Many female athletes struggle with eating disorders. These women want to change that.

Yet, while the national eating disorders awareness week (February 25 – March 3) is finishing its 33rd year, Lane 9 and others have invested in making a positive impact, knowing that there is still a lot of work to do. The National Eating Disorders Association (NEDA) estimates that about 30 million Americans are struggling with an eating disorder at some point in their lives. Gradually, however, a backlash against the American food culture and its binding to exercise takes place.

Runners, including many high-level competitors, are among the most striking in helping shed light on the problem and that is not for nothing: research has shown that as many as 47 percent of elite female athletes in "slenderness" sport disorderly food to experience. Men can also become victims. Esther Atkins, an American marathon champion, is one of those who raise her voice and speak openly.

Atkins herself has had a generally healthy relationship with nutrition and sport over the years, but she has known many others who have not been so happy – including her sister. "What I've realized is that eating disorders are a manifestation of and self-medicating for another underlying mental state," she says. "I believe that the way of acting to help prevent them is the stigma, so that people can recognize and accept the problem and get help much earlier than in the past."

This is where the Lane 9 project comes into play. "We are aware that we can train athletes, teachers, coaches and parents and provide a way for those affected to share their stories," says Caplan. "It's a grassroots approach and when people share their stories and awareness in their social circles, it spreads."

Both Atkins and Caplan point to the role of society in contributing to eating disorders. "There is so much social pressure to be skinny," says Atkins. "It is ingrained at a young age that fat means lazy and sloppy, it is not fair and it mans people."

In this respect, however, society is starting to play a more positive role. "There are several movements simultaneously, such as #metoo and positivity of the body, which remove the shame and allow people to tell their story," says Atkins. "We need more of that."

The conversation has to start early and everywhere

Conversations, awareness of social media and education are all positive steps in efforts to reduce the prevalence of eating disorders. This also applies to awareness of the risk factors, in particular for coaches, parents and caregivers, who often unintentionally contribute to the problem. "We've discovered holes in our health care experience for all three who have created Lane 9 when it comes to finding help," says Caplan. "Too often caregivers simply do not know what to do."

Atkins points out doctors who use BMI in adolescents over the age of 18 when determining the likelihood of a disorder. "A healthy BMI does not mean that someone has escaped an eating disorder," she says. "A condition can affect your life long before you show any deterioration."

Jody Whipple, RD, a dietitian who often works with athletes in Penn State, says that although disorderly food is different in any case, there are risk factors worth mentioning. "Family influence is huge, especially in adolescence," she says.

An essential part of this is parent modeling of a healthy body image and a "no diet" approach. "Family meals are an important place to exhibit and communicate this," says Whipple. "If there is a history of disorder, it is especially important to set up these glasses and use them for prevention."

Personality type is another factor. "Perfectionists will be more prone to a disorder," says Whipple, "while a relaxed personality who can see gray and be more flexible in his or her thinking will be more protected."

When it comes to external influences, sports coaches can play too big a role. "Coaches in many sports have unfortunately too often created toxic environments," says Whipple. "It's important for coaches to emphasize success as a whole person rather than just connecting with performance."

This is especially true in sports where weight is considered a performance factor. In many arenas, leaner is considered better, and when coaches can steer the conversation off, the athletes have improved their chances of a healthy body image.

Finally, there is the role of media, for better or worse. Unfortunately, there are numerous social media influencers, as well as traditional media, that have linked exercise and limited food, with the wrong outcomes. "Information like that is not useful for a 95-pound athlete who wants to get faster," says Atkins.