A young woman sits on the floor and eats a bowl of cereal. She wears athletic clothes and tennis shoes.
A fixation on weight or dieting could indicate your young athlete is grappling with issues that could harm her health. (For Spectrum Health Beat)

Exercise is essential for girls, but problems can occur if they take in too few calories.

Young females who eat too little risk menstrual irregularity, weak bones and eating disorders. Among high school girls, only 1% have all three issues, but between 16% and 54% have one of them, and that increases the risk for developing the others.

In terms of eating issues, some sports are riskier than others—namely those that involve endurance or weight-classes and those that emphasize appearance, especially thinness.

Focusing on one sport only from an early age, having a difficult family life and a pattern of dieting are other risk factors.

Your daughter’s pre-participation physical should include screening questions to help identify potential problems early on.

But pediatricians don’t always recognize these issues. So parents should keep a watchful eye.

What are the red flags?

  • When she worries about her weight.
  • When her weight influences how she feels about herself.
  • When she carefully controls the amount of food she eats, and diets to meet physical requirements for her sport.

Physical signs of calorie restriction include missed periods, which is linked to low bone mineral density and the risk for stress fractures.

The first goal in resolving the situation is increasing calories for overall health. Rebalancing exercise expenditure and dietary intake can help a girl return to a normal weight and regular periods.

She may have to cut back on exercise, but include weight-bearing activities and take in calcium and vitamin D to build bone.

If a serious problem develops—if she refuses to eat more, for example—treatment involves a team approach.

A physician, dietitian, certified athletic trainer and behavioral health clinician should work together to address the eating disorder.