Article

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

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Abstract

The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants were 204 college athletes (M age=20.16 years, SD=1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88 years (SD=16.68 years) and on their college team for 2.10 years (SD=1.03 years). Participants completed a demographic and weight background questionnaire, Questionnaire for Eating Disorder Diagnoses, and the Bulimia Test-Revised. The authors classified participants as eating disordered (n=4, 2.0%), symptomatic (n=52, 25.5%), and asymptomatic (n=148, 72.5%). Few participants engaged in binge eating; most used exercise, as opposed to vomiting, dieting, laxatives, or diuretics, to control their weight. Female athletes suffer from eating disorders, and most experience symptom levels that are subclinical but problematic.

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... 22,23 In addition, perfectionism and a drive to succeed, two characteristics that make an athlete a "good" athlete, have been frequently linked to female athlete eating disorders and disordered eating behaviors. 24, 25 Greenleaf and colleagues 26 note that while many female athletes demonstrate disordered eating behaviors, the majority of them manifest these behaviors at subclinical, yet problematic, levels. Although only 2% of the sample met the criteria for an eating disorder, 25% of the sample was identified as symptomatic, meaning they demonstrated subclinical levels of disordered eating. ...
... Although only 2% of the sample met the criteria for an eating disorder, 25% of the sample was identified as symptomatic, meaning they demonstrated subclinical levels of disordered eating. 26 Disordered eating behaviors may take a variety of forms, yet all of these unhealthy eating behaviors may "have significant maladaptive effects on development, and ultimately lead to a clinically diagnosable eating disorder or obesity". 5 The development of disordered eating behaviors in male athletes has been attributed to a combination of societal pressures, messages, and ideals that promote "norms" about weight, appearance, and masculinity. ...
... These findings were further supported through the interviews, where participants made statements like "I think body image is probably a big thing for most of the girls on my team" and "I would say body image is more of an issue than like eating behaviors," and are consistent with prior research, which suggests that for college athletes, body image concerns may be present in the absence of clinically diagnosable eating disorders, and therefore, tend to appear with greater frequency. 26 While these findings do not necessarily indicate clinical diagnoses of eating disorders, they do suggest that body image concerns and negative thoughts regarding eating are present in the population. ...
Article
Objective To examine the presence of body image concerns, drive for muscularity, and disordered eating behaviors in collegiate student-athletes. Participants One hundred and one NCAA Division I student-athletes participated in Phase I; 15 of these also participated in Phase II. Methods This study employed a mixed method, sequential explanatory design. Participants first completed survey measures assessing body image concern, drive for muscularity, and eating behaviors. These results influenced open-ended, semi-structured interviews, which were thematically analyzed. Results Body image and disordered eating behaviors were of greater concern than drive for muscularity. Student-athletes reported engaging in eating behaviors as opposed to not eating, yet these eating behaviors trended toward disordered behaviors such as obsessive “healthy eating” or orthorexia. Conclusions This study took a novel methodological approach to examining student-athlete body image and eating behaviors. Results emphasize the need for further support and education for student-athletes around body image and eating behaviors.
... Females participating in aesthetic sports (e.g., gymnastics, figure skating, cheerleading) are at an increased risk for eating disorders (EDs) and pathogenic behaviors-binge eating, purging, self-induced vomiting, use of diet pills or laxatives, and fasting-compared to non-aesthetic sports and non-athletes [3,[5][6][7][8][9][10][11][12][13][14]. Currently, several studies included the cheerleading population when examining ED risk [1,4,[15][16][17]; however, none are focused on the younger populations, specifically under the 18-year-old threshold. Of these studies, the majority are outdated [1,[15][16][17], used extremely low sample sizes (i.e., n = 1) [15], and included many other sports [15,16]. ...
... Currently, several studies included the cheerleading population when examining ED risk [1,4,[15][16][17]; however, none are focused on the younger populations, specifically under the 18-year-old threshold. Of these studies, the majority are outdated [1,[15][16][17], used extremely low sample sizes (i.e., n = 1) [15], and included many other sports [15,16]. The risk of ED for cheerleaders ranged from 13-33%, with the flyer position being at the highest risk [1,3]. ...
... Currently, several studies included the cheerleading population when examining ED risk [1,4,[15][16][17]; however, none are focused on the younger populations, specifically under the 18-year-old threshold. Of these studies, the majority are outdated [1,[15][16][17], used extremely low sample sizes (i.e., n = 1) [15], and included many other sports [15,16]. The risk of ED for cheerleaders ranged from 13-33%, with the flyer position being at the highest risk [1,3]. ...
Social agents associated with cheerleading environments are increasingly linked to body image dissatisfaction (BID) and eating disorders (ED). This study examined ED risk across team type, squad type, and position. An additional purpose determined BID in clothing type (daily clothing, midriff uniform, and full uniform), and meta-perceptions from the perspective of peers (MP peers), parents (MP parents), and coaches (MP coaches). Female cheerleaders (n = 268) completed an online survey which included demographics, the Eating Attitudes Test-26, and pathogenic behavior questions. Body image perceptions were assessed by using the Sex-Specific Figural Stimuli Silhouettes. Overall, 34.4% of cheerleaders (n = 268; mean age: 17.9 ± 2.7 years) exhibited an ED risk. Compared to All-Star cheerleaders, college cheerleaders demonstrated significant higher ED risk (p = 0.021), dieting subscale scores (p = 0.045), and laxative, diet pill, and diuretic use (p = 0.008). Co-ed teams compared to all-girl teams revealed higher means for the total EAT-26 (p = 0.018) and oral control subscale (p = 0.002). The BID in clothing type revealed that cheerleaders wanted to be the smallest in the midriff option (p < 0.0001, η2 = 0.332). The BID from meta-perception revealed that cheerleaders felt that their coaches wanted them to be the smallest (p < 0.001, η2 = 0.106). Cheerleaders are at risk for EDs and BID at any level. Regarding the midriff uniform, MP from the perspective of coaches showed the greatest difference between perceived and desired body image.
... universitaires ou les athlètes ou les jeunes adultes en raison de leur triple statut (étudiant.e, athlète et jeune adulte) et des nombreux stress inhérents à ces statuts (Greenleaf, Petrie, Carter et Reel, 2009 ;Hoerr, Bokram, Lugo, Bivins et Keast, 2002 ;Solmi et al., 2014 ;. En fait, les étudiant.es-athlètes ...
... Comme certains facteurs peuvent interférer avec les résultats, deux variables de contrôle Greenleaf et al., 2009 ;Petrie, Greenleaf, Reel, Carter, 20072009a ;2009b ;Sanford-Martens et al., 2005 (Anderson et Petrie, 2012 ;Greenleaf et al., 2009 ;Petrie, Greenleaf, Reel, Carter, 20072009a ;2009b ;Sanford-Martens et al., 2005). ...
... Comme certains facteurs peuvent interférer avec les résultats, deux variables de contrôle Greenleaf et al., 2009 ;Petrie, Greenleaf, Reel, Carter, 20072009a ;2009b ;Sanford-Martens et al., 2005 (Anderson et Petrie, 2012 ;Greenleaf et al., 2009 ;Petrie, Greenleaf, Reel, Carter, 20072009a ;2009b ;Sanford-Martens et al., 2005). ...
Thesis
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Les attitudes et comportements alimentaires problématiques (ACAP), tout comme les troubles des conduites alimentaires, réfèrent à des préoccupations envahissantes pour l’alimentation, l’apparence et le poids, à une influence du poids et de l’apparence sur l’estime de soi ainsi qu’à des perturbations des comportements alimentaires. Les ACAP entraînent des conséquences importantes (ex: détresse psychologique, dépression, anxiété, altération de la qualité de vie et des relations familiales et sociales, augmentation des risques de présenter des troubles des conduites alimentaires). Les étudiant.es-athlètes universitaires sont à risque de présenter des ACAP, car ils doivent surmonter au même moment des enjeux en lien avec le début de l’âge adulte, les études universitaires et la pratique de sport universitaire élite. L’étude actuelle a comme objectifs de 1. Déterminer la proportion d’étudiant.es-athlètes universitaires présentant des ACAP ; 2. Déterminer les différences sur le plan des caractéristiques psychologiques entre les étudiant.es-athlètes présentant ou non des ACAP ; 3. Évaluer quelles sont les variables psychologiques les plus fortement associées à la présence d’ACAP chez les étudiant.es-athlètes universitaires. L’échantillon est composé de 133 étudiant.es-athlètes faisant partie de l’équipe sportive de leur université québécoise, lors de l’année scolaire 2018-2019. Trois outils ont été employés pour mesurer les ACAP, soit l’Eating Disorder Inventory-3 (EDI-3), le Questionnaire for a diagnosis of orthorexia et le Muscle Dysmorphic Disorder Inventory. Trois outils ont été utilisés pour évaluer les caractéristiques psychologiques, soit l’EDI-3, le Sociocultural Attitudes Towards Appearance Questionnaire-3 et l’Indice de détresse psychologique de l’enquête santé Québec. En lien avec le premier objectif, 19,5 % de l’échantillon total présente des ACAP (21,1 % chez les femmes et 15,8 % chez les hommes, p > 0,05). Ensuite, les participant.es ayant des ACAP présentaient significativement (p ≤ 0,05) plus d’ascétisme, de difficulté de régulation émotionnelle, d’aliénation interpersonnelle, de problèmes cognitifs et une plus faible estime de soi que les participant.es exempts d’ACAP (second objectif). En lien avec le troisième objectif, une régression linéaire multiple a été réalisée, permettant d’observer que le sexe et le surcontrôle explique 36,3 % de la variance (p ≤ 0,01) du score d’ACAP. De ces deux variables, c’est le surcontrôle qui contribue le plus au modèle (ß = 0,595, comparativement au sexe ß = 0,208 ). En résumé, en contrôlant pour le sexe, plus un ou une étudiant.e-athlète universitaire aurait de surcontrôle, plus il ou elle présenterait un score d’ACAP élevé. Face à ces résultats, il est nécessaire de conscientiser les entraîneurs à la problématique des ACAP afin qu’ils en connaissent les manifestations et les conséquences permettant de repérer des étudiant.es-athlètes plus à risque et de leur offrir un soutien supplémentaire en prenant le temps de discuter avec eux ou en les référant à des professionnels spécialisés.
... Athletes in general have 2-3 times higher risk for suffering an ED in sports that have weight classifications, aesthetic ideals, or require athletes to wear tight or revealing clothing. Those that deem a smaller body shape advantageous for the sport have been noted for even higher risk [26,32,51,52]. Competitive cheerleading is a highly aesthetic sport that is judged in a subjective manner and often has athletes wear revealing uniforms; therefore, it is reasonable that the cheerleaders may suffer from disordered eating or clinical EDs that could lead to LEA. ...
... Our findings displayed competitive cheerleaders engaged in pathogenic behaviors, which included restricting, vomiting, or purging, use of laxatives, use of diet pills, and the overuse of exercise. These behaviors are commonly seen within college and elite athletes [51,60,65,66]. The current study findings demonstrate that cheerleaders present with higher rates than college athletes for dieting (52.6% vs. 15.6%) and laxative use (10.5% vs. 1.5%), similar rates for purging (5.3% vs. 2.9%), but lower rates for binge eating (0% vs. 18.6) [57]. ...
Article
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The purpose of this study was to examine individual and combined Female Athlete Triad components within collegiate cheerleaders, an at-risk group. Cheerleaders (n = 19; age: 20.3 ± 1.2 years) completed anthropometric measurements, health history questionnaires, resting metabolic rate, the eating disorder inventory-3 and symptom checklist, blood sample, and DXA scan. Participants completed dietary and exercise logs for 7 days and used heart rate monitors to track daily and exercise energy expenditure. Proportions were calculated for low energy availability (LEA) risk, disordered eating risk, and pathogenic behaviors. Chi-square analysis was used to determine the difference between cheerleaders who experience low EA with or without disordered eating risk. All cheerleaders demonstrated LEA for the days they participated in cheerleading practice, 52.6% demonstrated LEA with eating disorder risk and 47.4% demonstrated LEA without eating disorder risk, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low bone mineral density. Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders displayed LEA. These findings support the need for increased education on the individual components of the Triad and their potential consequences by qualified personal.
... Additionally, dietary interventions have been shown to improve mental health in several populations [5,6,8]. However, studies are lacking in their examination of this relationship in female collegiate athletes, despite the fact that they may have greater risk of experiencing anxiety, depression, and dietary insufficiencies [2,[9][10][11][12]. Moreover, the coronavirus disease of 2019 (COVID- 19) pandemic has impacted the lives of collegiate athletes in unique ways, which may increase their risk for dietary and mental health difficulties [13][14][15]. ...
