This Q&A was originally a part of the first Q&A here, but was republished as a new post to separate and make it easier to find questions/topics. This is part of a Q&A series with leading expert in eating disorders and sports and registered dietitian, Paula Quatromoni.
For more Q&As click here.
Q: Should coaches weigh their athletes to make sure their weight doesn’t get too low?
A (Paula Quatromoni): Coaches should NOT be weighing athletes.
If necessary for concern about an eating disorder, weight should only be monitored by a sports medicine professional (MD, AT or Nutritionist) – not the coach. An athlete that a coach is concerned about their weight dropping too low needs medical evaluation and supervision, and most likely they need intervention and treatment as well. All of these tasks are beyond the scope of the coach’s expertise, making it clear that monitoring weight is not the coach’s responsibility.
In the case of a high school athlete with an ED concern, the pediatrician and the school’s AT need to be on the case; NOT the coach monitoring weights. If a coach monitors an athlete’s weight because he/she is concerned about the athlete’s weight dipping too low, he/she is providing a false sense of assurance that someone is watching the situation, but the person monitoring it is not trained to do so or to recognize the medical risks. This is not appropriate and is opening up liability that I would imagine a coach would not want if something went wrong.
By trying to manage it him/herself and by not calling it out as a problem of concern to the AT, the coach is condoning the ED behavior that the athlete is displaying and is missing the opportunity to send the right message to the athlete and the parents that there is a problem here of serious concern that requires full medical evaluation if this student is going to be allowed to participate in sport. In this situation, the coach would be delaying a potential diagnosis, delaying treatment interventions, and worsening the health outcomes for this athlete.
The coach would also be sending a message to other athletes on the team that ED behaviors are acceptable within the culture of the team because observable behaviors do not go unnoticed by teammates. Eating disordered behaviors are role modeled by teammates and become contagious if not addressed.
In collegiate settings, weight (if required or justified for a weight-class sport like crew or wrestling) should be monitored by a nutrition professional, sports medicine doctor, athletic trainer, or perhaps a strength and conditioning coach. Since not all collegiate athletic departments employ registered dietitians, the practices are highly variable. But most sports medicine professionals agree that, particularly outside of these weight-class sports, to avoid contributing to weight bias, stigma, body image concerns, dieting, or disordered eating or exercise behaviors, coaches should not have access to specific information about athletes’ weights.
Dr. Quatromoni is a senior consultant for Walden Behavioral Care, and one of the nation’s top minds on the intersection of sports nutrition and eating disorders. As a registered dietitian, she has more than a dozen years of experience working with athletes with disordered eating and has published several papers on both clinical experiences and qualitative research on recovery experiences of athletes. Dr. Quatromoni is the Department Chair of Health Sciences and a tenured associate professor of Nutrition and Epidemiology at Boston University where she maintains an active, funded research program. In 2004, she pioneered the sports nutrition consult service for student-athletes at Boston University. Dr. Quatromoni was named a 2016 Outstanding Dietetics Educator from the Nutrition and Dietetic Educators and Preceptors (NDEP) Council. 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.