What is the Female Athlete Triad and why do women fall victim to it?

The Female Athlete Triad is characterized by disturbances in menstruation, hormone imbalances, low bone mineral density, eating disorders, and other serious health conditions.

Recovery can be difficult, and athletes may suffer long-term or even permanent debilitating conditions that may develop, such as osteoporosis, putting them at life-long risk of bone fractures and other afflictions.

Still, despite these risks, some female athletes choose to severely limit their food intake or engage in poor eating habits in their desire for thinness. Here are some reasons why.

Athletes are pressured by a culture within their sport that promotes low body weight and leanness

In many sports, a culture exists where maintaining a low body fat percentage and a low body weight is synonymous with the mindset that this will improve an athlete’s ability and performance. Athletes who operate within extremes of this culture may try to lose weight by intentionally restricting their caloric intake so that it falls far short of their total daily energy expenditure needs, resulting in a severe energy imbalance. This can lead to chronic low energy availability (LEA), a metric used to calculate the residual energy available to support the body’s physiological functions after accounting for the energy expended in physical activity. Athletes may resort to other tactics to stay lean that include frequent exercise at levels far exceeding what is required of their sport to stay in shape—an addictive behavior known as exercise dependence.

Sports classified as “lean,” which place a heavy emphasis on maintaining a low body weight, include dance, ballet, figure skating, gymnastics, swimming, and diving, among others. Numerous studies have demonstrated the prevalence of low energy availability in athletes who compete in these sports. One such study was cited in a recent article written by researchers from George Mason University’s School of Sport, Recreation, and Tourism Management (SRTM) on low energy availability in female athletes. The paper described a study involving the assessment of energy intake and expenditure in a group of ballet dancers. Twenty-five out of twenty-six of the dancers, or 96.2%, demonstrated the presence of low energy availability. The Mason paper also cited two existing studies of energy expenditures in synchronized swimmers. One found that 52% of the swimmers demonstrated low energy availability, while the second study found that a full 100% of the swimmers had low energy availability.

Some athletes face barriers to healthy eating or may lack an understanding of nutrition

Athletes may experience challenges in eating healthy meals due to time constraints in juggling training, game schedules, travel to games, and obligations surrounding school, work, and family. Other athletes may struggle with financial obstacles that limit their access to affordable, high quality, nutritious food options. For collegiate athletes living in student housing, kitchen facilities may not be available that would allow them to cook their own nutritionally balanced meals. In all these scenarios, athletes may opt to grab “fast food” on the go—food that will not help them replenish the macronutrients they need for top performance. Exacerbating this situation is the fact that students and coaches need better education on the fundamentals of good nutrition and appropriate fueling strategies to optimize performance and health.

Female athletes may feel pressured to lose weight because of body image issues

Sports such as figure skating, gymnastics, and synchronized swimming have a subjective component where female athletes are judged not only for their physical ability but for the aesthetics of their performance. While it is not explicitly acknowledged publicly, athletes may be evaluated based on their physical attributes which include whether they are small-statured, petite, lean, and light. Even outside of sports, female athletes may feel the pressure to attain what social media and mass media often portray as the “ideal” body type—typically promoted as being thin. These influences can lead female athletes to experience body dissatisfaction where they convince themselves that they are overweight, even if they have a light, lean physique with a low percentage of body fat. In extreme cases, this can lead to the development of a clinical eating disorder requiring treatment by a health care professional.

The issues addressed in this article are discussed in a paper authored by faculty in Mason’s School of Sport, Recreation, and Tourism Management in the College of Education and Human Development. We invite you to visit the school’s Sport Management program to learn more about our degree offerings.