... Given the relatively higher prevalence of mental distress, disordered eating, and eating disorders in female collegiate athletes [9,24,27,28,45] and evidence showing a direct relationship between higher diet quality and lower rates of depression and anxiety [3][4][5][6][7][8], this study sought to examine the association between diet quality and mental health in this population. This study occurred during a peak period of COVID-19 restrictions and, therefore, includes the unique contribution of pandemic stressors to the findings. ...
Article
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The International Olympic Committee has identified mental health as a priority that significantly affects the physical health and safety of collegiate athletes. Interventions that improve diet quality have been shown to improve mental health in several populations. However, studies are needed to examine this relationship in female collegiate athletes, who have elevated risk of experiencing anxiety and depression symptoms, as well as dietary insufficiencies. In a quantitative, cross-sectional study, female student athletes at a U.S. university completed three mental health questionnaires: Depression Anxiety and Stress Scale (DASS-21), Athlete Psychological Strain Questionnaire (APSQ), and COVID Stress Scales (CSS). Each female athlete also completed a validated, web-based Diet History Questionnaire (DHQ-III) resulting in a Healthy Eating Index (HEI). Seventy-seven participants completed all survey information. HEI scores were consistently higher for athletes with poorer mental health. HEI scores were significantly positively associated with stress (p = 0.015), performance concerns (p = 0.048), CSS components of danger (p = 0.007), contamination (p = 0.006), and traumatic stress (p = 0.003). Although findings support statistically significant associations among dietary quality and mental health indicators, including broad symptom severity or stressors specific to athletics or COVID-19, these associations were in the opposite direction hypothesized. Possible reasons for results and suggestions for future research are discussed.
... Berry and Howe (2000) warned that all athletes, regardless of the sport type, may be at risk for an ED if predisposing factors are present. As such, no di erences have been found in the vulnerability to and manifestations of EDs among athletes from several high-and low-risk sports (e.g., Gomes, Martins and Silva, 2011;Greenleaf, Petrie, Carter and Reel, 2009;Kirk, Singh and Getz, 2001;Sanford-Martens, Davidson, Yakushko, Martens and Hinton, 2005). Research conducted in Spain parallels this nding (e.g., Díaz and Dosil, 2012, study 2). ...
... Moreover, both pro les were similar to the moderate-risk cluster based on the CHAD dimensions. Furthermore, the composition of clusters based on the classi cation of sports as high-and low-risk is striking (Table 5). is is consistent with other research (e.g., Díaz and Dosil, 2012, study 2;Gomes et al., 2011;Greenleaf et al., 2009;Kirk et al., 2001;Milligan and Pritchard, 2006;Sanford-Martens et al., 2005;Torstveit and Sundgot-Borgen, 2005;Williams et al., 2003) and questions the usefulness of establishing the risk for an ED based on the sport type, at least exclusively. ...
Article
Eating disorders (EDs) are prevalent in sports. Although a distinction has been made to date between high- and low-risk sports for EDs, recent studies have indicated that footballers and other athletes in low-risk sports are as vulnerable for Eds as athletes from sports that emphasize weight and body appearance. The aim of this study was to determine whether there are particular configurations of psychosocial risk factors for EDs among athletes from different sports (N = 357), with a special focus on football players. The Athlete’s Eating Habits Questionnaire (CHAD) was used to establish intra-individual configurations through a multivariate k-means cluster analysis. We found that 10.9% of athletes and 11.4% of the footballers had scores on the CHAD ≥ 100 points, which indicates that a large number of athletes are at risk for developing or may already be suffering from an ED. Three configurations or risk profiles emerged based on the beliefs, attitudes and behaviours that reflect differential schemata for each cluster: high (8.7%), moderate (45.1%) and low (46.2%) risk. Football players had a profile that was similar to the moderate, though existent, risk cluster. Our findings also question the traditional classification of sports as high- vs. low-risk. Athletes, including footballers, may have a heightened risk for EDs when they have certain combinations of dysfunctional beliefs, attitudes and behaviours. Our findings indicate that it is important to consider relevant predisposing factors with the aims of risk detection and EDs prevention among athletes. The type of sport does not appear to be the most important risk factor.
... [8][9][10] In addition to depression, up to one in 3 athletes reports symptoms of anxiety, 2 10% of female athletes meet criteria for a clinical eating disorder, and 25% to 50% of female athletes exhibit disordered eating behaviors. [11][12][13] The American Medical Society for Sports Medicine recently issued a position statement on the need for early identification of athletes in need of MH services, recommending the use of validated assessment tools as a top priority for initiating this change and establishing MH treatments for athletes. 14 This call to action has also been supported by the National Collegiate Athletic Association (NCAA), who have urged for early identification and treatment of MH among athletes and suggest preparticipation physical examinations as a best practice opportunity. ...
... Many athletes (45%) in the current sample clinically elevated 3 or more MMPI-2-RF scales, which aligns with past research indicating that MH conditions and elevated symptomatology on self-report measures are common among student-athlete populations. [4][5][6][7][9][10][11][12]37 Although collegiate student-athletes have been found to self-report comparable levels of depressive symptoms as nonathletes, 38 for example, research consistently reveals unique risk factors for depressive symptoms and suicidality among athletic populations, such as injury, overtraining, and competitive pressure, that may cause poor academic outcomes (eg, risk of dropping out and low grade point average [GPA]) and athletic performance. [1][2][3]6,8 The current findings provide important new insights into the MH of student-athletes because they suggest it is possible to predict which athletes will exhibit these conditions during the competitive season. ...
Article
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Objective: To examine whether pre-season assessment using a validated assessment tool, the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), could predict college student-athletes identified as experiencing in-season mental health (MH) problems. Design: A prospective study of athletes who completed a pre-season evaluation in August 2018. Setting and participants: A total of 195 National Collegiate Athletic Association Division 1 student-athletes from a large midwestern university in northeast Ohio. Independent variable: The MMPI-2-RF, a 338-item self-report measure of constructs relevant to the assessment of psychopathology and personality. Main outcome measure: Mental health problems of student-athletes tracked throughout the competitive season (August 2018-May 2019) by a team of athletic department personnel who met weekly with a licensed clinical psychologist. Results: In pre-season assessment, 71.8% of athletes clinically elevated at least one MMPI-2-RF scale and underreporting was higher in student-athletes than normative controls. Pre-season levels of internalizing psychopathology, diffuse physical symptoms, and unusual thoughts predicted increased likelihood of experiencing MH problems during the competitive season. Conclusions: The current findings suggest that the MMPI-2-RF may be a promising tool for identifying student-athletes at risk for MH concerns.
... Though females displayed higher percentages than males for all behaviors, only purging was significantly greater. These same pathogenic behaviors are commonly used by collegiate and elite athletes [29,30,44]. Specifically looking at females, our study demonstrates higher rates in marching artists than athletes for dieting (51.2% vs 15.6%) and purging (16.7% vs 2.9%), but close similarities in exercise (21.4% vs 25.5%) and binge eating (19% vs 18.6%) [44]. ...
... These same pathogenic behaviors are commonly used by collegiate and elite athletes [29,30,44]. Specifically looking at females, our study demonstrates higher rates in marching artists than athletes for dieting (51.2% vs 15.6%) and purging (16.7% vs 2.9%), but close similarities in exercise (21.4% vs 25.5%) and binge eating (19% vs 18.6%) [44]. Similar to female athletes, these female artists may experience weight-related pressures, including pressures from instructors, teammates, and oneself to maintain a lean physique for performance, or that of performing in front of hundreds of fans and being on the media. ...
Article
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Background Marching band artists are a physically active population, composed of approximately 27,000 people in the United States. University marching band artists face many of the same physically active demands and mental stressors as student athletes, potentially predisposing them to injury, illness, and risk for eating disorders (EDs). The purpose of this study was to examine ED risk across sex in university marching band artists, and to determine the type of risk based on the Eating Disorder Inventory-3 (EDI-3) and Eating Disorder Inventory-3 Symptom Check List (EDI-3 SC). A secondary aim examined marching band artists and pathogenic weight control behavior use across sex. Methods This was a cross-sectional study. A total of 150 marching band artists (female: n = 84, male: n = 66, age = 19.9 ± 1.1 years) from three National Collegiate Athletic Association Division I university marching bands participated in the study. We screened for ED risk using the EDI-3, and the EDI-3 SC. Results Overall, marching band artists were at risk for EDs, using only the EDI-3, 45.3% ( n = 68) were at risk, with females at significant higher risk than males [χ ² = 5.228, p = .022]; using only the EDI-3 SC, 54% ( n = 81) were at risk and no significant differences were found across sex. Overall, 48% of all participants reported dieting and 20.7% engaged in excessive exercise to control weight. Significant differences were found between sex and purging to control weight [χ ² = 3.94, p = .047] and laxative use [χ ² = 4.064, p = .044], with females engaging in behavior more than males. Conclusions Eating disorder risk was prevalent for both female and male marching band artists, with females displaying higher risk for EDs than males. Furthermore, marching band artists are engaging in pathogenic behaviors to control their weight. Healthcare providers (e.g., physicians, athletic trainers, physical therapist, dietitians, etc.) working in this setting should be aware of the risk factors displayed in marching band artists, and be able to provide education, prevention, and clinical interventions to this population. Additionally, marching band administrators should be aware of all medical risk factors and the benefit of having a healthcare provider (e.g., athletic trainer) to oversee the healthcare and wellness of marching band artists.
... Participation in sports that require low body weight and overestimate aesthetics, using it as a criterion for obtaining good results in competitions -such as artistic gymnastics, synchronized swimming, running, and dance -is associated with a high incidence of eating disorders (Arcelus, Witcomb, & Mitchell, 2014;Arthur-Cameselle, Sossin, & Quatromoni, 2017;Doughty & Hausenblas, 2005;Maya & Moria, 2018;Petrie, 1993). For example, female collegiate athletes symptomatic for an eating disorder reported more perceived pressure to be thin than their asymptomatic peers (Greenleaf, Petrie, Carter, & Reel, 2009). ...
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Purpose: Research has suggested that in female athletes from aesthetic sports the prevalence of disordered eating attitudes is higher than in female athletes from other sports, mainly due to sport related factors like extreme training and practicing sports associated with high pressure and the idea that “being thin leads to success”. The study was conducted to examine the prevalence of disturbed eating attitudes and their relationship with body image concerns in aesthetic and non-aesthetic female athletes. Methods: 54 female athletes from aesthetic sports (synchronized swimming, artistic and rhythmic gymnastics, and dance), as well as 66 female athletes from non-aesthetic sports (volleyball, track and field, and soccer), completed the Eating Attitudes Test, the Body Shape Questionnaire, and the Figure Rating Scale (a visual scale used to assess body image dissatisfaction and body image dissatisfaction in relation to sport). Results: The results indicated that aesthetic athletes scored significantly higher than those involved in non-aesthetic sports in Dieting, and in Body Image Dissatisfaction. Moreover, aesthetic athletes demonstrated significantly lower BMI mean scores. Significant correlations were found between Body Mass Index and Oral Control, Body Image Dissatisfaction and Body Image Dissatisfaction in relation to Sport, and between Eating Attitudes Test and the Body Shape Questionnaire results in aesthetic athletes. Furthermore, significant associations were found between Body Mass Index and Body Shape Questionnaire, Body Image Dissatisfaction and Body Image Dissatisfaction in relation to Sport, and Eating Attitudes Test and Body Shape Questionnaire in non-aesthetic athletes. Conclusion: The study confirmed the relationship between body image concerns and pathological eating attitudes among female aesthetic sport athletes.
... Reports on collegiate athletes are mixed. Although female collegiate athletes have demonstrated a higher prevalence of EDs and ED symptomatology than male-identified collegiate athletes (e.g., Krebs, Dennison, Kellar, & Lucas, 2019), it is less clear if the prevalence in collegiate athletes exceeds that of non-athlete collegiate students (Greenleaf, Petrie, Carter, & Reel, 2009;Johnson, Powers, & Dick, 1999). Across ED behaviors, one of the only studies comparing college athletes, independent exercisers, and nonexercisers observed greater severity of ED symptomatology at higher levels of sport participation (Holm-Denoma, Scaringi, Gordon, Van Orden, & Joiner, 2009). ...
