Athletes and Body Dysmorphia

College athletes live in environments where their bodies are constantly being evaluated. They're measured for strength, speed, power, conditioning, body composition, recovery, and performance, while also being surrounded by mirrors, uniforms, social media, comparison, and expectations about what somebody in their sport or position is “supposed” to look like. That doesn't mean athletics causes body dysmorphic disorder, and we shouldn't use “body dysmorphia” as a catchall term for every athlete who struggles with body image. It does mean coaches need to understand that body image concerns are real in college athletics and can become serious.

The NCAA's research involving more than 23,000 student athletes gives us a pretty clear reason to pay attention. In that study, athletes in women's sports reported substantially lower positive body image than athletes in men's sports, and 45 percent of women surveyed reported trying to lose weight while more than 40 percent of men reported trying to gain weight. [oai_citation:0‡NCAA.org](https://www.ncaa.org/what-we-do/research/studies/student-athlete-health-and-wellness-study/?utm_source=chatgpt.com) Those numbers don't mean all of those athletes have a mental health disorder, but they do tell coaches that conversations about bodies, weight, food, and appearance aren't harmless background noise.

Understanding What We're Actually Talking About

Body dysmorphic disorder, commonly called BDD, is more serious than occasionally looking in the mirror and wishing something about your body looked different. It's a mental health condition involving significant preoccupation with perceived flaws or defects in appearance that may be minor or not observable to other people. That preoccupation can lead to repetitive behaviors, significant distress, and problems functioning in everyday life.

That's an important distinction for coaches because we're not qualified to diagnose an athlete based on what we notice in the locker room or weight room. We can recognize that something isn't right, have a conversation, document concerns when appropriate, and connect the athlete with qualified professionals.

We need to know where our lane ends.

We also need to understand that body image problems in athletes don't always look the way people expect them to. An athlete doesn't have to look unhealthy to be struggling, and athletic performance doesn't tell us what's happening inside somebody's head. Somebody can be strong, conditioned, successful, and performing at a high level while becoming increasingly consumed with their appearance, weight, food, or body.

That's why coaches can't assume, “They're playing well, so they must be fine.”

The Role of the Coach

Coaches have enormous influence over how athletes think about their bodies, whether we intend to or not. A careless comment about weight, appearance, somebody “looking heavy,” needing to “lean out,” or what an athlete's body used to look like can stick with them a hell of a lot longer than the coach who said it remembers.

We have to be smarter than that.

That doesn't mean coaches can never discuss strength, conditioning, nutrition, recovery, or legitimate performance needs. College athletics requires physical development, and pretending bodies have nothing to do with athletic performance would be ridiculous. What matters is how those conversations happen, why they're happening, and whether the people having them are actually qualified to give the guidance they're giving.

Coaches should coach performance. Strength and conditioning professionals should handle appropriate physical development. Sports dietitians and other qualified nutrition professionals should address nutrition needs, and mental health professionals should handle mental health treatment.

A coach shouldn't become an athlete's therapist because we care about them.

Our job is to recognize, support, refer, and continue treating the athlete like a human being instead of turning their struggle into another performance problem that needs to be fixed before Saturday.

That also means creating a culture where athletes aren't constantly hearing their bodies discussed as though they're public property. Teammates don't need to comment on somebody else's weight, food, body shape, or appearance, and coaches shouldn't normalize that behavior either.

Sometimes protecting athletes starts with shutting down conversations we've allowed to become normal.

Support Without Trying to Fix Them Yourself

When an athlete tells a coach they're struggling with their body image, that conversation needs to be handled carefully. They don't need a coach immediately saying, “That's crazy, you look great,” because although the intention may be good, body dysmorphic disorder isn't corrected by somebody else reassuring the person that they're attractive.

They need to be heard.

Ask what's been going on, listen without immediately trying to solve it, and help connect them with the appropriate professional support. Depending on what they're experiencing, that may involve sports medicine staff, a licensed mental health professional, a physician, or a sports dietitian.

And then keep coaching them like a person.

Don't start acting weird around them. Don't make them feel fragile, don't gossip about what they told you, and don't turn every bad practice into evidence that their mental health is falling apart. Respect appropriate confidentiality while following institutional policies and any safety obligations that apply.

There's also a difference between support and enabling. If an athlete's health or safety is at risk, coaches can't protect their playing time at the expense of protecting the athlete. Sometimes loving somebody means being willing to make a decision they're going to be pissed about today because their health matters more than what they can contribute to your lineup tomorrow.

If our concern for an athlete disappears the moment their struggle becomes inconvenient for our program, it wasn't much of a concern to begin with.

Faith Can Help Without Replacing Treatment

For Christian athletes, faith can be an important source of identity, community, prayer, hope, and perspective while they're struggling, but we need to be very careful not to turn faith into a substitute for professional treatment.

Telling somebody with a mental health condition to pray more, trust God harder, or memorize enough Scripture can create shame on top of something they're already struggling to understand. An athlete can deeply love God, pray consistently, know Scripture, and still need professional mental health care.

Those things aren't enemies.

