Sundgot-Borgen J, Larsen S. Pathogenic weight-control methods and self-reported eating disorders in female elite athletes and controls
To determine the use of pathogenic weight-control methods and prevalence of self-reported eating disorders (ED) among female elite athletes and non-athletic controls, the Eating Disorder Inventory (EDI) and a self-developed questionnaire were administered to the total population of Norwegian female elite athletes (n=603) and age- and home community-matched controls (n=522). The response rate in both athletes and controls was 86%; 97% of the athletes and 90% of the controls had body mass index (BMI) values within or below the optimal level (20–25). Athletes had a significantly lower mean BMI 20.8 (95% confidence interval (CI), 20.7–20.9) than controls 21.5 (95% CI 21.3–21.7). A similar fraction of the athletes (31%) and controls (27%) were dieting. Most athletes dieted to enhance performance (73%); most controls dieted to improve appearance (83%). Significantly more athletes (11%) than controls (7%) used pathogenic weight-control methods. Athletes competing in aesthetic and endurance sports were the leanest groups, and athletes competing in aesthetics, endurance- and weight-dependent sports most frequently reported the use of the more severe pathogenic weight-control methods. A similar fraction of athletes (22%) and controls (26%) were classified as being at risk of developing ED based on the subscale scores of the EDI. However, a higher fraction of athletes in aesthetics-, endurance-, and weight-dependent sports than athletes in technical sports, ballgames, power sports and non-athletic controls were classified as being at risk of developing ED. In contrast to previous reports, our results demonstrated that a number of athletes also competing in sports where the participants are considered less weight-conscious were using pathogenic weight-control methods (technical 10% and ballgames 8%). A similar percentage of athletes (12%) and controls (11%) actually reported having an ED.
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