Article
Objective We compared eating disorder (ED) characteristics and treatment seeking behaviors between self‐identified competitive athletes and non‐athletes in a large, community‐based sample. Method During the 2018 National Eating Disorders Awareness Week, 23,920 respondents, 14.7% of whom identified as competitive athletes, completed the National Eating Disorders Association online screen. Data were collected on demographics, disordered eating behaviors, probable ED diagnosis/risk, treatment history, and intent to seek treatment. Results The sample was predominantly White (81.8%), female (90.3%), and between 13 and 24 years (82.6%). Over 86% met criteria for an ED/subthreshold ED, and of those, only 2.5% were in treatment. Suicidal ideation was reported in over half of the sample. Athletes reported a significantly greater likelihood of engaging in and more frequent excessive exercise episodes than non‐athletes. Athletes also reported a significantly lower likelihood of engaging in and less frequent binge‐eating episodes compared with non‐athletes. Athletes were more likely to screen positive for an ED/subthreshold ED than non‐athletes, but percentages across all probable ED diagnoses were similar. No significant differences between athletes and non‐athletes emerged on treatment history or intention to seek treatment post‐screen (less than 30%). Discussion Although the distribution of probable ED diagnoses was similar in athletes and non‐athletes, symptom profiles related to disordered eating behavior engagement and frequency may differ. Athletes may be less likely to seek treatment due to stigma, accessibility, and sport‐specific barriers. Future work should directly connect survey respondents to tailored treatment tools and increase motivation to seek treatment.
... from 24%-73%, (Black et al., 2003;Greenleaf, Petrie, Carter, & Reel, 2009;Sundgot-Borgen & Torstveit, 2004;Torres-McGehee et al., 2012). Further, cheerleaders who identify as men, who are regularly ignored in this body of literature, demonstrated ED risk above the rate in the general population, with 34.0% of the men in our sample possessing at least one ED risk factor. ...
... Drawing on the eating disorder evidence-base, higher rates of eating disorders have been reported in aesthetic, endurance, and weight-class sports (Bratland-Sanda & Sundgot-Borgen, 2013;Joy, Kussman, & Nattiv, 2016;Thiemann et al., 2015). Although, other studies found no support for the relationship between sport type and disordered eating prevalence (Greenleaf, Petrie, Carter, & Reel, 2009;Sanford-Martens, Davidson, Yakushko, Martens, & Hinton, 2005). For example, Sanford-Martens et al. (2005) found no differences in eating disorder symptoms in "lean" versus "non-lean" sports. ...
Article
Objectives Poor adherence to nutritional guidance by athletes may compromise their health and performance. Enhancing adherence is therefore an important performance and welfare strategy. The aim of this study was to qualitatively explore the barriers and enablers of elite athletes' adherence to nutritional guidelines. Design Underpinned by our constructionist epistemological position and our relativist ontology, we conducted a qualitative study using focus groups. Methods We used the Capability, Opportunity, and Motivation Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) to conduct focus group discussions with a purposive sample of 39 UK-based funded athletes (mean age = 23 ± 3.81), participating in either Olympic and Paralympic sport (n = 30) or professional sport (n = 9), who had access to a nutritionist. Data were analysed using reflexive thematic analysis. Results Athlete adherence to nutritional guidance was seasonal and included inadequate energy intakes and episodes of binge eating. Underpinning these behaviours, athletes' emotional barriers (motivation) are reinforced through their social interactions within the high-performance environment (opportunity) and athletes' training environment limits developmental opportunities for food planning (capability). However, a holistic-developmental approach by the sports nutritionists (opportunity) supports athlete wellbeing and nutritional adherence. Conclusion These findings advance theoretical understanding of the barriers and enablers of nutritional adherence amongst elite-level athletes in high-performance sport and present a number of significant implications for athlete support personnel seeking to enhance performance in demanding sporting contexts. Drawing on the Behaviour Change Wheel (BCW), recommendations include the need to 1) train and educate sports nutritionists in human behaviour, 2) update regulations for sports nutrition profession practice to acknowledge the skills required to support athletes' emotional wellbeing, 3), educate coaches on the sensitivity of body weight and composition and develop guidelines for monitoring athletes' body weight and composition in sport, 4) persuade influential leaders to develop culture guidelines that shift the performance-narrative of high-performance (i.e., environmental restructuring).
... In a young man, it consists in possessing a body capable of enduring all efforts, either of the racecourse or of bodily strength…" It is the role of governing bodies and physicians to recommend time limits and to prescribe the appropriate amount of time to heal. We need to help them achieve what Aristotle then described as: "A happy old age is one that comes slowly with freedom from pain [1][2][3][4]." ...
... This is also a relevant concern for individuals with eating disorders, which are disproportionately common among elite athletes. [75][76][77][78][79] It is hypothesised that COVID-19, with attendant food insecurity and panic buying, will exacerbate the already complex, problematic relationship that patients, including athletes, with eating disorders have with food. 80 For athletes with eating disorders, during most in-person visits, at least some aspects of physical examination would be conducted (including blinded weight, blood pressure, heart rate, temperature and examination of the throat, heart, lungs and extremities). ...
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Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.
... from 24%-73%, (Black et al., 2003;Greenleaf, Petrie, Carter, & Reel, 2009;Sundgot-Borgen & Torstveit, 2004;Torres-McGehee et al., 2012). Further, cheerleaders who identify as men, who are regularly ignored in this body of literature, demonstrated ED risk above the rate in the general population, with 34.0% of the men in our sample possessing at least one ED risk factor. ...
... Additional research has documented psychologically distressing challenges among student-athletes associated with athletic injury (Putukian, 2016;Wolanin et al., 2015), sexual identity (Fenwick & Simpson, 2017;Kroshus & Davoren, 2016), and sexual violence (McCray, 2015). Further, the emotional response to these challenges may be associated with impaired mental health, evidenced by cases of depression (Armstrong et al., 2015;Wolanin et al., 2015), disordered eating behaviors (Chatterton & Petrie, 2013;Greenleaf et al., 2009), substance abuse problems (Druckman et al., 2015), and suicide (Rao et al., 2015) among student-athletes. ...
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Student-athletes are suggested to be an at-risk population for experiencing psychological distress, and coaches have been identified as support providers for distressed athletes. However, little is known about the interactions between student-athletes and their coaches when athletes disclose psychological distress. Therefore, the purpose of this research was to explore the experiences of student-athletes disclosing psychological distress to university coaches. Semi-structured interviews were conducted with 15 student-athletes (2 male, 13 female; Mage=24.5 years) and 15 university coaches (11 male, 4 female; Mage=41.9 years). Data were analyzed using a thematic analysis. Results indicated that perceived barriers (emphasis on athlete toughness, power of coaches, athlete’s position on a team, poor visibility of distress, and previous negative experiences with disclosure) discouraged student-athletes from disclosing distress and suggest that barriers may be overcome by coaches fostering supportive team cultures. Strategies for coaches to establish supportive team cultures were identified, such as building diverse coaching staff, using non-discriminatory language, and role-modeling desired behaviors. Based on the findings, guidelines are provided for effective coach support following disclosure. This research suggests that coaches have the potential to positively influence student-athletes’ disclosures of psychological distress and facilitate the process of athletes seeking help; however, clearer boundaries need to be established to govern the appropriate role of coaches in supporting psychologically distressed student-athletes. Lay Summary: We examined experiences of student-athlete disclosures of psychological distress to university coaches. Barriers, such as previous negative experiences with disclosure, perceptions of athlete toughness, and the athlete’s position on the team, prevented athletes from disclosing distress. Strategies for coaches to create cultures that support athlete help-seeking behaviors are presented. • Implications for Practice: • As a frontline preventative measure in supporting the psychological well-being of student-athletes, coaches should establish team cultures that address perceived barriers to disclosure and encourage athlete help seeking behaviors. Coaches may foster desired team cultures by applying recommendations made by the present research, such as adopting a holistic coaching philosophy, speaking openly with athletes about psychological distress, and providing transparent selection criteria. • When working with psychologically distressed student-athletes, coaches should engage in immediate, short-, and long-term support practices inclusive of responding supportively to athletes’ initial disclosures, assisting athletes in developing plans for managing their distress, and maintaining consistent communication and engagement with the athlete throughout the recovery process. • Coaches should prioritize the development of coach-athlete relationships founded on trust and bidirectional communication with student-athletes to facilitate student-athletes’ willingness and abilities to disclose distress and access early support.
... This result is similar to those of several studies conducted with female university student athletes. 6,9,[11][12][13][14][15]37 The second and final study objective was to assess which psychological variables were most strongly associated with DE in university student athletes. The results showed that many psychological variables were correlated with the presence of DE (eg,: perception of the media as a source of information on appearance, affective problems and general internalization of societal ideals of beauty), even though when they were put simultaneously in the regression, only two of those variables contributed to the model. ...
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Disordered eating (DE) corresponds to the presence of fasting, food restriction, skipping meals or consuming appetite suppressants, excessive physical exercise, image distortion, dissatisfaction with body weight and shape, fear of weight gain, and desire for thinness. University student athletes are particularly at risk of developing DE because they must adapt simultaneously to the demands of adult life, university life, and competitive high‐level sports. This study aimed to identify which psychological characteristics are most strongly associated with the presence of DE among university student athletes. In September 2018, 95 female participants completed an online survey composed of several questionnaires evaluating DE, psychological characteristics, and sociodemographic information. DE affected 21.1% of the sample. Among the psychological variables evaluated, overcontrol and perceived media pressure were the most strongly associated with the presence of DE. The more university students presented overcontrol and perceived media pressure, the more likely they were to present DE. In sports medicine, it is essential that professionals evaluate psychological vulnerabilities of university student athletes and offer them support in this regard.
... Il doit apprendre à partager son temps entre l'école, le travail, ses amis, sa famille et son conjoint(Boyd et Bee, 2017), ce qui peut augmenter son stress, particulièrement chez les jeunes femmes(Papalia et En plus d'être confronté à ces dé s développementaux, le jeune adulte qui entreprend des études universitaires doit s'ajuster à de nouvelles demandes académiques. D'abord, cette transition scolaire peut entraîner une perte de soutien social puisque l'étudiant doit généralement se reconstruire un réseau dans son programme universitaire(Greenleaf, Petrie, Carter et Reel, 2009). Ensuite, au plan pédagogique, les études universitaires sont associées à des aptitudes à acquérir, telles une plus grande autonomie dans l'acquisition des apprentissages ainsi qu'une pensée critique, philosophique et scienti que. ...
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Cet article publié dans la revue Psychologie Québec s'attarde au triple enjeu contextuel auquel font face les étudiant.es-athlètes universitaires. En effet, ces derniers doivent affronter au même moment plusieurs défis associés à la transition à la vie adulte, aux études universitaires et à la pratique sportive élite. Ce contexte particulier peut alors les prédisposer à développer des attitudes et comportements alimentaires problématiques (troubles des conduites alimentaires sous-cliniques). https://www.ordrepsy.qc.ca/-/attitudes-et-comportements-alimentaires-problematiques-chez-les-etudiants-athletes-universitaires-quand-le-contexte-augmente-le-risque?inheritRedirect=true&redirect=%2Fpsychologie-quebec
... Several studies have established that college athletes consume alcohol at higher rates than their non-athlete counterparts [6][7][8] and both male and female athletes report elevated rates of disordered eating behaviors. [9][10][11][12][13][14] While college athletes are at higher risk for engagement in alcohol misuse and disordered eating behaviors as independent behaviors, little is known about whether athletes may be a subgroup at particular risk of engaging in FAD behavior. In other words, are athletes at greater risk of engaging in disordered eating behaviors within the context of an alcohol use episode? ...
Article
Objective: This study investigated the association between self-identified athlete status and Food and Alcohol Disturbance (FAD) behaviors, and whether this association was moderated by drives for thinness or muscularity, and sex. Participants: 575 individuals (77.6% female, 40.0% identifying as athletes) recruited from a large southeastern university. Methods: Participants completed online measures of athletic identity, drives for muscularity and thinness, FAD behaviors, and demographic variables. Results: Compared to non-athletes, male athletes with higher drive for muscularity endorsed more alcohol effects behaviors; female athletes endorsed the inverse relationship. Higher drive for thinness was associated with more diet and exercise behaviors among all participants, and extreme weight control behaviors among athletes. Conclusions: Athlete status moderated the associations between drives for thinness/muscularity and FAD Alcohol Effects and Extreme Weight Control Behaviors. Regardless of athlete status, college students with higher drive for thinness are at risk for engaging in more FAD Diet & Exercise behaviors.
... Like the general population, athletes experience societal pressures to fit a society-determined body ideal. However, for athletes, this societal pressure can be compounded or placed at odds with the pressures of sport, creating a situation ripe for the development of disordered eating (DE; Anderson, Petrie, & Neumann, 2012;Cooper & Winter, 2017;Greenleaf, Petrie, Carter, & Reel, 2009). Although a number of studies have explored the development of eating pathology in athletes, inconsistency amongst the findings and methodologies has made it difficult to pinpoint causal elements in the development of DE and eating disorders (ED). ...