Psalm 139 is often brought into conversations about body image, and there's good reason for that, but we should use it for what it actually says instead of turning it into a Christian body positivity slogan.

Psalm 139:13 through 14 (ESV) says, “For you formed my inward parts; you knitted me together in my mother's womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well.” [oai_citation:1‡ESV Bible](https://www.esv.org/verses/Psalm%2B139%3A13%E2%80%9314/?utm_source=chatgpt.com)

David isn't telling us that everybody should look in the mirror and love every physical feature they see. Psalm 139 is about something much deeper. David is overwhelmed by God's complete knowledge of him and God's intimate involvement in creating him. The chapter begins with David acknowledging that God has searched him and knows him, knows his thoughts, knows his ways, and is present wherever he goes. [oai_citation:2‡ESV Bible](https://www.esv.org/Psalm%2B139/?utm_source=chatgpt.com)

That's a much stronger foundation than telling a struggling athlete, “You're beautiful just the way you are.”

Your body doesn't have to meet somebody else's standard for God to know you completely.

For Christian athletes dealing with distorted thoughts about their appearance, that truth can become part of a much larger process of learning where their identity actually rests. Their identity can't live in a mirror, on a scale, in a uniform, inside a recruiting profile, or in somebody else's opinion about whether they have the “right” body for their sport.

Sports will measure the hell out of you if you let them.

There will always be another number. Another athlete will be taller, leaner, stronger, faster, more muscular, more explosive, or built differently. If your peace requires winning every comparison, you're signing yourself up for a competition you can never finish.

That doesn't mean Scripture magically shuts off intrusive or obsessive thoughts associated with a mental health condition. It means Christian athletes have a truth deeper than those thoughts to return to while they're also getting the help they need.

Building a Healthier Team Culture

Coaches also need to examine the environments we're creating because we can't preach mental health awareness in August and then spend the rest of the year casually contributing to the exact pressures we're claiming to care about.

Listen to how your staff talks about athletes' bodies. Listen to what teammates say to each other in the weight room and locker room. Pay attention to whether food gets labeled in moral terms, whether athletes are praised for losing weight without anybody knowing why they lost it, and whether certain body types are treated like evidence of discipline while others are automatically treated like evidence of laziness.

We need to stop confusing appearance with character.

A particular body doesn't prove somebody works harder, cares more, eats better, or has greater discipline. Coaches see only a fraction of what is happening in an athlete's physical and mental health, which is exactly why qualified professionals need to be involved when concerns arise.

The NCAA's research also found that student athletes specifically wanted more conversations from coaches and athletic administrators about nutrition, mental wellness, weight management, and body image. [oai_citation:3‡NCAA.org](https://www.ncaa.org/media-center-student-athletes-in-womens-and-mens-sports-report-stark-difference-in-perceptions-of-weight-and-body-image/?utm_source=chatgpt.com) That doesn't mean coaches need to become experts in all four areas. It means athletes are telling us these things matter to them, so we'd better know enough to take them seriously and bring the right people into the conversation.

Performance Can't Be the Only Thing We Protect

College athletics has a bad habit of paying attention to health when health starts affecting performance. If an athlete is still producing, we can convince ourselves they're fine because acknowledging otherwise might require us to do something uncomfortable.

We have to be better than that.

An athlete shouldn't have to completely fall apart before somebody notices they're struggling. Coaches spend an incredible amount of time around their athletes, which puts us in a position to notice changes and ask questions, but it doesn't make us diagnosticians. When something concerns you, don't diagnose it and don't ignore it. Start the conversation and get qualified people involved.

For Christian coaches, there's another layer of accountability because if we're going to tell athletes they're more than what they produce, our behavior better prove we actually believe it.

That means the starting outside hitter matters when she isn't hitting .300. The injured athlete matters when they can't contribute a point. The athlete struggling mentally matters even when supporting them becomes complicated, and the person underneath the uniform has to matter more than what their body can do for our program.

That's where our theology gets tested.

It's easy to tell athletes they're fearfully and wonderfully made when they're healthy, confident, and performing well. The harder question is whether we still treat them like somebody created and known by God when they're struggling with something we don't understand, when recovery isn't moving fast enough for our season, or when protecting their health costs us something competitively.

Christian coaches shouldn't use faith to minimize body dysmorphic disorder, and we shouldn't hand an athlete Psalm 139 and act like we've completed our responsibility. We can pray with them if they want prayer, encourage them spiritually, help connect them with Christian community if that's meaningful to them, and remind them that their identity is bigger than their appearance or athletic performance.

Then we help them get qualified care.

There's nothing unspiritual about that.

Athletes don't need coaches who are scared to address difficult things, but they also don't need coaches who think every problem can be solved with toughness. Body dysmorphic disorder isn't weakness, vanity, attention seeking, or an athlete needing somebody to tell them to stop worrying about what they look like.

Take it seriously.

Listen before you lecture, watch the language being used inside your program, stay inside your professional lane, involve qualified professionals, and make damn sure your athletes know that asking for help isn't going to change the way you see them.

We can demand excellence without demanding perfection, coach bodies without reducing people to bodies, and care about performance without making performance the price athletes have to pay to receive our care.

That's the standard.