How Families can Support Their Loved Ones While Integrating Exercise into ED Treatment by Amanda Tierney

Hello Sport Parents, let me introduce myself,

I am Amanda Schlitzer Tierney, MS, CSCS. I am the eating disorder & health at every size (HAES) informed and sensitive fitness professional at The Victory Program at McCallum Place and Owner/Founder of Discovering Balance: Fitness Coaching and Support. I am a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA) and have my Master’s in Sport Science and Exercise Psychology.

After almost losing a friend and teammate to an eating disorder (ED), I decided to solely focus my energy on helping competitive and recreational athletes/exercisers as they work to heal and rediscover their relationship to fitness and sport training while in ED treatment.

When I first started in the field of ED treatment in 2006 there were limited resources and guidance on how to safely reintegrate joyful movement and sport training into the treatment model. I felt quite alone in my role. I started having conversations with other eating disorder professionals on the significance of incorporating fitness training into treatment and providing specialized care to athletes/exercisers, as they work though the eating disorder recovery process.

For the past 15 years, I have been privileged to have matchless opportunities to immerse myself into the treatment process. I am truly grateful for the support, guidance and reassurance that I received in the beginning of my career as I navigated a way to mesh all of my passions into one job. Many individuals have shared that addressing the exercise component has been the “missing piece” of their recovery puzzle. It’s an honor to work side-by-side as our clients and athletes reintegrate exercise and sport training into their lives.

It’s been so wonderful seeing the network of eating disorder and sport and rehabilitation professionals continue to grow. I am overjoyed by the momentum around incorporating sport and joyful movement into ED treatment. The insights that I will share come from my lens and experience of working with athletes/exercisers undergoing ED treatment and my newly cherished role as a mom!

What role do you play as a strength and conditioning coach in eating disorder recovery?

My role is to help bridge the gap between research and clinical practice, as well as communicate and collaborate with all of the key players involved in the care and development of our patient-athletes. It’s important for me to meet each individual “where they are” and cultivate trust and transparency; to provide supervision, guidance and support during the challenging, yet important, work of (re)establishing a balanced and sustainable relationship to physical activity and sport training.

During the healing process, my hope is to create a compassionate and non-judgmental space to restore confidence and rediscover passion, both in sport and in life. I truly believe that with the right mix of supervision, support, clear guidance and intentional practice, an unbalanced familiarity with fitness can develop into a joyful experience that is both safe and sacred.

How families can support their loved ones while integrating exercise into ED treatment:

  • Early detection and referral is essential for the opportunity for optimal recovery
  • Be able to spot the signs and symptoms of eating disorders/unwholesome relationship to exercise
  • Get to know your local eating disorder treatment providers
  • Advocate for the appropriate care for your child
  • Verify that treatment providers are working within their scope of practice and expertise
  • Remember that eating disorders are not a sign of weakness
    • Eating disorders are medical conditions that need treatment
    • Eating disorders are considered a metabolic injury
  • Develop a supportive and non-judgemental space for communication
  • Communicate and collaborate with your child’s treatment team
  • Provide consistent messaging and support
  • Seek out ED informed and sensitive fitness professionals and coaches
    • Words have lasting meaning
  • Confirm that your child’s coaches are creating a safe and supportive training environment
  • Make sure coaches are:
    • encouraging proper fueling and training habits
    • emphasizing rest and recovery days
    • promoting sport-life balance
    • supporting interests outside of athletics
  • Be aware of the added sport and pressures that children face from coaches, peers, siblings, parents, judges, and the media which frequently can lead to increased body dissatisfaction, injury, decreased athletic performance and loss of passion for sport and life.
  • Monitor your child’s overall sense of well-being:
    • Levels of weakness and fatigue
    • Muscle loss and soreness that lingers longer than typically expected
    • Slow recovery times post physical exertion
    • Plateau or decline in strength, conditioning and overall performance
  • Understand that performance success in sport does not always equal good health
  • Educate yourself on the various factors and body functions that are impacted by improper fueling and training
    • See the International Olympic Committee’s consensus statement of Relative Energy Deficiency in Sport (RED-S – 2018)
  • Evaluate your own relationship with body, food and exercise
  • Be mindful of the messages you send to your children about food and weight
    • Explore how these messages impact your child
  • Show your child that you care about their short and long term health
    • Emphasize their overall well-being
  • Be willing and open to talk to your child able their struggles with unbalanced eating or risky exercise habits
  • Set boundaries to preserve your own emotional well-being

Please note that athletic performance may not initially decline. Performance may even be enhanced in the short term, but a low energy state is not sustainable and could create more health risks. Keep in mind that your child’s health may be dangerously compromised, even if they don’t display signs and symptoms of disordered eating. Their vital signs and labs may fall within normal ranges and it is common that a child may report feeling “fine” while underplaying their struggles and believing that they can manage their difficulties on their own! Remember, you are a key component in the recovery process by supporting your child and encouraging them to follow through with treatment appointment and recommendations. Hold the line with unified treatment guidelines, in a supportive and compassionate way. Parents, you play such an important and supportive role in the connection that your child has with their body, food and sport. Having a balanced relationship with fitness and sport training is absolutely possible!

*Original blog content created for Family Eating Disorders (FED) Connect.  To learn more about their services, visit