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Objective: The theoretical model by Petrie and Greenleaf (2007, 2012) is an admirable attempt to collate the causal factors of disordered eating in athletes. The aims of this systematic review are (a) to provide an overview of the findings from the relevant literature, (b) to assess whether the model is supported by the existing research, (c) to evaluate the different designs, methods, and measures used to test the mediators in the model, and (d) to highlight areas for improvements and future research. Method: A systematic review of four major online databases identified 37 relevant papers on risk factors of disordered eating in athletes, which were reviewed and critically compared with the theoretical model. Results: There is a lack of longitudinal research with the relevant mediators in athlete populations, which makes it difficult to determine whether the potential mediators described by Petrie and Greenleaf are causal risk factors rather than simply correlates of disordered eating for athletes. Findings for all the potential mediators are inconsistent, and the range of measures used makes it problematic to draw conclusions. Conclusions: Future research needs to use gold standard measures and longitudinal designs in order to fully test and possibly update the model.
... Sports attire thus can heighten athletes' awareness of their build and accentuate feelings of body shame (Tylka and Hill, 2004;Galli et al., 2013;Cooper and Winter, 2017). Competition attire may exemplify society and sportrelated dictations of weight and body shape standards, since a revealing design is often necessary for peak performance (e.g., tight-fitting outfit for cyclists, swimmers, or aerodynamic sprinters) (Greenleaf et al., 2009). Sometimes, however, the criterion is purely esthetic, while in other cases, uniforms may be used as a lure for spectators (e.g., beach volleyball). ...
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We determined the prevalence of eating disorder (ED) symptoms among elite Spanish athletes from a broad range of sports and levels of competition and examined the associations between the presence of symptoms and perceived sport-specific weight pressures. We surveyed 646 elite athletes (16.7 ± 4.4 years; 51.08% females) representing 33 sports from top-division teams and two elite athlete training centers in Catalonia. Based on the results of the Eating Attitudes Test-26 responses, 5.1% of athletes (7.6% of females and 2.5% of males) were at risk of EDs. The highest rates of ED symptoms were observed in male endurance athletes and female esthetic athletes. Competition level was not a risk factor. The only gender differences in the presence of ED symptoms by competing level were observed in athletes competing at the national level. Female athletes with ED symptoms scored higher on the two subscales of the Spanish version of the Weight Pressures in Sport (WPS) tool: coach and sport-specific pressures and pressures from teammates and due to uniform. Male athletes with ED symptoms scored higher on the pressures due to uniform subscale. Finally, symptomatic female but not male athletes competing at international and national levels also perceived greater sport-specific weight pressures.
... A livello fenomenologico, i maschi tendono a occultare il disturbo dietro regimi alimentari rigidi, associati a intense pratiche sportive: sono spesso coinvolti in attività fisiche che enfatizzano la muscolosità e sono più inclini, rispetto alle femmine, all'esercizio fisico eccessivo 11 , tanto che i DA vengono spesso associati ai disturbi di "dismorfismo muscolare" o "vigoressia" 12 . Queste considerazioni sono in linea con una serie di ricerche che attestano tra i giovani atleti una maggiore prevalenza di disturbi alimentari [13][14][15][16] . Inoltre, i ragazzi ricorrono al vomito, ai farmaci diuretici e ai lassativi in misura minore rispetto alle donne (25% vs 50%), prediligendo come pratiche compensatorie in caso di abbuffate l'esercizio fisico o il digiuno nei giorni successivi 11 . ...
... The majority of the quantitative studies also explored one of, or a combination of the following factors; physique or social physique anxiety (Hasse, 2009;Hausenblas & Mack, 1999), pathogenic weight behaviours (Greenleaf, Petrie, Carter, & Reel, 2009;Torres-McGehee, Monsma, Gay, Minton, & Mady-Foster, 2011), body image (Anderson et al., 2012;Hulley & Hill, 2001;Torres-McGehee et al., 2011), body (dis)satisfaction (Anderson et al., 2011(Anderson et al., , 2012Brannan 2009;Kong & Harris, 2015;Smith & Petrie, 2008), thin-internalization (Smith & Petrie, 2008), sexual harassment (Sundgot-Borgen et al., 2003), academic status (Torres-McGehee et al., 2011), personality traits/qualities (e.g. perfectionism) (Brannan et al., 2009), psychosocial skills (e.g. ...
Article
Objectives This article examines the current state of literature focusing exclusively on mental health and mental illness of elite female athletes. The scoping review aimed to (1) identify the methodology used in this research, (2) explore the use of theory in these studies, and (3) provide an overview of the research purposes to identify gaps in the literature and provide recommendations for future research. Design Scoping Review Method Following the methodological framework by Arksey and O'Malley (2005), four databases were searched for studies that fulfilled the inclusion criteria. Following the identification of studies using broad search criteria, specific exclusion criteria were applied. Results Twenty-four studies met the review criteria, of which twenty studies (83.3%) used quantitative methods and a cross-sectional research design. Of these studies, the majority (95%) focused on eating disorders and/or disordered eating prevalence rates in elite female athletes who compete in ‘lean-physique’ or endurance sports (e.g., gymnastics, long-distance, running). The restricted sample population of USA collegiate athletes, overreliance on quantitative methods, and heavy focus on eating disorder prevalence rates demonstrates an ongoing need for sport scholars to expand their research samples, methods, and aims. Conclusion Findings highlight the need for greater methodological diversity to advance our conceptual and theoretical understanding of elite female athletes' experiences of mental health and mental illness beyond numeric interpretations. Future research is needed to explore mental health in elite female athlete populations beyond ‘lean-physique’ athletes.
... During the past two decades, there has been a plethora of published studies that have examined the potential harmful consequences of disordered eating attitudes among athletes. However, research has focused primarily on adult (mainly college-age) elite female athletes [11,[51][52][53][54][55][56]. Less studies have examined the health consequences, and especially those related to the nutritional status, of disordered eating behaviors in adolescent elite and non-elite athletes. ...
Article
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In their attempt to achieve the optimum weight or body shape for their activity, athletes frequently use harmful weight-control practices that may lead to the development of disordered eating or eating disorders. These practices are linked to several medical and mental consequences that may be more serious in adolescent athletes, as their bodies must meet both intensive growth demands and training requirements at the same time. Among other consequences, adolescent ath- letes may be at nutritional risk, due to their high nutrient needs and unhealthy eating behaviors. A literature review was conducted to examine the main nutritional risks and malnutrition issues faced by adolescent athletes that present disordered eating attitudes or eating disorders. Most studies re- fer to adult elite athletes, however research on adolescent athletes also indicates that the most com- mon nutritional risks that may arise due to disordered eating include energy, dehydration and electrolyte imbalances and Educational pro- grams and early detection of disordered eating and eating disorders are crucial to avoid the emer- gence and ensure timely management of nutrition-related problems in the vulnerable group of ad- olescent athletes.
... poor performance, and long term mental and physical health conditions) of common weight-loss behaviours for elite athletes (e.g. under-eating, restrictive eating, over-exercising, excessive focus on food and weight) (Greenleaf et al. 2009;Sundgot-Borgen and Torstveit 2010;Mancine et al. 2020). Similar to Junge and Prinz (2019), our study revealed that those who responded 'currently' needing psychological support reported higher scores for depressive and anxiety symptomology. ...
Article
Mental health research in sport is almost entirely focused on elite male athletes. However, recent research suggests that elite female athletes are at higher risk for mental ill-health when compared to their male counterparts. Given the recent growth of women's football in England and lack of research surrounding mental health in this population, this study sought to explore the prevalence of, and factors associated with depression, anxiety, and eating disorder symptoms in females competing in the top two tiers of English football. An anonymous online questionnaire pack, which measured personal and player characteristics and included the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder scale (GAD-7), Brief Eating Disorder Questionnaire (BEDA-Q), and General Help-Seeking Questionnaire (GHSQ), was completed between November 2020 and March 2021 by elite female footballers competing in the Women's Super League (WSL) and Women's Championship. A total of 115 players completed the questionnaire (63 from the WSL; 52 from the Women's. Championship). 36% displayed eating disorder symptoms (BEDAQ) 11% displayed moderate to severe anxiety symptoms (GAD-7), and 11% displayed moderate to severe depression symptoms (PHQ-9). Significant associations emerged between starting status, want for psychological support, student-athlete status, help-seeking intentions score, and mental ill-health symptoms. In summary, elite female footballers in England reported significant mental health symptoms, particularly disordered eating symptoms. Further research should explore the experiences of mental ill-health in this population, focusing on the factors that were important in this study.
... Table 1. Risk factors for eating disorders and investigated aspects in the present study [1,3,4,5,18,25,27,29,30,31] ...
Article
Introduction: Recent studies indicate high prevalences of disordered eating or eating disorders in adult athletes and a worrying increase in adolescent athletes. Although several risk factors for developing eating disorders have been identified for adult athletes (e.g., personality factors, sport-related pressure), research on risk factors in adolescent athletes is scarce. Methods: This study investigates the prevalence of disordered eating and eating disorder symptoms and its association with personality- and sport-related risk factors in a sample of 439 elite athletes aged 13–18 years. Self-regulatory personality factors, sports and social pressure, as well as sports biographical data, were investigated in relation to different weight control methods and the Eating Disorder Examination Questionnaire measuring disordered eating and eating disorder symptoms. Results: Results indicate a prevalence rate of clinically significant eating pathology of 5.5% for the total sample, in which female athletes aged 15–18 years show the highest rate (9.6%). The structural equation model indicates a predominant association of sports and social pressure and personality factors with eating disorder symptoms. Conclusion: Being in the age range 15–18 years, being female, and being an athlete in a high-risk sport (e.g., aesthetics, weight class, or endurance sports) were identified as risk factors as well as athletes’ mental association with weight loss and success, and athletes’ perceived social pressure on eating and on body shape. Disordered eating and eating disorders are not only of concern for adults but also for young elite athletes and recommendations for adolescent elite athletes, coaches, and parents are given.
... Estimates indicate that the overall prevalence of disordered eating and/or eating disorders among athletes ranges from 0 to 19% in men and 6 to 45% in women [107], both of which are higher than non-athletes, which is estimated to be 0.7-2.2% and 2.2-8.4% for adult men and women, respectively [115]. Previous literature identified~25% of NCAA DI collegiate athletes from a variety of sports including gymnastics, softball, synchronized swimming, tennis, basketball, lacrosse, soccer, cross country, cheerleading, diving, field hockey, swimming, and track and field to exhibit disordered eating behaviors [116]. Further, several studies have examined the relationship between disordered eating and sport type, specifically the differences between lean sports, where an emphasis is placed upon low body weight and physique, versus non-lean or ball sports [117][118][119][120][121][122]. ...
Article
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Relative Energy Deficiency in sport is experiencing remarkable popularity of late, particularly among female athletes. This condition is underpinned by low energy availability, which is a byproduct of high energy expenditure, inadequate energy intake, or a combination of the two. Several contributing factors exist that may predispose an athlete to low energy availability, and therefore a holistic and comprehensive assessment may be required to identify the root causes. The focus of the current narrative review is to discuss the primary contributing factors as well as known risk factors for low energy availability among female athletes to help practitioners increase awareness on the topic and identify future areas of focus.
... Eating disorder symptoms are common in athletes (Bratland-Sanda & Sundgot-Borgen, 2013;Joy et al., 2016). Prevalence estimates for mild eating disorder symptoms (i.e., disordered eating) have been suggested to range from 20% to 46% in female athletes and from 10% to 19% in male athletes (Anderson & Petrie, 2012;Greenleaf et al., 2009;Krebs et al., 2019;Martinsen et al., 2010). Prevalence rates across different sport types have also been explored, yet the results are conflicting. ...
Article
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Objective: The primary aim was to assess the feasibility of undertaking a study evaluating the novel Motivational and Psycho-Educational Self-Help Programme for Athletes with Mild Eating Disorder Symptoms (MOPED-A). A mixed-methods approach was adopted to explore the feasibility of recruiting and retaining participants, and to evaluate the acceptability of measures, procedures and the intervention. A secondary aim was to explore the potential efficacy of MOPED-A in reducing athletes' eating disorder symptoms. Method: Thirty-five athletes were recruited. Participation involved completing MOPED-A over a 6-week period and completing self-report measures at baseline (T1), post-intervention (T2) and 4-week follow-up (T3). A subsample (n = 15) completed an interview at T2. Results: Retention was good throughout the study (n = 28; 80%). Quantitative and qualitative feedback suggested the format, delivery, content and dosage of MOPED-A were acceptable. Athletes valued that the intervention was tailored to them, and this facilitated both participation and completion. Over a third of participants reported disclosing their eating difficulties and deciding to seek further support. Large reductions in eating disorder symptoms were detected at T2 and sustained at T3. Conclusions: The MOPED-A intervention can be feasibly implemented, is acceptable to participants, and demonstrates potential for reducing symptoms in athletes. A larger, controlled trial is warranted.
