Possible Eating Disorder or Intentional Restriction

A coach observes restriction, purging behavior, compulsive extra exercise, intense body distress, or other eating-disorder warning signs.

Recognize

What to notice before you act

1/5

The situation

A coach observes restriction, purging behavior, compulsive extra exercise, intense body distress, or other eating-disorder warning signs.

Observable signs and patterns

Food rules or skipped meals become rigid or secretive.
The athlete expresses fear, guilt, or distress around eating or body changes.
Extra exercise continues despite injury, illness, or instructions to rest.
Purging, laxative use, binge episodes, or rapid functional change is disclosed or observed.

May be routine

A food preference without fear, impairment, or rigid restriction.
A temporary schedule problem that resolves with access.

Needs attention

Behavior is persistent, escalating, secretive, or impairing.
There is purging, acute medical symptoms, suicidality, self-harm concern, or inability to follow safety instructions.

Coach boundary: Coach scope is observe, protect, communicate, and refer. Do not diagnose, order testing, prescribe treatment, promise confidentiality, store detailed health histories, or override the school emergency action plan or a qualified clinician's participation instructions. Eating-disorder assessment, treatment, and return-to-sport decisions require an interdisciplinary clinical team.

Respond

What to say and do today

2/5

Opening script

“I care about your health, and I have noticed specific changes in eating, training, and how distressed you seem. I am not going to comment on your body or diagnose you. I cannot keep a safety concern secret, so I need to involve the adults and health professionals who can help.”

Neutral questions to ask

1How safe do you feel right now?
2Are you able to eat and drink enough to get through the school day?
3Have you been vomiting, using laxatives, or exercising to compensate for eating?
4Have you felt faint, had chest pain, or had a racing or irregular heartbeat?
5Are you thinking about hurting yourself?
6Which trusted adult should be with us as we make the next call?

Actions for today

Move the conversation away from teammates but keep it observable and consistent with school safeguarding policy.
Notify the parent or guardian and athletic trainer through the approved private process.
If immediate medical or psychiatric danger is possible, activate the emergency and crisis pathway.

Do not do this

Do not debate whether the athlete looks sick enough.
Do not ask for weight, calories, photos, detailed food logs, or proof.
Do not negotiate return to sport, provide therapy, or promise secrecy.

Act

Green, yellow, and red decisions

3/5

Green · Concern without acute signs

A single non-urgent observation
The athlete is medically stable and denies immediate danger

Document the observation and consult the athletic trainer or designated safeguarding lead the same day.

Yellow · Persistent or explicit behavior

Restriction, compulsive exercise, bingeing, purging, or marked distress is reported
Function, injury, mood, or training tolerance is changing

Contact the parent or guardian and interdisciplinary clinical team promptly; follow their written participation plan.

Red · Medical or psychiatric emergency

Fainting, chest pain, confusion, severe weakness, blood, seizure, acute dehydration, suicidality, self-harm intent, or inability to remain safe

Stop participation, stay with the athlete, activate the school's emergency action plan, and contact the parent or guardian through the approved process.

What happens to training

green: Do not add extra training or use exercise as a reward while the concern is reviewed.
yellow: Participation follows the clinician-led plan; coaches do not create a clearance test.
red: Stop participation and activate emergency support.

Implement

Make the response repeatable

4/5

Implementation objective

Make early reporting safe and keep all diagnosis and treatment with a qualified interdisciplinary team.

Weekly routine

1.Train staff on warning signs and neutral language.
2.Name one private reporting path.
3.Ban public body and food policing.
4.Keep emergency and mental-health contacts current.

Resources needed

School safeguarding policy
Emergency and crisis contacts
Interdisciplinary referral list
Secure incident-reporting channel

Owner: Athletic director or safeguarding lead owns policy; athletic trainer coordinates health referral.
Cadence: Review preseason and after any incident; do not conduct team self-screening exercises.
Cost and purchasing: Use existing school safety infrastructure; any outside clinical cost is a household and provider matter, not a team promise.

Who should be involved

Parent or guardian

Any meaningful concern involving a minor is referred.

Physician and athletic trainer

They assess medical stability and participation.

Eating-disorder-informed RDN and mental-health clinician

They provide specialized nutrition and psychological care.

Follow up and refer

Close the loop without becoming the clinician

5/5

Follow-up timing

Confirm adult handoff the same day; follow written clinical guidance thereafter.

Questions to recheck

Was the athlete transferred to an appropriate adult?
Is immediate safety addressed?
Are participation instructions documented?
Is team gossip or body talk being stopped?

How to know the response is working

A qualified team owns care.
The athlete has a safe, pressure-free route back to sport if and when cleared.
Coaches consistently avoid weight and food surveillance.

Copy-ready parent message

I am contacting you because of specific changes we observed in eating-related behavior, training, or distress. We are not diagnosing an eating disorder. This deserves prompt review by the athletic trainer and an eating-disorder-informed clinical team, and we will follow their participation guidance.

