Sundgot-Borgen J, Larsen S. Pathogenic weight-control methods and self-reported eating disorders in female elite athletes and controls

Norwegian University of Sport and Physical Education, Oslo, Norway
Scandinavian Journal of Medicine and Science in Sports (Impact Factor: 2.9). 01/2007; 3(3):150 - 155. DOI: 10.1111/j.1600-0838.1993.tb00379.x


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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    • "This clearly distinguishes it from the non-pathogenic weight-control, which is purely functional and targeted in line with sport specific demands. Pathogenic refers to all unhealthy ways of controlling weight and can be carried out in two ways: gradual and rapid [10,15]. Gradual weight-control behaviour is a method of reducing or gaining weight in a more careful, continuous way, for example through restraint, selective eating or exercising over a longer period of time. "
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    ABSTRACT: Weight-control behaviour is commonly observed in a wide range of elite sports, especially leanness sports, where control over body weight is crucial for high peak performance. Nonetheless, there is only a fine line between purely functional behaviour and clinically relevant eating disorders. Especially the rapid form of weight manipulation seems to foster later eating disorders. So far, most studies have focussed on adult athletes and concentrated on manifest eating disorders. In contrast, our review concentrates on young athletes and weight-control behaviour as a risk factor for eating disorders. An electronic search according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement was performed using Pubmed, PsychInfo and Spolit. The following search terms were used: weight-control, weight-control behaviour, weight gain, weight loss, pathogenic weight-control behaviour and weight-concerns, each of them combined with elite athlete, young elite athlete, adolescent elite athlete and elite sports. Overall, data are inconsistent. In general, athletes do not seem to be at a higher risk for pathogenic weight concerns and weight-control behaviour. It does seem to be more prevalent in leanness sports, though. There is evidence for pathogenic weight-control behaviour in both genders; male athletes mostly trying to gain weight whereas females emphasise weight reduction. There is not enough data to make predictions about connections with age of onset. Young elite athletes do show weight-control behaviour with varying degrees of frequency and severity. In particular, leanness sports seem to be a risk factor for weight manipulation. Further research is needed for more details and possible connections.
    Journal of Eating Disorders 05/2013; 1(1). DOI:10.1186/2050-2974-1-18

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