... Among the three issues, male athletes (2013) reported that 6.5% of female athletes and 12.2% of male athletes reported engaging in unhealthy eating and weight control behaviours. However, this compensatory behavior among female and male athletes were lower if compared to the findings of other previous research (Carter & Rudd, 2005;Greenleaf, Petrie, Carter, & Reel., 2009;Petrie, Greenleaf, Reel, & Carter, 2008). Among female and male collegiate athletes, respectively, 3.0% vs. 6.5% vomit, 1.0% vs. 7.9% use laxatives, 1.5% vs. 7.0% use diuretics, 40.7% vs. 46.9% ...
... Sex differences exist in EDs, with higher rates (11-32.8%) typically reported for females, with increases over the years (5,6,8,(12)(13)(14)(15)31). Taking a further look into EDs in females, Sundgot-Borgen (13) categorized athletes based on the demands of their sports (endurance, aesthetic, power, weight-dependent, ball/team, and technical), and reported prevalence accordingly. ...
Article
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Purpose: Orthorexia nervosa (Orthorexia) is an eating attitude and behavior associated with a fixation on healthy eating, while eating disorders (EDs) are clinically diagnosed psychiatric disorders associated with marked disturbances in eating that may cause impairment to psychosocial and physical health. The purpose of this study was to examine risk for Orthorexia and EDs in student-athletes across sex and sport type and determine the association between the two. Methods: Student-athletes ( n = 1,090; age: 19.6 ± 1.4 years; females = 756; males = 334) completed a survey including demographics, the ORTO-15 test (<40 and <35 threshold values), the Eating Attitudes Test-26 (EAT-26; >20 score), and additional questions about pathogenic behaviors to screen for EDs. Results: Using a <40 threshold value for the ORTO-15, 67.9% were at risk for Orthorexia, a more restrictive threshold value of <35 determined 17.7% prevalence across student-athletes with significant differences across sex [ <40: χ ( 1 , 1 , 090 ) 2 = 4.914, p = 0.027; <35: χ ( 1 , 1 , 090 ) 2 = 5.923, p = 0.015). Overall, ED risk (EAT-26 and/or pathogenic behavior use) resulted in a 20.9% prevalence, with significant differences across sex (χ ² = 11.360, p < 0.001) and sport-type category (χ ² = 10.312, p = 0.035). Multiple logistic regressions indicated a significant association between EAT-26 subscales scores and Orthorexia, and between Orthorexia positivity, ORTO-15 scores, and risk for EDs. Conclusions: Risk for Orthorexia and ED is present in collegiate student-athletes. While healthy and balanced eating is important, obsessive healthy eating fixations may increase the risk for EDs in athletes. More education and awareness are warranted to minimize the risk for Orthorexia and EDs in student-athletes.
... Research suggests that the prevalence of mental health symptoms and disorders in male elite athletes in team sports (cricket, football, handball, ice hockey and rugby) varies from 5% for burnout and alcohol abuse, to nearly 45% for anxiety and depression (Nixdorf et al., 2013;Gulliver et al., 2014;Beable et al., 2017;Brown et al., 2017;Gouttebarge et al., 2017a,b;Schuring et al., 2017;Drew et al., 2018;Kiliç et al., 2018). In female athletes, mental health disorders range from 10% to 25% for depression and eating disorders in particular (Greenleaf et al., 2009;Proctor and Boan-Lenzo, 2010;Brand et al., 2013;Wolanin et al., 2016). There is also evidence to suggest that occurrence of such mental health disorders amongst elite athletes are associated with higher incidence of severe injuries, surgeries, recent adverse life events, a higher level of career dissatisfaction and a lower level of social support (Gouttebarge et al., 2017b). ...
Article
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Countries all over the globe have implemented mandatory social distancing measures in an attempt to suppress and control the spread of the Coronavirus disease (COVID-19). This enforced period of isolation, disruption to normal training routines and competition cancellation, could be having an adverse effect on the mental health and wellbeing of athletes. This study sought to explore the perceived impact of the COVID-19 social distancing measures on athlete wellbeing. Fourteen elite athletes who were unable to train or compete due to government imposed lockdown measures were recruited to participate in this qualitative study. Utilising the photo elicitation method, participants were asked to take a series of photographs that represented their experiences as athletes living in lockdown. These photographs were used to guide discussions in follow up unstructured interviews. Reflexive inductive thematic analysis identified three main themes that captured athletes’ experience of social distancing measures and the implications for their wellbeing: (1) threats to wellbeing; (2) adapting routines and maintaining motivation; and (3) reflecting on participation in competitive elite sport. The initial sudden loss of sport in the athlete’s lives posed a threat to their wellbeing, but over the duration of the lockdown period the athletes developed numerous strategies to protect their wellbeing. Furthermore, their time away from sport encouraged them to reflect on their athletic identity and to make life changes that would protect their wellbeing during the rest of the lockdown period and when they returned to sport. A number of immediate practical recommendations are offered for athlete support personnel working with athletes during the crisis, these include developing self-care strategies and social networks, adapting routines, setting new goals and encouraging the pursuit of dual-careers. Future research is encouraged to investigate how practitioners can deliver effective psychological support through tele-consulting, and to consider whether their support is best focused on therapeutic counselling or mental skills training during the pandemic.
... Papers with numerous outcomes have been cited across multiple performance and health outcome categories . The table is meant to showcase extensive symptom overlaps between RED-S versus training-overload studies, but not be an exhaustive collective of every study published in the respective OTS and RED-S [43-48, 51, 65, 150, 184, 185, 188-192, 194, 195, 197-200, 223 [ 75,193,202,203,211,226,227,242,244,[261][262][263][264][265] Content courtesy of Springer Nature, terms of use apply. Rights reserved. ...
Article
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The symptom similarities between training-overload (with or without an Overtraining Syndrome (OTS) diagnosis) and Relative Energy Deficiency in Sport (RED-S) are significant, with both initiating from a hypothalamic–pituitary origin, that can be influenced by low carbohydrate (CHO) and energy availability (EA). In this narrative review we wish to showcase that many of the negative outcomes of training-overload (with, or without an OTS diagnosis) may be primarily due to misdiagnosed under-fueling, or RED-S, via low EA and/or low CHO availability. Accordingly, we undertook an analysis of training-overload/OTS type studies that have also collected and analyzed for energy intake (EI), CHO, exercise energy expenditure (EEE) and/or EA. Eighteen of the 21 studies (86%) that met our criteria showed indications of an EA decrease or difference between two cohorts within a given study (n = 14 studies) or CHO availability decrease (n = 4 studies) during the training-overload/OTS period, resulting in both training-overload/OTS and RED-S symptom outcomes compared to control conditions. Furthermore, we demonstrate significantly similar symptom overlaps across much of the OTS (n = 57 studies) and RED-S/Female Athlete Triad (n = 88 studies) literature. It is important to note that the prevention of under-recovery is multi-factorial, but many aspects are based around EA and CHO availability. Herein we have demonstrated that OTS and RED-S have many shared pathways, symptoms, and diagnostic complexities. Substantial attention is required to increase the knowledge and awareness of RED-S, and to enhance the diagnostic accuracy of both OTS and RED-S, to allow clinicians to more accurately exclude LEA/RED-S from OTS diagnoses.
The purpose of this study was to provide a systematic scoping review of the research focussing on student-athletes' mental health (MH). More specifically, we aimed to describe and synthesise: (a) the study and sample characteristics of the dual career (DC) and MH research literature, (b) the types of MH outcomes examined in student-athlete populations, (c) comparisons of student-athletes' MH in relation to other populations of interest, and (d) the variables associated with student-athletes' MH. Articles were collected from four databases: SPORTDiscus, PsycInfo, Scopus, and PubMed. In total, 159 studies spanning three decades met the inclusion criteria. Most studies were conducted within the North American collegiate context. The majority (62.5%) examined mental ill-health outcomes (e.g., disordered eating, depression, anxiety), 22.6% examined positive mental health outcomes (e.g., subjective well-being, psychological well-being), and 13.8% combined both perspectives. Most studies using non-student-athlete comparison groups found that student-athletes were at a similar or decreased risk for MH problems, although notable exceptions were identified. Finally, 49 distinct variables were associated with student-athletes' MH. Most variables related to generic or sport-specific factors, with only a limited number of studies examining DC-specific factors. Findings from our scoping review are critically discussed in view of the existing literature.
Article
Objective: Positive and negative influences from teammates (e.g., supportive teammate friendships, modelling of teammates' disordered eating) have been associated with athletes' eating/exercise psychopathology. However, research is yet to explore how an athlete's psychological well-being and gender may impact upon these relationships. This study aimed to explore whether psychological well-being mediates the relationship between teammate influences and eating/exercise psychopathology, and to determine whether gender moderates the significant mediation effects identified. Method: Athletes (N = 195, mean age 18.35 years, n = 110 female, n = 81 lean sport athletes) completed a survey three times over an 8-month period exploring teammate influences, psychological well-being (self-esteem, anxiety, depression) and eating/exercise psychopathology. Mediation and moderated-mediation analyses were conducted. Results: Higher levels of anxiety significantly mediated the positive relationships between bulimia modelling and teammate pressure with eating and exercise psychopathology. Higher levels of depression significantly mediated the positive relationship between teammate pressure and body dissatisfaction, and the negative relationship between supportive friendships and body dissatisfaction. Higher levels of self-esteem mediated both inverse relationships between supportive friendships and a lower drive for thinness (fully) and body dissatisfaction (partially). Gender did not significantly moderate any mediation relationships. Discussion: Male and female athletes with poor psychological well-being (i.e., high levels of anxiety or depression) are more susceptible to negative teammate influences, while athletes with good psychological well-being (i.e., high self-esteem) reap the protective benefits of supportive teammate friendships. Understanding the circumstances under which teammates are influential is vital for the development of targeted intervention and prevention strategies to reduce athlete eating and exercise psychopathology.
Chapter
This chapter provides a framework for the recognition and treatment of four feeding and eating disorder subtypes that occur during childhood and adolescence: anorexia nervosa (AN), bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID). Eating disorders are chronic disorders that begin in childhood or adolescence and typically continue into adulthood. The typical course of eating disorders is marked by periods of symptom remission and exacerbation. Streptococcal infections are biological triggers that have been studied in relationship to acute onset AN and ARFID. Psychosocial factors interact with genetic and biological vulnerability to increase the risk for eating disorder onset and/or relapse. Family adversity, including childhood exposure to trauma and maltreatment, has been cited as a factor contributing to the risk for eating disorders. Primary care practitioner and psychiatric mental health‐advanced practice registered nurses have important roles in the assessment, diagnosis, and management of children and adolescents with eating disorders.
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Purpose: The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world. Methods: An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex. Results: Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p-Value = 0.001. Bayesian meta-analysis produced an odd estimate of 0.24 [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased. Conclusions: These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment.
Article
Purpose: This study aimed to identify the factors influencing abnormal eating behavior among adults who visit obesity clinics.Methods: Questionnaires were used to collect data from 234 adults who visit obesity clinics at K University Hospital. The questions included eating attitude, alexithymia, and depression. Data were analyzed using t-test, ANOVA, Scheffétest, Pearson’s correlation coefficient, and multiple regression analysis.Results: Abnormal eating behaviors were significantly associated with alexithymia, depression, and body mass index. The predictors of abnormal eating behaviors were depression, body mass index, difficulty identifying feelings, perceived economic status, body image perception, and gender, which explained 28% (Adj. R2=.28) of the abnormal eating behaviors.Conclusion: The findings revealed a need for educational programs that can contribute to desirable eating behaviors and strategies for healthy weight control. In addition, a support program should be availed to help them recognize and properly express their feelings along with prevention and management of depression.
Article
Mental illness among elite and intercollegiate student-athletes is of growing concern, as researchers have found high rates of anxiety, depression, and eating disorders among this population. As a result, a call has been made for sport psychology consultants (SPC) to increase their contribution to promoting athletes’ mental health. Infographics can be used as a mental health promotional tool given their ability to visually communicate complex information. This paper draws on the infographic literature in healthcare and education to provide SPC with recommendations for creating infographics to promote mental health among elite and student-athletes with whom they consult. Tips are also provided on effective implementation of infographics in the sport environment.
