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Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors
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.
... 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 Of these studies, the majority are outdated [1,[15][16][17], used extremely low sample sizes (i.e., n = 1) [15], and included many other sports [15,16].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 Of these studies, the majority are outdated [1,[15][16][17], used extremely low sample sizes (i.e., n = 1) [15], and included many other sports [15,16].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). ...
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.
... 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. ...
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.
... Evidence suggests high-level athletes demonstrate a similar risk of developing anxiety disorders as compared to the general population (Gulliver et al., 2015). Similarly, 17% to 21% of college-aged males and females meet criteria for depression in both athlete and non-athlete populations (Yang et al., 2007;Weigand et al., 2013) and nearly one-quarter of females in this age group, including athletes, endorse subthreshold symptoms of disordered eating (Greenleaf et al., 2009). One of the key concerns for mental health providers who treat college athletes is the high rate of comorbidity of psychological problems in this population. ...
... In addition, student-athletes demonstrate an elevated risk of developing sleep problems (Brown et al., 2014), and disordered eating (Bratland-Sanda and Sundgot-Borgen, 2013. Student-athletes have repeatedly demonstrated similar rates of clinical depression (Yang et al., 2007;Weigand et al., 2013) and eating disorders (Greenleaf et al., 2009), when compared to non-athlete peers. However, some findings suggest athletes may be particularly susceptible to these two disorders (Rice et al., 2016). ...
Introduction
There is a need to psychometrically develop assessment instruments capable of screening mental health disorders in athlete populations. The current study was conducted to determine reliability, validity and clinical utility of the Mental Health Disorders Screening Instrument for Athletes (MHDSIA).
Methods and results
259 collegiate athletes completed the MHDSIA. Factor analysis determined a single factor with good internal consistency, and this factor was positively correlated with an established measure of psychiatric symptomology (Symptom Checklist 90-R), demonstrating its concurrent validity. An optimum clinical cutoff score (i.e., 32) was determined using Receiver Operating Characteristic (ROC) analyses to assist appropriate mental health referrals.
Discussion
Results suggest the MHSIA is a reliable, valid, and relatively quick and easy to interpret screen for the broad spectrum of mental health disorders in collegiate athletes. As expected, NCAA athletes reported lower MHDSIA scores than club and intramural athletes, while males reported similar severity scores as females.
... One subset of the college population that is at-risk of developing an eating disorder or disordered eating are college athletes (Ahlich et al., 2019;Martin et al., 2020). College athletes face both internal and external pressures to remain fit (Greenleaf et al., 2009). Internal and external pressures might include negative mood states, low self-esteem, desire for weight control, involvement in a hurtful relationship outside of athletics and perfectionism (Ahlich et al., 2019;Arthur-Cameselle & Quatromoni, 2011). ...
... Internal and external pressures might include negative mood states, low self-esteem, desire for weight control, involvement in a hurtful relationship outside of athletics and perfectionism (Ahlich et al., 2019;Arthur-Cameselle & Quatromoni, 2011). Researchers believe patterns of disordered eating are common in college athletes as a way to enhance performance (Bonci et al., 2008;Chatterton & Petrie, 2013;Greenleaf et al., 2009). However, eating disorders and disordered eating can have grave consequences for college athletes. ...
One subset of the college population that is at-risk of developing an eating disorder or signs of disordered eating are college athletes. College athletes face both internal and external pressures to remain fit. Of particular importance for this study is the role of the athletic trainer (ATs) in helping college athletes with a diagnosed eating disorder or patterns of disordered eating. This study followed a logical, systematic, and multiphase phenomenological approach to capturing reflections of athletic trainers’ (n = 7) subjective experiences related to managing student-athletes who have a diagnosed eating disorder. Using an open-ended interview guide, athletic trainers participated in an intensive interview with one of the researchers. Researchers categorized statements into one of three themes: (1) AT and college athlete relationship, (2) barriers to care, and (3) opportunities for improvement. These results provide insight concerning the intersection of ATs and their role in addressing eating disorders with college athletes. ATs play an important role in providing both support to aid physical recovery from ailments and injuries and also serve as a source of psychosocial referral and support.
... 47 A survey of 204 DI athletes in 17 sports at 3 universities showed that 2% of female athletes met the diagnostic criteria for an eating disorder, but 25.5% exhibited subclinical symptoms. 48 In addition, a survey of 203 DI male athletes from 3 universities (50% in football) revealed that nearly 20% reported significant pathological eating and weight control behaviors. 49 In the first research 50 comparing eating behaviors and body image disturbances between DI and DIII female athletes in refereed sports, the highest rates of disordered eating behaviors were 40.4% in DI and 49.2% in DIII athletes. ...
