Athlete-Focused Eating Disorder Programming in Higher Levels of Care: Feasibility and Clinical Outcomes From a Naturalistic Setting

Why It Matters

Athlete‑specific programming fills a critical gap in eating‑disorder treatment, improving outcomes for a high‑risk population and potentially reducing dropout and relapse rates.

Key Takeaways

• 182 athletes attended minimum four specialized therapy groups.
• Dysfunctional exercise scores halved by discharge.
• ED symptoms fell below clinical cutoff at 12‑month follow‑up.
• Depression and anxiety showed large, sustained improvements.
• Early improvements remained stable through one‑year post‑treatment.

Pulse Analysis

Athletes face a disproportionate risk of eating disorders, with prevalence estimates reaching 45% in female and 19% in male elite competitors. Traditional treatment models often mandate complete exercise abstinence, a stance that can clash with athletes' identity and performance goals, leading to resistance and premature dropout. Recent clinical guidelines advocate for a nuanced, stage‑based approach that balances medical stability with psychological reintegration of sport‑related activity, yet empirical data on such tailored interventions remain scarce.

The Frontiers in Nutrition study evaluated a dedicated athlete‑focused curriculum embedded within partial hospitalization and intensive outpatient settings. Over a four‑year enrollment period, 182 participants who completed at least four group sessions were tracked from admission through 12‑month follow‑up. Linear mixed‑effects models revealed medium‑to‑large effect‑size reductions in dysfunctional exercise (d≈1.2), eating‑disorder severity (d≈1.7), clinical impairment (d≈1.8), depression (d≈1.1) and anxiety (d≈1.4). Notably, the most pronounced gains occurred between admission and mid‑treatment, and gains were maintained without significant relapse, suggesting that early, sport‑specific psychoeducation and identity work can catalyze durable recovery.

These findings have practical implications for treatment centers and sports medicine programs seeking evidence‑based strategies to engage athletic patients. Incorporating modules on RED‑S, body‑image pressures, and structured return‑to‑sport planning may enhance adherence and mitigate the injury‑risk profile associated with compulsive exercise. However, the study’s single‑arm design limits causal inference; future randomized trials comparing athlete‑focused versus standard care are needed to refine guidelines. As the field moves toward personalized mental‑health care, this research underscores the value of integrating athletic context into higher‑level eating‑disorder treatment.