Article
Introduction: The current report is a 25 year follow-up on individuals who experienced a devastating earthquake on December 7, 1988 in the Republic of Armenia. The focus of the initial study was to determine whether there were any differences in emotional reactions between children (ages 13-14) who experienced the earthquake and remained in the earthquake city compared to a similar group of exposed children and relocated to an intact city with no damage two and one half years after the earthquake. This study followed traumatized in adolescents after a devastating earthquake for 25 years to identify what resilient traits remained consistent during their adulthood. Methods: The subjects for the initial study at Time1 were chosen randomly by a convenient sample by the principal of a local school. At Time 2, the same principal identified 19 of the original 25 subjects 20 years later (Time2). The same principal was still active in the community in 2014 and helped locate 11 of the original 25 subjects (4 men and 7 women). Results: Traits that supported resilient functioning and remained consistent over time were: education, employment, marriage, hobbies, a purpose in life, a tie to the community and religious activity. Many of these personal and social attributes may be incorporated in a recovery plan for traumatized individuals regardless of the traumatic event. These interventions may improve the clinical and social outcomes in survivors of trauma.
Article
Objectives Female athletes experience eating disorders (ED) at clinical, and subclinical, levels; most studies have determined point-prevalence rates through cross-sectional methodologies. To date, few studies have examined the long-term stability of EDs in female athletes; none extend into retirement. Design A longitudinal investigation of ED classification (i.e., Clinical ED, Subclinical ED, Healthy) and weight control behaviors (e.g., vomiting, laxative use) from when athletes actively competed (T1) into their retirement (T2). Methods Participants included U.S. female athletes (N = 193) who were collegiate competitors (T1) and eventually were retired from their collegiate sports six years later (T2). Results At T2, athletes were classified as Healthy (69.9%), Subclinical ED (26.9%), and Clinical ED (3.1%). Overall percentage of Subclinical EDs increased from 18.7% (T1) to 26.9% (T2); 52.8% of T1 Subclinical ED athletes continued to meet criteria for either Subclinical or Clinical ED at T2. Of the 13 Clinical ED athletes at T1, six (46.2%) continued to meet criteria for either a subclinical or clinical ED at T2. Though exercising (2+ hours/day; n = 8, 4.1%) and dieting/fasting (4+ times/year; n = 14, 7.3%) were the most frequently used weight control behaviors at T2, rates were substantially lower than at T1. Conclusions Retirement does not result in immediate remittance of eating concerns among female athletes; many continue or develop Subclinical and Clinical ED symptoms. Thus, addressing healthy body image and nutrition when athletes are competing is imperative to assist prevention and intervention efforts that may alleviate ED symptoms as athletes transition from sport.
Article
The current article describes recommendations for identifying and developing referral sources for student-athletes seeking counseling services. A Counseling Center at a northeastern state university collected data from student-athletes presenting for mental health services about who referred them and what sport they played. Findings indicated a disparity between the number of female student-athletes presenting for services and male student-athletes as well as more student-athletes presenting for services during the Fall semester than the Spring semester. It was also found that athletic trainers and coaches were the biggest referral sources to university counseling services. Recommendations for other Counseling Centers are provided in creating and improving upon referral sources for student-athletes.
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Objectives This project examined risk factors of disordered eating in athletes by adapting and applying a theoretical model. It tested a previously proposed theoretical model and explored the utility of a newly formed model within an athletic population across gender, age, and sport type to explain disordered eating. Design The design was cross-sectional and the first phase in a series of longitudinal studies. Methods 1,017 athletes completed online questionnaires related to social pressures, internalisation, body dissatisfaction, negative affect, restriction, and bulimia. Structural equation modelling was employed to analyse the fit of the measurement and structural models and to do invariance testing. Results The original theoretical model failed to achieve acceptable goodness of fit (χ² [70, 1017] = 1043.07; p < .0001. CFI = .55; GFI = .88; NFI = .53; RMSEA = .12 [90% CI = .111-.123]). Removal of non-significant pathways and addition of social media resulted in the model achieving a parsimonious goodness of fit (χ² [19, 1017] = 77.58; p < .0001. CFI = .96; GFI = .98; NFI = .95; RMSEA = .055 [90% CI = .043-.068]). Invariance tests revealed that the newly revised model differed across gender, age, level, competition status, and length of sport participation. Conclusion This study showed that the formation of disordered eating symptomology might not be associated with sport pressures experienced by athletes. It revealed that disordered eating development varies across gender, competition level, sport type, and age, which must be considered to prevent and treat disordered eating in athletes.
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Doğru beslenme; enerji dengesini sağlayarak, vücut ağırlığı yönetimini ve vücudun en uygun şekilde fonksiyonlarını sürdürmesini sağlar. Besinlerle yeterli enerji alırsanız daha aktif olabilir, yeterli protein alırsanız kas kütlenizi koruyabilirsiniz. Beslenme; aktif kişiler ve sporcuların egzersiz için yaptığı hazırlığın önemli bir parçasıdır. Sporcu beslenmesi, sporcuların yaptıkları spor dalına göre hem antrenmanlarını hem de müsabaka sırasındaki atletik performanslarının geliştirilmesi için hazırlanan özel bir beslenme programıdır. İster yürüyüş yapın, ister pilates yapın, ister fitnes yapın, isterseniz maraton koşun. Hangi sporu yaparsanız yapın, spor yapanların sağlığın korunması, dayanıklılığın artması, konsantrasyon ve dikkat yeteneğinin iyi olması ve spordan maksimum faydayı sağlamak için sağlıklı beslenmelisiniz. Son yıllarda beslenmenin sağlık ve sporcu performansı üzerinde etkilerini belirten birçok çalışma yapılmıştır. Bu kitapta besin ögelerinin sağlık ve sporcu performansı üzerindeki etkilerinin yanısıra, kan gruplarına göre beslenme, alkali beslenme ve yeme bozuklukları gibi konularda işlenmiştir. Kitap hazırlanırken 300’den fazla eski ve yeni kaynaktan yararlanılmıştır. Bu kaynakların çoğunluğunu yabancı literatür oluşturmaktadır. Kitap üniversitelerin Spor Bilimleri fakülteleri ve Beden Eğitimi ve Spor Yüksekokulları’nın Sporcu Beslenmesi, Egzersiz ve Beslenme derslerinde işlenebilecek düzeydedir. Kan gruplarına göre beslenme konusu Mehmet Ali Bulut ve Peter J. D’Adamo isimli yazarların kitaplarından işlenmiştir. Kan gruplarına göre beslen-me konusu bilimsel geçerliliği henüz net olarak tespit edilmese de, birçok kişinin uyguladığı ve kendilerini daha hissettiklerini belirten bir yöntemdir. Alkali beslenme konusu hazırlanırken birçok kaynaktan faydalanılmıştır. Ayrıca kitapta anoreksiya nevroza, bulimia nevroza ve ortoreksiya nevroza yeme bozukluklarındanda bahsedilmiştir. Son olarak kitabın yazılmasındaki her aşamada katkı sağlayan Dr. Rıdvan Kır’a teşekkür ederiz.
Article
Eating psychopathology symptoms are common in athletes, however, it is unknown which symptoms are detected, and to what extent, by sport professionals. This study aimed to develop and evaluate a self-report questionnaire to explore which features of eating psychopathology in athletes are detected by sport professionals, and how observation of these symptoms might vary. Thirty-one questions were developed, and 232 sport professionals (56% male) participated in the study. Exploratory Factor Analysis revealed a 20-item, 5-factor solution (Negative Affect, Dieting Practices, Fear of Eating in Social Contexts, Bingeing and Purging, and Compulsive Exercise). Participants most frequently reported observing athlete dieting practices, while symptoms of a fear of eating in social contexts were observed least frequently. This study has developed and preliminarily tested the Athlete Eating Psychopathology Observation Questionnaire (AEPOQ) which now requires further validation. The findings provide important directions for education initiatives with sport professionals regarding identification of eating psychopathology symptoms.
Chapter
Elite athletes perform at a very high level and often spend hours and years training, participating in their sport and working with coaches and teammates. In addition to being susceptible to injuries and illness, increasingly important to consider are mental health (MH) concerns in athletes. The most common MH concerns encountered in athletes include anxiety/stress, depression and suicide, overtraining, disordered eating/eating concerns, response to injury, sleeping disorders, Attention Deficit/Hyperactivity Disorder ADHD, substance use, and substance abuse. In addition, issues such as sexual misconduct, hazing and bullying, transition from sport, and psychological response to injury are issues that are often unique in the setting of sport. This chapter will briefly review the MH concerns that are commonly encountered in athletes, with a focus on what might be different in their presentation in elite athletes compared to the general population, and how the medical staff can incorporate early detection and management strategies that are important in supporting the health and wellness of elite athletes.
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Disordered eating and eating disorders have huge impact on athletic health and performance. Understanding risk factors for disordered eating development is paramount to protecting the health and performance of these athletes. This project tested a model longitudinally to test whether body dissatisfaction (mediated by negative affect) and societal pressures (mediated by internalisation) predicted bulimic symptomatology at 1 year. The study recruited 1017 male and female athletes in a range of sports at three time points over a year. Cross-lag meditation modelling in MPLUS was utilised to test the hypothesised model. Results indicated that societal pressures mediated by general internalisation led to bulimic symptomatology and that gender and sport type do moderate the relationships. However, measurement issues indicate that scales not originally created for athletes may not reliably measure athletes’ experience. This research highlights how understanding how to better assess risk factors and disordered eating related concepts in athletes is a key next step. The study is unique in its longitudinal design and in its sampling of a wide range of sports in both male and female athletes.
Article
Objective Due to high prevalence, female athletes are considered a high‐risk group for eating disorders (i.e., clinical ED = 2.0% to 19.9%; subclinical ED = 7.1% to 49.2%). Cross‐sectional and longitudinal research have identified psychosocial factors that influence current and future disordered eating (e.g., appearance pressures, body satisfaction), but are limited in design (e.g., timeframe, active competitors). Quantitative evaluations of psychosocial predictors of female athletes' disordered eating in retirement are lacking. Method The current study investigated the predictive ability of psychosocial risk factors (e.g., body dissatisfaction, negative affect) from Time1, when collegiate female athletes were actively competing, to Time2, 6 years later when the women were retired (N = 194; Mage = 25.75 years [SD = 1.19]). Results From Time1 to Time2, 23.5% of the women who were Healthy moved to the Disordered classification; 51% remained in Disordered. The full model for athletes who maintained their Disordered status correctly classified 76% of the athletes. Dietary intent, pressure to exercise and change appearance, body satisfaction, and internalization significantly predicted athletes' maintenance as Disordered. Discussion Early intervention efforts that address appearance pressures, body image, and healthful eating when athletes are actively competing are vital to help alleviate future distress, particularly in retirement.
Article
Eating disorders (ED) are complex mental illnesses and are not a result of personal choice. Full recovery from an ED is possible. The severity and inherent lethality of an ED is undisputed, and the role of the registered dietitian nutritionist (RDN) is essential. Clinical symptomology presents at varying developmental milestones and is perpetuated through a sociocultural evaluation of beauty and drive for ascetic idealism. ED are globally prevalent in 4.4% of the population aged 5 to 17 years, yet affect individuals across the entire lifespan, including all cultures and genders. The Behavioral Health Nutrition Dietetic Practice Group, along with the Academy of Nutrition and Dietetics Quality Management Committee, revised the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for RDNs in Eating Disorders. Including the RDN in ED treatment is vital for all levels of care. The RDN must be perceptive to negative symptoms indicative of psychological triggers when exploring food belief systems, patterns of disinhibition, and nutrition misinformation with clients. Through a conscious awareness of medical, psychological, and behavioral strategies, the implementation of the SOP and SOPP supports a dynamic and holistic view of ED treatment by the RDN. The SOP and SOPP are complementary resources for RDNs and are intended to be used as self-evaluation tools for assuring competent practice in ED and for determining potential education, training, supervision, and mentorship needs for advancement to a higher practice level in a variety of settings.
Article
CONTEXT: Female athletes/performing artists can present with low energy availability (LEA) either through unintentional (e.g., inadvertent undereating) or intentional methods (e.g., eating disorder [ED]). While LEA and ED risk have been examined independently, little research has examined these simultaneously. Awareness of LEA with or without ED risk may provide clinicians with innovative prevention and intervention strategies. OBJECTIVE: To examine LEA with or without ED risk (e.g., eating attitudes, pathogenic behaviors) in female collegiate athletes/performing artists. DESIGN: Cross-sectional and descriptive. SETTING: Free-living in sport-specific settings. PARTICIPANTS: Collegiate female athletes/performing artist (n=121; age: 19.8±2.0 years; height: 168.9±7.7 cm; weight: 63.6±9.26 kg) in equestrian (n=28), volleyball (n=12), softball (n=17), beach volleyball (n=18), ballet (n=26) and soccer (n=20) participated in this study. MAIN OUTCOME MEASURES: Anthropometric measurements (height, weight, body composition), resting metabolic rate, energy intake, total daily energy expenditure, exercise energy expenditure, Eating Disorder Inventory-3 (EDI-3), and EDI-3 Symptom Checklist were assessed. Chi-square analysis examined differences between LEA and sport type, LEA and ED risk, ED risk and sport type, and pathogenic behaviors and sport type. RESULTS: Female athletes/performing artists (81%; n=98) displayed LEA and significant differences were found between LEA and sport type (χ25=43.8, P<.01). Female athletes/performing artists (76.0%; n=92) presented with ED risk with no significant difference between ED risk and sport. EDI-3 Symptom Checklist revealed 61.2% (n=74) engaged in pathogenic behaviors, with dieting the most common (51.2%; n=62). Athletes/performing artist displayed LEA with ED risk (76.0%; n=92). No significant differences were found between LEA with ED risk and sport. Softball was the highest with 82.4% (n=14) reporting LEA with ED risk followed by ballet (76%; n=19). CONCLUSION: Our results suggest a large proportion of collegiate female athletes/performing artists are at risk for LEA with ED risk, thus warranting education, identification, prevention, and intervention strategies relative to fueling for performance.
