International rugby referee Nigel Owens has been suffering with the eating disorder bulimia for almost 30 years, he said in an interview with the BBC.
Owens, international rugby's first openly gay referee, said the eating disorder had crossed over into his professional life as recently as last month.
The 46-year-old is a highly respected official in rugby, and was the referee for the 2015 World Cup final between Australia and New Zealand at Twickenham.
However, ahead of the airing of a BBC Panorama programme focused on eating disorders among men, the Welshman said that during England's tour of Argentina in June, where he was officiating, his bulimia returned.
"I thought I was in control but since making the Panorama programme, I've realised I'm not," he said.
"I came back from refereeing the England summer tour in Argentina a few weeks ago. While I was out there, I made myself sick three to four times."