Rebecca Quinlan – Written evidence (NPS0023)



As an adolescent I was a competitive athlete, being ranked in the top 30 in the UK as a teenager for the 400 metre hurdles, and I hoped to pursue it as a career. However, from the age of 14 I was trying to lose weight in order to become a better runner. It was when I started at Loughborough University and was training with athletes competing in the Olympics, Commonwealth Games and world championships, that anorexia truly started to take over my life. My dreams of becoming an Olympian slipped away as I fell into the grips of anorexia. I was admitted to an eating disorder hospital on the brink of death. For several years later, I was a revolving door patient and, on each admission into hospital, I was told it was touch and go if I survived. I am now in recovery and achieved a distinction in my Masters in Sport and exercise Physiology, after graduating from Loughborough University in 2015 with First Class Honours in Sport and Exercise Science. I am now a public speaker and deliver talks on eating disorders to universities, sports clubs, businesses and schools.


The following evidence addresses questions 4, 7, and 8:

Prioritising mental health, what can be done to improve duty of care, and how can national governing bodies be more accountable.


What is the issue?

  1. Level 1 Coaching qualifications in sport do not provide education on eating disorders.
  2. Many coaches do not know how to spot the signs and symptoms of eating disorders or what to do if they are worried about someone.

Why is this a problem?

  1. Athletes are at greater risk of developing eating disorders or disordered eating than the general population
  2. Because all athletes (both elite & amateur) are at risk of eating disorders, coaches need the knowledge of how to help prevent eating disorders, to spot the signs/symptoms and know how to intervene/help.
  3. Offering optional mental health/eating disorder CPD courses further along the coaching pathway is not adequate to ensure that all coaches of all levels are equipped with the necessary knowledge and awareness of eating disorders.


How do you know this is an issue – The Evidence

Athlete ED statistics

-          Prevalence of eating disorders is higher in athletes than the general population (13.5% vs 4.6%) (UK Sport - Sundgot-Borgen 2004)

-          Prevalence in female athletes is 20%, male athletes is 7.7% (UK Sport - Sundgot-Borgen 2004)

-          When disordered eating is included, the prevalence in athletes is estimated between 6-45% (Australian Institute of Sport 2020; Karrer 2020)

-          16% of 181 UK ranked middle/long distance female runners had an eating disorder (Hulley & Hill 2001)

FOI from UK sport

-          A Freedom of Information request from UK Sport outlined that eating disorders are not covered on any level 1 coaching qualifications as a standard practice (UK Sport 2020)

-          UK Sport indicated that National governing bodies can choose to add it or offer it as a standalone CPD opportunity (UK Sport 2020).

-          However, across all sports there is no evidence that any governing bodies have chosen to do this within the level 1 Coaching qualification. If any eating disorder training is offered, the majority of sports provide this as extra CPD once coaches have become more highly qualified. (UK Sport)

-          For example, British Athletics offer a course on Mental wellbeing in sport and physical activity however, this is an optional course and not included in any level of their coaching qualifications (British Athletics)

Research demonstrating coaches lack of knowledge of EDs

-          Two thirds of elite coaches did not consider eating disorders an issue in their sport despite the majority of them having coached athletes with eating disorders (Nowicka 13).

-          Coaches lacked the capacity to identify eating disorders, & know where/how to find & access support services for eating disorders, regardless of coaching level & whether training elite or club level athletes (Nowicka 2013; Plateau 2015).

-          Coaches do not have the knowledge to recognise the signs & symptoms of eating disorders & do not know how to approach athletes with a suspected problem (Sherman 2005)

-          In an American study, only 1 in 4 coaches felt confident in identifying an athlete with an eating disorder (Vaughan 2004)

-          US study of head coaches from NCAA found that coaches were not effective in identifying athletes with eating disorders/disordered eating (check nowicka)

-          “Coaches are insufficiently prepared for early intervention in cases of eating disorders in athletes.” (Nowicka 2013).


What can be done to improve duty care and to prioritise mental health?

  1. Compulsory eating disorder education on all level 1 coaching qualifications.
  2. Increased eating disorder education across the whole coaching pathway


Why is education needed?

Benefits of education

Professional Recommendations for education

The importance of education on Level 1 Qualifications

The role of the coach

Dangers of limited coaching knowledge of EDs

The dangers of EDs

25 January 2021