Article
Little is known about the rates of disordered eating behaviors in the athletes who compete in the disciplines that comprise collegiate English Equestrian sports. Importantly, in some subdisciplines, riders' scores depend upon judges' assessment of their appearance while riding, rather than upon solely objective measures such as time to complete a course. The purpose of the present research was to 1) assess the current rate of disordered eating behaviors in college equestrian athletes, 2) test whether certain disciplines of English riding (i.e., those that focus on aesthetics or non-aesthetics) at the collegiate level have higher rates of disordered eating behaviors, and 3) test whether these athletes face different pressures for appearance and weight if they specialize in aesthetic riding disciplines. English equestrian student athletes from across the United States (N = 330; 97 % female) and from the following disciplines were surveyed: equitation (aesthetic), dressage (aesthetic), hunters (aesthetic), jumpers (non-aesthetic), and eventing (non-aesthetic). The results suggest a high prevalence of disordered eating in the sport (35 % met cut off for disordered eating using the EAT-26). Findings suggest similar rates of disordered eating behaviors between the aesthetic and non-aesthetic disciplines. Findings also indicate that student athletes in aesthetic disciplines were much more likely to say that they were weighed by coaches and pressured to lose weight. Thus, the current study lends empirical support to the notion that coaches can be a source of pressure for these athletes. Issues of addressing disordered eating in coaching and future research are discussed.
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Collegiate student athletes are faced with the same developmental challenges and stressors as their nonathlete peers, but they are also expected to deal with the challenges of athletic involvement (e.g., time demands, physical demands, travel schedules). Such additional demands may put athletes at greater risk for experiencing physical and psychological health problems. The current article was written for student affairs administrators as an overview of the current knowledge about several healthrelated issues commonly faced by collegiate student athletes (i.e., training and overtraining, alcohol, drug use and drug testing, depression and suicidality, dysfunctional eating behaviors, injury, and hazing), and to provide assistance to these administrators for making decisions about the best practices for dealing with such issues.
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The complex legacy of social class on African American lesbians in relationships was examined using a case study approach. Six highly educated, middle class African American lesbians in their mid-thirties to mid-fifties were interviewed in this exploratory study. Differences in social class were perceived as the reason for the conflict in these relationships. Conversely, similarities in social class were described as making relationships operate more smoothly. Although similarities in race can generate shared cultural values, it is the meaning given to a couple's perceived similarities and differences that influences the quality of the communication between partners. These preliminary findings highlight a previously unexplored contribution to the dynamics in African American lesbian relationships.
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Despite many theorists' assertions and researchers' findings that eating disturbances have personal, sociocultural, and relational correlates, no model of eating disorder symptomatology incorporating all 3 of these domains has been proposed. The purpose of this study, then, was to examine empirically such a model. Personal, sociocultural, and relational variables were chosen, based on their solid relations with eating disorder symptomatology, to be included within the model. Theoretical frameworks and empirical findings were used to specify variable relations and paths, and the model was tested via structural equation modeling with data from 463 college women. As expected, the model fit the data adequately, and sociocultural, personal, and relational variables all made unique contributions within the model. Most model predictions were supported, and personal and relational variables were found to fully mediate the effects of the sociocultural variable on disordered eating scores. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The Bulimia Test —Revised [(BULIT-R) M. H. Thelen, J. Farmer, S. Wonderlich, & M. Smith; see record 78:17280] was given to participants who met the criteria in the fourth edition of the Diagnostic and Siatistical Manual of Mental Disorders (DSM-IV) for bulimia nervosa and control participants to determine if the test continues to be a valid measure of bulimia nervosa. Although the BULIT-R was developed and validated with bulimic individuals as determined by the DSM-III-R criteria, it appears to be a valid instrument with which to identify individuals who meet DSM-IVcriteria for bulimia nervosa. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The Questionnaire for Eating Disorder Diagnoses (Q-EDD) operationalizes eating disorder criteria of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and differentiates (a) between those with and without an eating disorder diagnosis, (b) among eating-disordered, symptomatic, and asymptomatic individuals, and (c) between those with anorexia and bulimia diagnoses. Three studies examined the Q-EDD"s psychometric properties. Convergent validity was supported by correspondence between Q-EDD diagnoses and established inventory scores. Criterion validity was supported by high correspondence between Q-EDD and interview or clinician diagnoses. Incremental validity was supported by greater accuracy of Q-EDD diagnoses than those yielded by an established inventory. Test-retest reliability and interscorer agreement were very good. Future use is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Due to the equivocal research examining body image between athletes and nonathletes and the serious negative effects of body image disturbance a meta-analytic review of the literature was undertaken (N = 78 studies, 294 effect sizes). A small effect was found which indicated that athletes had a more positive body image compared to the nonathletes. Examination of the moderator variables revealed that the magnitude of the effect size: (a) for unpublished research was larger compared to published research; (b) for comparison groups which were included within the study was smaller than for comparison groups based on normative data; (c) did not differ between the female athletes compared to the male athletes; (d) did not vary among the aesthetic, endurance, and ball game sport athletes; and (e) did not differ by age or body mass index. Possible explanations for the more positive body image of the athletes than the nonathletes are discussed.
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The authors examined a proposed profile of eating-related behaviors, associated features, developmental issues, and help-seeking behavior among college women, using an eating disorder response program. The most common symptom scenario was a pattern of regular binge eating, together with daily exercise and occasional purging. The most common associated features were distressing or dysfunctional overconcern about body image and self-esteem, usually with day-to-day stress and intermittent depression. The women who fit this pattern also presented developmental issues of perfectionism, conflictual relationships with parents, and struggles for independence; and they tended to be ambivalent about seeking services. Implications for practice, including the need to develop a framework for eating disorder responses on campus that includes preventive programs and developmental interventions to target emerging and moderate concerns are discussed; limitations and the preliminary nature of the findings are explicated.
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The objectives of the study were to examine the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), anorexia athletica (AA), and eating disorders not otherwise specified (ED-NOS) in both male and female Norwegian elite athletes and a representative sample from the general Norwegian population. A 2-step study including self-reported questionnaire and clinical interview. The entire population of Norwegian male and female elite athletes (n=1620) and controls (n=1696) was evaluated for the presence of eating disorders (EDs). Based on the results of the questionnaire, all athletes and controls classified as at risk for EDs, and a representative sample of athletes and controls classified as healthy participated in the clinical part of the study to determine the number of subjects meeting the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for EDs. More athletes (13.5%) than controls (4.6%; P<0.001) had subclinical or clinical EDs. The prevalence of EDs among male athletes was greater in antigravitation sports (22%) than in ball game (5%) and endurance sports (9%; P<0.05). The prevalence of EDs among female athletes competing in aesthetic sports (42%) was higher than that observed in endurance (24%), technical (17%), and ball game sports (16%). The prevalence of EDs is higher in athletes than in controls, higher in female athletes than in male athletes, and more common among those competing in leanness-dependent and weight-dependent sports than in other sports. A collaborative effort among coaches, athletic trainers, parents, physicians, and athletes is optimal for recognizing, preventing, and treating EDs in athletes.
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This meta-analytic review of prospective and experimental studies reveals that several accepted risk factors for eating pathology have not received empirical support (e.g., sexual abuse) or have received contradictory support (e.g., dieting). There was consistent support for less-accepted risk factors(e.g., thin-ideal internalization) as well as emerging evidence for variables that potentiate and mitigate the effects of risk factors(e.g., social support) and factors that predict eating pathology maintenance(e.g., negative affect). In addition, certain multivariate etiologic and maintenance models received preliminary support. However, the predictive power of individual risk and maintenance factors was limited, suggesting it will be important to search for additional risk and maintenance factors, develop more comprehensive multivariate models, and address methodological limitations that attenuate effects.
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Disordered eating among athletes is well documented, but the management and treatment of athletes can present unique challenges. This article provides information about several aspects of disordered eating among athletes: identification of the disorder, the relationship between disordered eating and sport, the composition and roles of treatment and management teams, and special treatment issues. Recommendations are offered to increase the psychologist's understanding of, and appreciation for, athletes and the sport environment. Implications for training professional psychologists to work with this special population emphasize firsthand experiences within the sport environment and training in manual-based treatment for eating disorders.
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Although eating disorders have been the focus of much research, the inclusion of minority populations in such investigations has been minimal. Thus, the purpose of this study was to examine personality and physical correlates of bulimic symptomatology in a sample of Mexican American female college students. Hierarchical regression analysis revealed that body mass and endorsement of U.S. societal values concerning attractiveness were related positively to bulimic symptomatology, accounting for a combined 38% of the variance. Age, body satisfaction, and acculturation level, however, were unrelated to bulimic symptoms. Implications for counseling interventions as well as directions for future research are discussed.
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Sports have received widespread attention for the risk of disordered eating, but prevalence rates among athletes have varied from one to 62 percent across studies (Beals, 2004). One explanation for this discrepancy has been the tendency for previous studies to select “at-risk” sports for examination. The current study extends prior inquiry by expanding the sample to the entire student-athlete group at Ohio State University. Approximately 800 varsity student-athletes at this large Division I university completed the Questionnaire for Eating Disorder Diagnosis (Q-EDD; Mintz, O’Halloran, Mulholland, & Schneider, 1997) in 2001 and 2002, allowing gender and type of sport comparisons. The purposes of the study were to identify at-risk athletes as part of a screening process designed for eating disorder prevention, and to continue to refine the assessment of disordered eating in athletes. Not surprisingly, results showed that subclinical eating problems were more prevalent than clinical eating disorders in athletes, with 19 percent of female athletes and 12 percent of male athletes reporting eating disorder symptoms in year one, and 17 percent of female athletes and nine percent of male athletes in year two. Because the Q-EDD does not fully capture male body image problems, in 2002 questions were added to the Q-EDD that assessed preoccupation with muscularity, and preliminary Endings showed that one percent of male athletes fit a diagnosis of Muscle Dysmorphia. For both years, athletes from lean sports reported significantly more eating disorder symptoms than did athletes from nonlean sports. Specific policies employed by this university and prevention strategies will be discussed.
Article
The purposes of this exploratory study were to examine athletic body image and social body image among former competitive female athletes. Additionally, the perceived influence of past competitive experiences on current body image was explored. In-depth interviews were conducted with six former competitive collegiate athletes. The participants ranged in age from 23 to 31, with a mean age of 26. Common factors reported as influencing how participants felt about their bodies as athletes included uniforms, teammates, appearance, fitness, and coach attitudes and behaviors. Participants’ experiences and feelings about their bodies in athletic and social settings varied. Participants recognized some conflict between their athletic body and social ideals, however this incongruence did not seem problematic for most of the participants. Across participants, their current feelings and thoughts about their bodies were based on their former competitive athletic bodies.
Article
Research shows inconclusive results pertaining to the comparison of eating disorder indices between athletes and nonathletes and among different subgroups of athletes. The purpose of this study was to meta-analytically review the literature on (a) bulimia nervosa indices, (b) anorexia nervosa indices, and (c) drive for thinness (a cardinal feature of both anorexia and bulimia) in male and female athletes. Results of 92 studies with 560 effect sizes (ES) revealed small ESs (range: -.01 to .30) in relation to group membership characteristics. Results for female athletes revealed small ESs for bulimia and anorexia indices, suggesting that female athletes self-reported more bulimic and anorexic symptomatology than control groups; nonsignificant group differences were evidenced for drive for thinness. Results for male athletes revealed small ESs on all three indices, suggesting that male athletes self-reported more eating disorder symptomatology than control groups. Moderator variables that might contribute to understanding the results are examined, and future research directions are presented.
