44% of high school girls and 15% of boys diet);
    • Hair loss;
    • Intolerance to cold
    • Obsessive exercising



Bulimia is where a girl engages in "binge eating" (i.e. eating too much uncontrollably in one sitting) and then purging (vomiting, exercising intensely) to get rid of the food just eaten.

  • Warning Signs:
    • frequent use of bathroom after eating
    • Fluctuating weight
    • Bloodshot eyes
    • Swollen glands
    • Swollen extremities
    • Discolored teeth (i.e. eroded tooth enamel from frequent vomiting)
    • Feelings of depression, guilt or shame about eating
    • Suicide attempts
    • Drug use
    • Aches and pains
    • Dramatic fluctuations in athletic performance


Serious Health Problems

Disordered eating results in serious health problems, some of which are potentially fatal (the mortality rate in severe cases can be as high as 10 to 15% from heart failure, hormonal imbalances or suicide), including:

  • heart problems such as irregular heart beat;
  • muscle weakness or fatigue;
  • fainting;
  • loss of concentration in school work and athletics;
  • irreversible bone loss;
  • decrease in athletic performance (decrease in endurance, strength, reaction time, speed);
  • depression
  • fluid and electrolyte imbalance; and
  • suicide