022 - Safe to Play: Returning to Sport After an Eating Disorder (with Megan Hellner and Katherine Hill)

Episode 022

Safe to Play: Returning to Sport After an Eating Disorder (with Megan Hellner and Katherine Hill)

In this episode, Jenni Gaines and Laura Cohen sit down with Dr. Katherine Hill, a board-certified physician and former NCAA Division I swimmer, and Dr. Megan Hellner, a registered dietitian and researcher, the co-founders of AthleatMD, to talk through one of the questions caregivers ask most: when is it safe for an athlete to return to sport after an eating disorder? Katherine and Megan explain what makes athletes a unique population, why weight suppression and stress fractures so often get missed, and how RED-S (Relative Energy Deficiency in Sport) overlaps with eating disorders across all genders and sports. They walk through early warning signs, the medical red flags that warrant pulling an athlete from training, and how to tell an athletic heart from a malnourished one. Laura also shares her own lived experience as a dietitian who missed the signs in her gymnast daughter. Listeners will come away with a hopeful, practical roadmap for a low-and-slow return to sport, guidance on working with coaches and athletic staff, and specific tools, including the SEES return-to-activity guidelines, to bring to their own care team.

00:00 Introduction and Disclaimer

01:40 Guest Introductions: Katherine Hill and Megan Hellner

04:00 What Makes Athletes a Unique Population

08:00 Higher-Risk Sports and Early Warning Signs

12:30 Laura's Lived Experience: Stress Fractures and Weight Suppression

16:40 What Is RED-S and Low Energy Availability

20:00 Low Testosterone and Missed Signs in Male Athletes

24:00 ARFID, Underfueling, and Overtraining

28:00 Bradycardia and Medical Red Flags to Stop Training

32:45 Deciding Whether to Step Away from Competition

37:15 Coaches, Schools, and How Much to Share

47:15 Returning to Sport and the SEES Guidelines

SUPPORT & RESOURCES - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

FEAST website:

https://feast-ed.org/

FEAST programs and services:

https://feast-ed.org/programs-and-services/

AthleatMD:

https://www.athleatmd.com/

FEAST webinar — Helping Parents of Athletes Navigate Return to Sport While Battling RED-S and/or Eating Disorders:

https://www.youtube.com/watch?v=OIpNYWqMkB0

SEES — Safe Exercise at Every Stage guidelines:

https://www.safeexerciseateverystage.com/sees-guidelines

Guest Bios:

Katherine Hill, MD, is a board-certified physician, eating disorder specialist, and co-founder of AthleatMD. She completed her undergraduate degree, medical degree, and clinical training at Stanford University, where she later joined the faculty in Adolescent Medicine. She went on to serve as the lead physician at Equip Health for four years before launching AthleatMD with Megan Hellner. A former NCAA Division I swimmer, Dr. Hill brings both clinical expertise and lived athletic experience to her work with athletes navigating eating disorders, RED-S, and the pressures of sport.

Dr. Megan Hellner is a registered dietitian, researcher, and co-founder of AthleatMD, where she specializes in helping athletes and individuals recover from eating disorders and Relative Energy Deficiency in Sport (RED-S). For more than two decades, she has served as the founding dietitian for some of the nation's leading eating disorder treatment programs. She is passionate about giving caregivers the knowledge, tools, and reassurance they need to confidently support their loved one's recovery journey.