Can Coaches Tell Athletes to Lose Weight? Q&A with Dr. Paula Quatromoni

This Q&A was originally part of the first Q&A here, but is republished below to separate and make it easier to find questions/topics. This is part of a Q&A series with the leading expert in eating disorders and sports and registered dietitian, Paula Quatromoni. For more Q&As click here.

Q: Can coaches tell athletes to lose weight?

A (Dr. Quatromoni): Weight concerns should be managed by a qualified nutrition professional, not a coach. So if a coach has a concern about an athlete’s weight, he/she should express that concern to the nutrition professional (not to the athlete). The coach should let the nutritionist assess the athlete, determine whether weight change is appropriate, and initiate a proper plan of nutrition intervention.

The work between the nutritionist and the athlete should remain private and confidential. A coach should place full trust that the nutritionist is managing the case and monitoring the athlete’s progress towards goals. This allows the coach to focus interactions with the athlete on skill, technique, and training, not on weight.

A coach who tells an athlete to lose weight may be very well-intentioned and caring, yet he/she risks inducing a lot of collateral damage. First, the power of a head coach who determines who earns a spot in the starting line-up and who gets how much playing time makes messages about body shape and size very much tied to those highly coveted sports outcomes in the minds of student-athletes. Weight should not be used to make decisions about playing time and starting line-ups. Those coaching decisions should be based on performance, fitness, skill, and other indicators of readiness to play, not weight. No matter how carefully the coach tries to deliver a message about weight loss, the athlete is likely to hear it as a criticism or a judgment. This can be internalized by the athlete as, “I’m not good enough” because of their weight, shape, or size, threatening the athlete identity and undermining self-confidence.

Second, if a coach says, “drop 5 pounds,” the average athlete, so determined to please, will drop 10. One who is vulnerable to an eating disorder won’t stop there. Disordered thoughts and behaviors quickly become ingrained and the dieting and the weight loss become the sole focus. This can overshadow performance because the number on the scale becomes the most important indicator of success.

Third, it could be humiliating or devastating for an athlete to be told to lose weight by their coach, a trusted and highly respected authority figure, inducing tremendous psychosocial distress and damaging self-esteem.

Finally, and most importantly, if a coach tells an athlete to lose weight without connecting them to a qualified nutrition professional to help the athlete understand their unique nutritional needs and manage their weight (even if changes in body composition truly are indicated to benefit sport performance), they are contributing to potential problems.

Adolescents and young adults do not, on their own, have ready access to nutritionists to guide them in these pursuits. In a desperate attempt to do what the coach mandated, they will set off on their own. They would be vulnerable to restrictive eating habits and fad diets, over-train, and turn to a variety of other disordered behaviors. This can include laxative abuse and self-induced vomiting as a means of achieving a weight goal with no understanding of their nutritional needs for growth, development or fueling for sport. This strategy ultimately sabotages athletic performance and both emotional and physical well-being. Research shows that it predisposes athletes to eating disorders.

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Paula Quatromoni, DSc, MS, RD is a registered dietitian, academic researcher, and one of the country’s leading experts in the prevention and treatment of eating disorders in athletes. Dr. Quatromoni is a tenured associate professor of Nutrition and Epidemiology, and Chair of the Department of Health Sciences at Boston University where she maintains an active program of research. She publishes widely on topics including clinical treatment outcomes and the lived experiences of athletes and others with and recovering from eating disorders. In 2004, she pioneered the sports nutrition consult service for student-athletes at Boston University, and in 2016, she led the creation of the GOALS Program, an athlete-specific intensive outpatient eating disorders treatment program at Walden Behavioral Care where she serves as a Senior Consultant. Dr. Quatromoni is an award-winning educator. She earned her B.S. and M.S. degrees in Nutrition from the University of Maine at Orono, and her Doctorate in Epidemiology from the Boston University School of Public Health.