The Female Athlete Triad, Anorexia Nervosa, and Bulimia Nervosa

The Female Triad

The three main components to make up the female athlete triad would consist of menstrual dysfunction, eating disorder, and low bone density (Benardot, 2012, p.218). Based on surveys, females tend to under-consume which potentially increases their chances of developing some form of eating disorder. Potential eating disorders and malnutrition may lead toward reproductive issues for females, commonly developing amenorrhea or oligomenorrhea (Benardot, 2012, p.219).

Anorexia nervosa

The psychiatric disease, anorexia nervosa, is classified by the status of low-weight from self-induced starvation. This disease is associated with hormonal adaptations, such as functional hypothalamic amenorrhea, nonthyroidal illness syndrome, and GH resistance, in which minimize energy expenditure in the setting of low nutrient intake (Fazelo, & Klibanski, 2018).

Bulimia nervosa

Bulimia nervosa is a disease in which the individual performs recurrent binge eating episodes, “accompanied by a feeling of lack of control over eating” (). The individual with bulimia nervosa might self-induce vomit or innapproriately consume laxatives to prevent gaining any weight. When evaluating the likelihood of treatment recovery, researchs utilize binge/purging episode frequency prior to treatment as a factor on success rate (Skunde, et al., 2016).

In the instance that I find an athlete displaying symptoms of the female athlete triad, I would honestly first consult with the sports psychologist and come up with a game plan of approach. Typically the immediate coach is the lifeline, while the nutritionist and psychologist are supplemental to the program. If I am the individual noticing the symptoms, I would probably consult with the psychologist and coach together as a staff meeting to collaborate on whether this is one individual or a group, how often these symptoms are occuring, and whether there should be immediate action on our part. Although rough in some cases, it should be your obligation to confront the athlete, confidentially, to address any concerns you may have. If the athlete does not confess to any form of inappropriate dietary habits, then I would emphasize the importance nutrition places in both performance and general health. It is honestly a tough question, because we may all come across this issue one day as health professionals. Any if you are not even part of a university or high school, then what supervisor or direct authority do you turn to? What if you were a strength and conditioning coach at a gym, and your client displays symptoms of an eating disorder? How would you address the issue with your client, and who would you turn to for advice?


Benardot, D. (2012). Advanced Sports Nutrition (2nd ed.). Champaign, IL: Human Kinetics

Fazeli, P. K., & Klibanski, A. (2018). Effects of Anorexia Nervosa on Bone Metabolism. Endocrine reviews, 39(6), 895–910.

Skunde, M., Walther, S., Simon, J. J., Wu, M., Bendszus, M., Herzog, W., & Friederich, H. C. (2016). Neural signature of behavioural inhibition in women with bulimia nervosa. Journal of psychiatry & neuroscience : JPN, 41(5), E69–E78.

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