What is it about these particular sports that puts girls at greater risk? In the judged sports, says Johnson, girls compete in scanty or tight-fitting clothing and are thus concerned about “appearance thinness.” They know from experience that judges, influenced by popular culture, tend to reward thinness, independent of a girl’s skill in the sport. The gymnastics community, which has seen many ED victims and at least one well-publicized death (that of U.S. gymnast Christy Henrich), has been particularly at fault, says Johnson. He adds, however, that it has begun addressing this issue lately, with gymnasts’ weights going up again.

In endurance sports like running, athletes are more concerned with “performance thinness”—the belief that the lower their percentage of body fat, the better their performance will be. While that is often true for male endurance athletes, it’s a dangerous idea for women and girls, Johnson says.

Girls and women need more body fat
Women and girls need at least 17 percent body fat to menstruate, and 22 to 25 percent body fat for normal fertility. Combine dieting with a training regimen, and girl athletes often stop menstruating (a condition known as amenorrhea). Amenorrhea contributes to an obsession with food, leading to a vicious—and often deadly—cycle.

One of the scariest things about dieting, says Johnson, is that a subgroup of people seems to have a genetic liability related to weight loss. When the weight of those people drops too low, it triggers a compulsion to diet that takes on a life of its own—almost like alcoholism. “It’s a chemical crapshoot,” he says.

Despite these hazards, the NCAA survey found that fully 70 percent of female athletes aspired to get their body fat lower than the dangerous 17 percent threshold. “It’s male coaches trying to transfer their knowledge of male athletes and performance onto female athletes,” notes Johnson.

Training girls in a method that equates low body fat with peak performance can bring disastrous results, Johnson says. “All of us need to understand the risk of weight loss and realize that girls’ weight loss is not a benign behavior.”

What parents should know
In fact, eating disorders are often deadly. University of Minnesota psychiatrist and eating disorder specialist Dr. Scott Crow says EDs have the second highest death rates of any mental illness (only opium addictions are higher), and the highest suicide rates. In a 10-year study of anorexics, Crow found that 10 percent had died of their disease, either from suicide or from medical complications like heart failure.

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