PART 2 “I think my body image issues and difficulty with eating is impacting my sporting performance, what should I do?”
The following BASE Journal entry was written by Christen Christen-Lee Bezuidenhout. Christen is an Accredited Practicing Dietitian (APD) based in QLD and NSW, Australia.
PLEASE NOTE: This Journal post comprehensively unpacks understanding RED-S, The Relationship Between Under-fuelling for Performance, Food Relationships, and Body Image Among Athletes in Competitive Sports.
We have shared this journal in 2 parts
Part 1 - How can undereating impact my sporting performance?
Part 2 - I think my body image issues and difficulty with eating is impacting my sporting performance, what should I do?
We encourage reading both journals in order at your own pace.
My Clinical Experience with RED-S
Within my private practice experience as a dietitian, I’ve worked with quite a few young athletes in particular experiencing RED-S. Some as young as 15 have presented with a history of stress fractures, amenorrhoea, mood disruptions, and disordered eating behaviours. Generally, these individuals are often high-achieving, are dedicated to their sports performance and are also sometimes influenced by social media figures promoting unrealistic athletic body shapes’ with confusing and conflicting non-evidence-based nutrition messages as well as societal pressures inflicted in the school environment, or even at home from family members.
Competitive sports culture and social media at times can unfortunately play such a significant and influential role, among young and impressionable athletes in promoting leanness, “clean eating”, restrictive intake with/without restriction of specific core food groups as prerequisites to attain X body shape and/or size. Unfortunately, some sporting and athletic organizations reinforce behaviours that can be quite harmful to a young person’s relationship with food, body image and confidence. As healthcare professionals, I find it quite an important topic to raise awareness on, and advocate for better health and nutrition education for athletes, coaches, and sports organizations.
Strategies to Overcome Disordered Eating Behaviours and Negative Body Image
Recovery from RED-S is possible, however it requires a shift in mindset and approach to food, professional guidance, and very often requires a multidisciplinary approach.
Here are some of the strategies that have helped my clients in identifying and addressing disordered eating behaviours and thoughts associated with food and body image (as one of the causes of RED-S symptoms)
1. Assess Food Beliefs
Ask yourself:
Am I restricting foods to achieve a specific body shape?
Am I dissatisfied with my body after eating a specific food?
Do I feel guilt or anxiety around eating?
Am I choosing “healthier” options out of fear rather than nourishment?
Do I feel the need to “burn off” any calories that I may have consumed through my food?
After looking at some social media accounts that promote a certain body shape, do I feel guilty about my body? Do I then feel the need to either do one or both of the following: restrict my intake or exercise excessively?
Identifying these thought patterns is the first step in shifting towards a healthier mindset with food and body image.
2. Reframe Negative Body Image Thoughts
Use the ‘Cognitive Restructuring’ method - for every single negative thought about your body, challenge it with three positive statements about your skills, personality, or strengths.
Cognitive restructuring is an evidence-based technique that challenges maladaptive thought patterns. By replacing negative body-related thoughts with positive affirmations regarding your skills, personality, or strengths, individuals can reframe cognitive distortions. This promotes healthier cognitive schemas, boosts self-esteem, and supports a balanced self-concept. Research highlights its’ efficacy in reducing body dissatisfaction and improving mental health by fostering a more adaptive mindset.
3. Increase Energy Intake to Support Regular, Adequate and Balanced Eating
Eat regular meals of adequate size (Breakfast, Lunch and Dinner) - Including a source of carbohydrates, fibre from vegetables/salads, lean protein and healthy fats.
Eat snacks every 3 - 4 hours.
Prioritize carbohydrates for energy.
Include healthy fats and lean protein sources to support hormonal health.
Don’t skip pre-training easy-digesting carbohydrates!
Don’t skip post-training recovery meals - protein and carbohydrates are key!
4. Adjust Training If Needed
Sometimes, reducing training intensity or volume temporarily allows the body to recover and restore energy balance.
5. Seek Professional Support
Overcoming RED-S is about more than just eating more - it involves retraining your mindset around food beliefs, nourishment, exercise, and performance.
NOTE: The above examples are foundational nutrition strategies that I utilise to support adequate energy intake and address disordered eating behaviours/patterns in young athletes experiencing RED-S symptoms. If you do experience any of the following symptoms of RED-S or identify with any of the disordered eating behaviours as mentioned above, please seek help from your Doctor/Paediatrician to assess your medical status as well as an Accredited Practicing Dietitian (APD) with knowledge and training in this area to receive tailored nutrition advice for your individual needs and health considerations.
Final Thoughts from Christen-Lee - Accredited Practicing Dietitian (APD)
Your body is your greatest asset in sports or athletic performance - it deserves to be nourished, not deprived. If you’re experiencing symptoms of RED-S, know that you’re not alone, and recovery is very possible with the right healthcare professional on your side, and a support system among friends and family. Adequate fuelling will not only protect your current and long-term health and nutrition status, but will also enhance your performance, energy, and overall mental, physical and psychological well-being.
Christen x