... 46,47,51,52 In addition, life transitions, such as graduating from high school and going to college, are known risk factors for the new onset of eating disorders or relapses in eating disorders in high-risk individuals of every gender. 48 Thus, athletic programs must have robust screening and referral processes in place that include care provided by RDNs with specialty training in eating disorders, whether they are staff, consultants, or providers in the local community. 53 Several position papers and consensus statements 9,46,52-54 written by professional organizations involved in athlete care have been published on the identification and treatment of eating disorders. ...
Collegiate athletic programs are increasingly adding nutrition services to interdisciplinary sports medicine and sports performance departments in response to scientific evidence highlighting nutrition's integral role in supporting athletic performance and overall health. Registered Dietitian Nutritionists (RDNs) specializing in sports dietetics (ie, sports RDNs) and credentialed Board-certified Specialists in Sports Dietetics (CSSDs) are the preferred nutrition service providers for these programs. Their extensive training and proficiency in medical nutrition therapy, education and behavioral counseling, food-service management, exercise physiology, physical performance, and administration, as defined by the ''Standards of Practice and ''Standards of Professional Performance'' for Registered Dietitian Nutritionists in Sports Nutrition and Human Performance,'' make these practitioners uniquely qualified to deliver the breadth of care required in the collegiate setting. Therefore, this document, guided by a multidisciplinary panel, introduces four sports nutrition models through which any collegiate athletic program can deliver sports RDN-directed nutrition services. In each model, the most effective staffing and scope of service are indicated and reviewed. In addition, recommended organizational structures for sports RDN are provided that best support the delivery of the model's nutrition services in a variety of collegiate athletic programs and organizational settings. Lastly, future research initiatives and nutrition interventions to help improve the standard of care through these sport nutrition models are explored.
... Laxatives and vomiting are considered DE purging compensatory behaviors that mimic the psychopathology found in ED. Numerous studies have categorized compensatory behaviors, such as laxative and self-induced vomiting, as a form of DE (Greenleaf, Petrie, Carter, & Reel, 2009;Neumark-Sztainer et al., 2011;Stephen, Rose, Kenney, Rosselli-Navarra, & Weissman, 2014;Kelly-Weeder, 2010). Furthermore, the American College Health Association-National College Health (ACHA) Assessment II (2013), which collected data from 289,024 students across 223 U.S. universities, categorized these behaviors as DE. ...
... Among college students, exercise is the most common weight control method, with nearly 73% of students reporting exercising to lose weight (Kelly-Weeder, 2010); this is particularly prevalent among college athletics. Among 204 college athletes, 25.5% showed signs of DE and were more likely to use exercise as a means of controlling body weight over other DE behaviors (e.g., vomiting, dieting, using laxatives, or diuretics; Greenleaf et al., 2009). ...
... 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]. ...
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. ...
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.
... Practice and competition uniforms may exemplify this culmination of sport and societal pressures, since a revealing design is often necessary for peak performance-for example, an aerodynamic sprinter uniform (Greenleaf, Petrie, Carter, & Reel, 2009). These revealing uniforms can increase body shame and feelings of guilt, creating a higher likelihood for athletes to engage in disordered eating (Tylka & Hill, 2004). ...
... It was demonstrated that sport-specific and societal pressures contribute to disordered eating, both of which are widely evidenced in the literature (Anderson et al., 2012;Greenleaf et al., 2009;Sundgot-Borgen & Torstveit, 2004). This study expands the knowledge in the field by adding a level of specificity about sportspecific demands that had been lacking. ...
Background: This research focusses on disordered eating and eating disorders (DE/ED) in athletes. DE/ED negatively impact athletes’ physical and mental health and performance. Hence, understanding their development is key. Petrie and Greenleaf’s (2007) model is specific to athletes and served as a theoretical basis for this work. This model posits that initial predictors of disordered eating are sport pressure and societal pressure and describes several moderators and mediators. Aims and Methods: The thesis aimed to improve understanding of the development of DE/ED in athletes and develop a new model to predict DE/ED in athletes. The first task was to systematically review the evidence for Petrie and Greenleaf’s (2007) model. The next was to test the model’s applicability in a large cross-sectional sample. A qualitative study was undertaken to better understand the experiences of the athletes in the sample. Finally, a longitudinal study was conducted to test the model over time, using structural equation modelling and cross-lag mediation. Results: The systematic review yielded inconsistent findings, providing further support for the need to test Petrie and Greenleaf’s theoretical model. Testing their model in a large athlete sample revealed that it does not adequately explain DE/ED in athletes and a new model was developed that better fit the sample. This new model was then used in a longitudinal study, where it showed that societal pressures, mediated by internalisation, predicted later bulimic symptomatology. The qualitative study highlighted the complex interaction between societal expectations, social comparisons, and sport pressures that contribute to the development of disordered eating. Conclusions: These findings suggest that development and prevention of DE/ED in athletes may align with principles already established in research and practice for nonathlete populations. A key limitation was that the scales used were not reliable for athletes across time. Future research should include scales specifically designed for athletes.