Brief documentation template

Only observable behavior and exact safety statementsDate, time, and locationImmediate actionAdults and professionals contactedParticipation direction received

Evidence and scope

Coach scope is observe, protect, communicate, and refer. Do not diagnose, order testing, prescribe treatment, promise confidentiality, store detailed health histories, or override the school emergency action plan or a qualified clinician's participation instructions. Eating-disorder assessment, treatment, and return-to-sport decisions require an interdisciplinary clinical team.

Open the paired athlete handout

This guide is general education for school sport operations. Follow current school policy, the venue-specific emergency action plan, safeguarding requirements, and written instructions from qualified health professionals.

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All coach protocols

Possible Eating Disorder or Intentional Restriction

A coach observes restriction, purging behavior, compulsive extra exercise, intense body distress, or other eating-disorder warning signs.

Recognize

What to notice before you act

1/5

The situation

A coach observes restriction, purging behavior, compulsive extra exercise, intense body distress, or other eating-disorder warning signs.

Observable signs and patterns

Food rules or skipped meals become rigid or secretive.
The athlete expresses fear, guilt, or distress around eating or body changes.
Extra exercise continues despite injury, illness, or instructions to rest.
Purging, laxative use, binge episodes, or rapid functional change is disclosed or observed.

May be routine

A food preference without fear, impairment, or rigid restriction.
A temporary schedule problem that resolves with access.

Needs attention

Behavior is persistent, escalating, secretive, or impairing.
There is purging, acute medical symptoms, suicidality, self-harm concern, or inability to follow safety instructions.

Respond

What to say and do today

2/5

Opening script

Neutral questions to ask

1How safe do you feel right now?
2Are you able to eat and drink enough to get through the school day?
3Have you been vomiting, using laxatives, or exercising to compensate for eating?
4Have you felt faint, had chest pain, or had a racing or irregular heartbeat?
5Are you thinking about hurting yourself?
6Which trusted adult should be with us as we make the next call?

Actions for today

Move the conversation away from teammates but keep it observable and consistent with school safeguarding policy.
Notify the parent or guardian and athletic trainer through the approved private process.
If immediate medical or psychiatric danger is possible, activate the emergency and crisis pathway.

Do not do this

Do not debate whether the athlete looks sick enough.
Do not ask for weight, calories, photos, detailed food logs, or proof.
Do not negotiate return to sport, provide therapy, or promise secrecy.

Act

Green, yellow, and red decisions

3/5

Green · Concern without acute signs

A single non-urgent observation
The athlete is medically stable and denies immediate danger

Document the observation and consult the athletic trainer or designated safeguarding lead the same day.

Yellow · Persistent or explicit behavior

Restriction, compulsive exercise, bingeing, purging, or marked distress is reported
Function, injury, mood, or training tolerance is changing

Contact the parent or guardian and interdisciplinary clinical team promptly; follow their written participation plan.

Red · Medical or psychiatric emergency

Fainting, chest pain, confusion, severe weakness, blood, seizure, acute dehydration, suicidality, self-harm intent, or inability to remain safe

Stop participation, stay with the athlete, activate the school's emergency action plan, and contact the parent or guardian through the approved process.

What happens to training

green: Do not add extra training or use exercise as a reward while the concern is reviewed.
yellow: Participation follows the clinician-led plan; coaches do not create a clearance test.
red: Stop participation and activate emergency support.

Implement

Make the response repeatable

4/5

Implementation objective

Make early reporting safe and keep all diagnosis and treatment with a qualified interdisciplinary team.

Weekly routine

1.Train staff on warning signs and neutral language.
2.Name one private reporting path.
3.Ban public body and food policing.
4.Keep emergency and mental-health contacts current.

Resources needed

School safeguarding policy
Emergency and crisis contacts
Interdisciplinary referral list
Secure incident-reporting channel

Owner: Athletic director or safeguarding lead owns policy; athletic trainer coordinates health referral.
Cadence: Review preseason and after any incident; do not conduct team self-screening exercises.
Cost and purchasing: Use existing school safety infrastructure; any outside clinical cost is a household and provider matter, not a team promise.

Who should be involved

Parent or guardian

Any meaningful concern involving a minor is referred.

Physician and athletic trainer

They assess medical stability and participation.

Eating-disorder-informed RDN and mental-health clinician

They provide specialized nutrition and psychological care.

Follow up and refer

Close the loop without becoming the clinician

5/5

Follow-up timing

Confirm adult handoff the same day; follow written clinical guidance thereafter.

Questions to recheck

Was the athlete transferred to an appropriate adult?
Is immediate safety addressed?
Are participation instructions documented?
Is team gossip or body talk being stopped?

How to know the response is working

A qualified team owns care.
The athlete has a safe, pressure-free route back to sport if and when cleared.
Coaches consistently avoid weight and food surveillance.

Copy-ready parent message

Brief documentation template

Only observable behavior and exact safety statementsDate, time, and locationImmediate actionAdults and professionals contactedParticipation direction received

Evidence and scope

Open the paired athlete handout