Many athletes struggle with eating disorders. These women want to change that.

Still, while National Eating Disorder Awareness Week (February 25-March 3) completes its 33rd year, Track 9 and other people investing in a positive impact know that there is still much work to be done. The National Eating Disorders Association (NEDA) estimates that about 30 million Americans struggle with an eating disorder at some point in their lives. Slowly, however, a reaction against the culture of the United States diet and its connection with exercise is steadily gaining ground.

Runners, many of them top-level contenders, are among the most active to help clarify the issue and for good reason: Research has shown that up to 47% of elite athletes in "lean" sports experience disorderly eating. Males can also be victims. Esther Atkins, the US marathon champion, is among those who raised their voices and spoke publicly.

Atkins herself has had a healthy overall relationship with food and sports over the years, but she knows many others who were not so lucky – including her sister. "What I realized is that eating disorders are a manifestation and a self-medication of another underlying mental condition," she says. "I believe the course of action to help prevent them is to remove the stigma so that people can more easily recognize and accept the problem and get help much earlier than historically."

That's where the Track 9 Project comes in. "We realize that we can help educate athletes, teachers, coaches and parents, as well as provide a way for the affected to share their stories," Caplan says. "It's been a grassroots approach and as people share their stories and awareness in their social circles, the word spreads."

Atkins and Caplan point to the role of society in contributing to eating disorders. "There's a lot of social pressure to be thin," Atkins says. "It is rooted in a young age that fat means lazy and sloppy. It is not fair and it hurts people. "

Society is starting to play a more positive role in this regard, however. "There are several movements that come together at the same time, such as #metoo and body positivity, which are removing shame and allowing people to tell their stories," Atkins says. "We need it more."

Talk needs to start early and everywhere.

Social media conversations, awareness, and education are positive steps in efforts to help decrease the prevalence of eating disorders. It is also bringing awareness to risk factors, especially for coaches, parents and health care providers, who often unintentionally contribute to the problem. "All three of us who founded Lane 9 had gaps in our health care experience when they sought help," says Caplan. "Often healthcare professionals just do not know what to do."

Atkins points to doctors who use BMI in adolescents over the age of 18 to determine the likelihood of a disorder. "A healthy BMI does not mean that someone has escaped an eating disorder," she says. "A disturbance can affect your life long before you show deterioration."

Jody Whipple, a nutritionist who often works with athletes at Penn State, says that although disordered eating is different in all cases, there are risk factors worth noting. "The influence of the family is enormous, especially in adolescence," she says.

Part and parcel of this is parental modeling of healthy body image and a "no-diet" approach. "Family meals are an important place to expose and communicate," says Whipple. "If there is any history of disorder, it is especially important to wear the glasses and use them for prevention."

The personality type is another factor. "Perfectionists will be more prone to a disorder," says Whipple, "while a relaxed personality who may see gray and is more flexible in his thinking will be more protected."

When it comes to outside influences, sports coaches can play an oversized role. "Coaches in many sports, unfortunately, have often created toxic environments," says Whipple. "It's important for coaches to emphasize success as a whole person, rather than just linking it to performance."

This is especially true in sports where weight is considered a performance factor. In many arenas, the lean are considered better, and when coaches manage to keep the conversation away, athletes improve the chances of a healthy body image.

Finally, there is the role of the media, for better or for worse. Unfortunately, there are plenty of social media influencers as well as traditional media, which associates exercise and food restriction with wrong results. "Information like this is not useful for a 100-pound athlete trying to get faster," says Atkins.