When we set out on our career path, we expected to be helping people stay well, improve their health, and perform their best. What we quickly learned was that working in nutrition and sports medicine would require us to become specialists in eating disorders.

It turns out that compared to non-athletes, the prevalence of disordered eating and clinical eating disorders is significantly higher in athlete populations across the board. The same is true for performing artists. And it’s by no means exclusive to the small minority of elite and professional athletes or dancers. It’s everyone.

We’ve cared for patients as young as 8 years old in their first dance class to adult age-group athletes running marathons at age 50 as well as Para athletes, major league baseball players, DI football players, elite cross-country runners, professional ballet dancers, national level wrestlers, and everyone in between. Eating disorders do not discriminate by age, gender, ability, race or ethnicity, sexuality, body size, sport or type of dance, or level of performance.

After 20 years of doing this work, it’s hard for us to believe that not much has changed. The level of awareness, education, and support for preventive services remains abysmal in many organizations and many of our colleagues in sports medicine and sports performance are under-trained and ill-equipped to manage these complicated problems. Policies and strategies we advocated for in our positions working for various organizations often fell on deaf ears in favor of the status quo. The pressure coaches and athletes face to win and remain competitive makes it easy to take risks and ignore the signs of impending physical breakdown or an emerging eating disorder and the consequences are never immediate. They’re always later.

By the time we see athletes in our offices, it’s too late and the price was too high. We want things to be different - to be better than they are. As do many athletes and artists who are finding their voices and speaking out about harmful environments, mental health needs, and their experiences with eating disorders.

We remain hopeful because there has always been that one coach, or one director, or that stellar athletic trainer or sports psychologist, or steadfast parent, or team doctor who ‘gets it’ and supports us wholeheartedly. For now, our work is for these partners and the athletes and artists themselves. With the right tools, you have the power to rebuild the system from within, one person, one organization at a time.