... 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. ...
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.
... Dietary and training restrictions implemented by athletes participating in sports with weight categories often contribute to the development of eating disorders [29,30,55,56]. Furthermore, endurance sports, such as running, track and field, and swimming, are considered high-intensity sports and have been found to be related to eating disorder development among athletes [57,58]. For endurance and track and field athletes, a higher body fat percentage can negatively affect performance [59]. ...
Background
Eating disorders negatively influence athletes’ health and performance. To achieve a high level of performance and conform to cultural expectations regarding an athletic body type, female athletes often restrict their diets, which can lead to eating disorders. In addition to factors related to the sports environment, adolescent athletes are subject to changes caused by the maturation process. Therefore, the same factors may have different effects on eating disorder risk among adolescent and adult athletes. This study examined the relationship between eating disorder risk, specific aspects of the sports environment (sport type, level of competition [national and international], and training background), and individual aspects (body satisfaction and body mass index) in two groups of athletes: adolescents and adults.
Methods
The sample included 241 highly trained female athletes aged 12–30 years (M = 20.68, SD = 4.45) recruited from different sports clubs in Poland. The subgroup of adolescents consisted of 82 athletes, while the number of adult athletes was 159. The Eating Attitudes Test questionnaire was used to assess the eating disorder risk among the athletes. Body satisfaction was measured using the Feelings and Attitudes Toward Body Scale incorporated into the Body Investment Scale.
Results
Eating disorder risk was prevalent among 14.6% of the adolescent and 6.9% of the adult athletes. Significant associations between eating disorder risk and the studied variables were noted only among adolescent athletes. Univariate logistic regression analysis revealed that the occurrence of eating disorder risk was associated with participation in lean non-aesthetic sports (OR = 11.50, 95% CI: 3.58–37.09). Moreover, eating disorder risk was associated with athletes’ lower body satisfaction (OR = 0.80, 95% CI: 0.70–0.92). Body mass index was not included in the final regression model.
Conclusions
The study indicated that eating disorder risk in adolescent female athletes was related to sport type and body satisfaction. The findings showed that, in adolescent athletes, eating disorder risk was the most associated with practicing lean non-aesthetic sports. Coaches and athletes should be aware that eating disorder risk increases among individuals with a lower body image.
... During adolescence, male and female athletes are more susceptible to developing abnormal eating pathologies compared to non-athletes [18][19][20][21]. Prevalence studies vary in their results [22,23], but athletes participating in lean sports have an increased risk of suffering from abnormal eating pathology [21,[24][25][26]. ...
The combined demands on an adolescence in an elite sports high school can negatively affect mental health (eg, stress, burnout, depression, anxiety). Late adolescence is also when elite-striving athletes typically transition from junior-to-senior level programs. In addition, adolescent elite lean sports athletes have an increased risk of suffering from abnormal eating pathology. The purpose of this study was to investigate the perceived psychosocial needs that young, elite-striving lean sports athletes in sports high schools find essential for their sports careers and transition from junior-to-senior level sports. Eight Swedish elitestriving lean sports athletes (2 men and 6 women; median age 17.0 years, range: 16–18 years) participated in this study and sports represented were athletics (n = 1), gymnastics (n
= 3), and wrestling (n = 4). Semi-structured interviews were performed, and data was analyzed by thematic analysis. Results showed integration, both in the present situation and for
the future, as an overarching theme perceived as essential for a successful elite sports career over time. Three additional themes were also identified: (a) Psychosocial stress (combined performance demands, diminished social life, sports-related body weight demands, taboo talking about eating disorders, injuries), (b) Protective psychosocial factors (social support and psychological safety, communication and coordination school and
sports, self-care/health behaviors), and (c) support needs junior-to-senior transition (career advice and mentorship, individualized support). As a result, elite-striving, lean sports athletes attending sports high schools need additional support to excel in their academic and athletic endeavors. Sports developmental programs continue to provide inadequate support before and during the junior-to-senior level transition. Similarly, despite the continued calls for reducing the stigma of mental health, athletes in sports schools still encounter barriers from coaches and peers, making the subject taboo, particularly surrounding eating pathologies.
... Student-athletes often turn to the aforementioned disordered eating patterns to stay in shape, maintain societal expectations, and enhance their way of life. (Greenleaf et al., 2009;Thompson & Sherman, 2007). ...