Article
Seventy-three college female and 84 high school female cheerleaders participated in the current study on eating disorders and pressures within cheerleading. The participants completed the Eating Disorder Inventory (EDI), the Social Physique Anxiety Scale (SPAS), and CHEER, a measure developed by the authors to identify pressures within cheerleading. A one-way MANOVA indicated significant differences between high school and college cheerleaders on CHEER and SPAS. Correlational analyses revealed a strong relation between SPAS, body dissatisfaction scores, and eating behavior, suggesting that body image is an important predictor for eating disorders in cheerleaders. Moreover, although high school cheerleaders reported fewer pressures than their college counterparts, they exhibited greater body dissatisfaction and disordered eating patterns.
Article
The Bulimia Test—Revised (BULIT—R; M. H. Thelen et al, 1991) is a 28-item questionnaire that shows promise as a sound and valid global self-report measure of the multidimensional bulimia nervosa construct. This study estimated the reliability and construct validity of the BULIT—R. Specifically, the study examined the correspondence between BULIT—R scores and the self-monitored frequency of the bulimic symptoms of binge eating and purging among 39 college-aged women. Results support the internal consistency, temporal stability, and construct validity of the BULIT—R. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This paper presents five studies with 2,420 total participants on the development and validation of the Exercise Dependence Scale (EDS), which is conceptualized based on the Diagnostic and Statistical Manual-IV (APA, 1994) criteria for substance dependence, and differentiates among at-risk, nondependent-symptomatic, and nondependent-asymptomatic exercisers. Results of the studies revealed evidence for the a priori hypothesized components, acceptable test-retest and internal consistency reliability, and content and concurrent validity of the EDS. Individuals at-risk for exercise dependence reported more strenuous exercise, perfectionism, and self-efficacy compared to the nondependent groups. The findings provide initial support for the EDS and indicate the need for a multifaceted approach to its conceptualization and measurement.
Article
Eating disorders are believed to be a significant problem for many athletes. It has been suggested that aspects of the athletic environment not only increase the athlete's risk of developing such a disorder, but also make identification of at-risk athletes more difficult. The literature regarding “good athlete” characteristics and the literature with respect to personality characteristics associated with anorexia nervosa were briefly reviewed. Six traits were drawn from the anorexia literature and compared with six corresponding traits from the athlete literature and athletic environment. Comparisons revealed similarities between athlete and anorexic traits. Implications regarding identification and treatment are discussed.
Article
The general purpose of this study was to examine the prevalence and symptoms of eating disorders (ED) for 412 high school, university, and elite male and female track and field athletes and higher- and lower-active nonathletes. Participants completed the Eating Disorder Inventory-2 (Garner, 199110. Garner , D. M. 1991 . Eating Disorder Inventory-2. Professional manual , Odessa, FL : Psychological Assessment Resources . View all references) to assess ED symptoms and the Questionnaire for Eating Disorder Diagnosis (Mintz, O'Holloran, Mulholland, & Schneider, 199723. Mintz , L. B. , O'Holloran , M. S. , Mulholland , A. M. and Schneider , P. A. 1997 . Questionnaire for eating disorder diagnosis: Reliability and validity of operationalizing DSM-IV into a self-report format . Journal of Counseling Psychology , 44 : 63 – 79 . [CrossRef], [Web of Science ®], [CSA]View all references) to assess ED prevalence. We found that: (a) the women had greater Drive for Thinness and Body Dissatisfaction symptoms and a higher prevalence of ED than the men, (b) nonathletes reported greater Body Dissatisfaction symptoms than the athletes, (c) higher-active nonathletes had a higher prevalence of ED than the athletes and lower-active nonathletes, (d) the high school athletes had greater Ineffectiveness and Maturity Fears symptoms than the college and elite athletes, and e) there were no sport-group differences (i.e., middle/long distance, sprint, and field) for either ED symptoms or prevalence. Implications of these results and future directions are discussed.
Article
Disordered eating among athletes is well documented, but the management and treatment of athletes can present unique challenges. This article provides information about several aspects of disordered eating among athletes: identification of the disorder, the relationship between disordered eating and sport, the composition and roles of treatment and management teams, and special treatment issues. Recommendations are offered to increase the psychologist's understanding of, and appreciation for, athletes and the sport environment. Implications for training professional psychologists to work with this special population emphasize firsthand experiences within the sport environment and training in manual-based treatment for eating disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This articles extends the discussion of eating disorders to men and athletes, 2 populations at risk for these disorders, yet somewhat overlooked. The authors do not want counseling psychologists to be left with the belief that only women are at risk. Thus, the authors have focused on these 2 populations, in which eating disorders do exist and may be more of a problem than previously thought. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Few studies have been conducted examining male athletes and eating disorders, even though the sport environment may increase their risk. Thus, little information exists regarding the relationship of putative risk factors to eating disorders in this group. To address this issue, we examined the relationship of eating disorder classification to the risk factors of body image concerns (including drive for muscularity), negative affect, weight pressures, and disordered eating behaviors. Male college athletes (N = 199) from three different NCAA Division I universities participated. Only two athletes were classified with an eating disorder, though 33 (16.6%) and 164 (82.4%), respectively, were categorized as symptomatic and asymptomatic. Multivariate analyses revealed that eating disorder classification was unrelated to the majority of the risk factors, although the eating disorder group (i.e., clinical and symptomatic) did report greater fear of becoming fat, more weight pressures from TV and from magazines, and higher levels of stress than the asymptomatic athletes. In addition, the eating disorder group had higher scores on the Bulimia Test-Revised (Thelen, Mintz, & Vander Wal, 1996), which validated the Questionnaire for Eating Disorder Diagnosis (Mintz, O'Halloran, Mulholland, & Schneider, 1997) as a measure of eating disorders with male athletes. These findings suggest that variables that have been supported as risk factors among women in general, and female athletes in particular, may not apply as strongly, or at all, to male athletes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Although eating disorders have been the focus of considerable research, African American women generally have been overlooked, despite recent investigations indicating they also are at risk. In this study, the authors examined physical, psychological, and societal correlates of bulimic symptomatology in African American college women. Regression analysis revealed that body mass, body dissatisfaction, and low self-esteem were significantly related to bulimic symptomatology, accounting for 29% of the variance. Internalization of U.S. societal beliefs about attractiveness, level of identification with White culture, and level of depression, however, were not significant predictors of bulimic symptoms in the regression equation. The findings are discussed in the context of sociocultural approaches to understanding eating disorders. Implications for counseling interventions as well as directions for future research are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The purpose of this study was to examine the prevalence of both clinical and subclinical eating behaviors among National Collegiate Athletic Association (NCAA) Division I collegiate athletes as compared to their nonathlete peers. A total of 489 individuals participated in the study, 325 of whom were involved in intercollegiate athletics at an NCAA Division I university. There was a fairly equal number of male and female athletes in the sample, with the gender difference larger for the non-athletes (65.9% female). Data were collected at mandatory meetings that were held at the beginning of the 2001 fall semester for all university athletes. After verbal explanation of the study's purpose and obtaining participants' informed consent, the Questionnaire for Eating Disorder Diagnoses (Q-EDD) and a Food Frequency Questionnaire that was part of a separate study were administered. Overall results indicated that more females than males exhibited eating behaviors that were classified as diagnostic or Symptomatic of an eating disorder. In addition, a greater number of Non-athletes than Athletes were both symptomatic or met diagnostic criteria for an eating disorder. Last, results indicated that athletes participating in sports that emphasized leanness and body aesthetics (lean) did not report more problematic eating behaviors than their non-lean athlete peers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Although eating disorders have been the focus of much research, the inclusion of minority populations in such investigations has been minimal. Thus, the purpose of this study was to examine personality and physical correlates of bulimic symptomatology in a sample of Mexican American female college students. Hierarchical regression analysis revealed that body mass and endorsement of U.S. societal values concerning attractiveness were related positively to bulimic symptomatology, accounting for a combined 38% of the variance. Age, body satisfaction, and acculturation level, however, were unrelated to bulimic symptoms. Implications for counseling interventions as well as directions for future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Extended the examination of the eating disorders continuum to the population of female athletes. The study also determined whether these athletes differed on various attitudinal and personality characteristics that have been associated with eating disorders. 215 female collegiate gymnasts, classified as normal/nondisordered eaters, exercisers, bingers, dieter/restricters, subthreshold bulimics, or bulimics, were compared on several personality and attitudinal measures. Over 60% of the Ss met the criteria for 1 of the intermediate disordered eating categories. Only 22% reported eating behaviors that could be classified as normal or nondisordered. Higher levels of disordered eating disturbance were associated with a desire to weigh less, lower self-esteem, and greater endorsement of sociocultural values regarding women's attractiveness. Findings provide partial support for the eating continuum in female athletes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Examined the relationship between 28 female college gymnasts' attitudes about weight and their gymnastic performance. Ss' scores on the Eating Attitudes Test, the Eating Disorder Inventory (EDI [D. M. Garner et al, 1983]), and an obesity knowledge test were measured. Ss were very concerned about their weight, although they used dangerous forms of weight control less frequently than previously studied samples and had EDI scores that did not differ significantly from norms for adolescent girls (J. C. Rosen et al; see record 1988-25257-001). Data suggest a need for education about nutrition, obesity, and weight control. Nationally competitive Ss were less preoccupied with their weight. Although competitive gymnasts are concerned about their weight, their degree of concern may not be statistically abnormal. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Chapter
What are Eating Disorders?Prevalence and Measurement of Eating DisordersRisk FactorsInterventionConclusion
Article
The current study evaluated body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary controls. Thirty subjects comprised each group, evenly proportioned by gender. The results indicated that weightlifters were significantly more accurate in estimating body size than runners and controls, although the latter two groups did not differ from one another. All subjects overestimated waist and hips to a greater degree than thighs; this finding was also true for their estimates of the size of a department store mannequin. Females were more dissatisfied with their body than males, with the exception that male and female weightlifters were equivalent on body dissatisfaction indices. Runners and weightlifters had greater eating disturbance than controls; females evidenced greater eating psychopathology than males. These findings indicate that type of physical activity may be related to size estimation accuracy and body satisfaction. The results are discussed with regard to the need to further refine subtypes of both obligatory runners and weightlifters for future investigations.
Article
Various factors have been implicated in the development of body image dissatisfaction. Especially important are three constructs: awareness of a thin ideal, internalization of a thin ideal, and perceived pressures to be thin. Using meta-analysis, we calculated the strength of the relationships between each of these constructs and body image, and we evaluated the differences in magnitude across the average effect sizes. We also tested the moderating effects of age and ethnicity, and we compared the average effect sizes with those from meta-analyses of prospective and experimental studies in order to determine whether the effect sizes differed by study design. The results indicated the following: all three sociocultural factors had statistically significant relationships with body image; internalization and perceived pressures have a significantly stronger relationship to body image than does awareness; the effect sizes from cross-sectional studies were significantly larger than those of both longitudinal and experimental studies; and neither age nor ethnicity was a statistically significant moderator of the relationship between awareness and body image or that between internalization and body image. In this article, we discuss the limitations and implications of the findings on future research, theory, and clinical application.
Article
The current study explored how body dissatisfaction and challenges associated with the transition to university predicted symptoms of binge eating. Participants were 101 female full-time first-year university students (M=18.3 years of age; SD=.50) who completed a background questionnaire and a web-based daily checklist assessing binge eating. Hierarchical Generalized Linear Modeling results showed that participants who were more dissatisfied with their bodies were three times as likely to report symptoms of binge eating compared to participants who were less dissatisfied. Participants who lived away from home were three times as likely to report symptoms of binge eating compared to participants living with parents. Finally, poor perceived social adjustment to the university context was associated with an increased likelihood of binge eating. Discussion calls for more research exploring the role that university challenges and adjustment play in predicting eating problems.
Article
Multivariate analyses were used to compare key eating behavior, cognitive, affective, and body variables to determine the similarities and differences between eating-disordered, symptomatic, and asymptomatic female undergraduates. On the eating behavior (i.e., bulimic symptoms, concern for dieting, weight fluctuation), and some of the cognitive (i.e., impression management, approval by others, dichotomous thinking, self-control, rigid weight regulation, weight and approval) and body (i.e., concern with body shape, satisfaction with face) variables, the eating-disorder group reported the most severe symptoms, followed linearly by the symptomatic and asymptomatic groups. On the affective (i.e., sad, anxious, guilty, shameful, stressed, happy, confident, overall self-esteem) and the remaining cognitive (i.e., vulnerability, catastrophizing) and body (i.e., importance of being physically fit and being attractive, satisfaction with body) variables, the symptomatic and eating-disorder groups did not differ from one another but had higher levels of distress than did the asymptomatic women. These findings suggest that (1) counselors need to be aware that a large percentage of female undergraduates are nondiagnosable yet experience eating-disorder symptoms, and (2) these symptomatic women are experiencing high levels of distress, particularly in the areas of affect and body image.