Worldwide, mental illness affects a variety of student-athletes. 41% of student-athletes were frequently overwhelmed. Nearly a quarter of student-athletes reported exhaustion from the mental demands of their sport. 10-21% of student-athletes reported depressive symptoms but did not know how to handle them. With mental illness affecting many student-athletes, the purpose of this study was to analyze a student-athlete’s access to both psychological services and resources between the United States Ivy League Conference and Japan’s Kansai Big Six League. Results confirmed that the United States focused on performance; whereas, Japan focused on holistic health. Furthermore, young adulthood is a period of heightened susceptibility for mental health disorders, making college an important setting for a student-athlete’s early identification and management. Early identification is critical, yet diagnosed student-athletes rarely seek help as 19.4% of student athletes experience some form of mental health disorder, 360,000 student-athletes struggle with depression, and only 18% of student-athletes seek treatment when struggling with poor mental health.
... Other studies suggested high rates of substance use (Yusko et al., 2008), alcohol use (Taylor et al., 2017), and eating disorders (Greenleaf et al., 2009) in the student-athlete population. There are unique aspects of the collegiate athletic culture that can increase the risk for mental health concerns. ...
The high rates of depression, anxiety, suicide, and other mental health disorders among collegiate student-athletes have resulted in the need for appropriate mental health services. The National Collegiate Athletic Association (NCAA) has released a best practices guide for mental health in college sport that includes licensed psychologists (LP), licensed clinical social workers (LCSW), and licensed professional counselors (LPC) as competent to provide mental health services to student-athletes. However, an examination of the differences between these three licenses is absent from the literature. This essay offers an overview on these differences to clarify the purview of each license as there is confusion surrounding the different types of professionals that can provide mental health services. A detailed description of what is means to hold an LP, LCSW, and LPC distinction is provided, followed by a discussion of the difference between mental health licensure and certification as a certified mental performance consultant (CMPC). This will assist administrators, athletic administrators, and student-athletes in making informed decisions about mental health care.
... 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% ...
This study examined the perception of Malaysian sport coaches on the sport coaching standards (SCS). A total of 384 coaches (age = 28.84+4.02 years; male = 67.7%, female = 32.3%) responded to the survey via an online google document. Almost 59% of the respondents were club level coaches with 42% having 1-3 years coaching experience. Majority (56.2%) of the coaches was involved in soccer, frisbee, dodgeball, and futsal. The adopted research instrument consisted of 40 coaching standards and were categorized into eight domains. The items were measured through an 11-point (0-10) Likert scale. The results suggested that Malaysian coaches perceived the 40 standards (minimum = 6.94 and maximum = 9.00) as knowledge and abilities that effective coaches must possess. As for the domains, Malaysian coaches ranked the top three domains to be ‘Growth and Development’, ‘Teaching and Communication’, and ‘Skills and Tactics’ respectively. Similar ranking of the domain was also reported according to gender. Even though coaching education in terms of sport specific and sport science programs is in place in Malaysia, it is imperative for Malaysian Sport Coaching Academy and National Sport Associations to incorporate some coaching standards in their relevant coaching education curriculum.
... En relación a los datos disponibles de prevalencia de TCA en la población general, se destaca el elevado porcentaje de chicas que presentan sintomatología relacionada con TCA en el presente estudio. Al mismo tiempo, dentro del ámbito deportivo, la presencia de deportistas mujeres con alteraciones en la alimentación es menor al detectado en anteriores estudios (Greenleaf, Petrie, Carter, y Reel, 2009;Martinsen, Bratland-Sanda, Eriksson, y Sundgot-Borgen, 2010). Por otro lado, se observa como existe relación entre las chicas con síntomas de TCA y mayor percepción de presión por modificar su cuerpo. ...
... 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. ...
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] ...
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]. ...
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. ...
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.
... 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. ...
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.
... 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% ...
Student athletes have to balance numerous demands such as academic pursuit, training and competition, thus these could bring stress and challenges. This study examined personal issues as sources of stress experienced by university student athletes. A total of 273 student athletes (Males = 160, Females = 113; Age = 20.4 + 2.5 years) participated in this study. A 16-item questionnaire was adopted from the Organizational Stress Inventory developed by Fletcher and Hanton (2003). The inventory was divided into three sub-scales of ‘nutrition’, ‘injury’, and goals and expectations’. The results suggested that both male and female student athletes were stressed, in order of importance by ‘nutrition’, ‘injury’ and ‘goal & expectation’ respectively. Inferential statistics showed that there were no significant differences in ‘nutrition’, ‘injury’ sub-scales according to gender. However, for the ‘goal and expectations’ sub-scale, there was a statistically significant difference in ‘unclear goals’ and ‘tension because of personal goals within the team’ where male athletes demonstrated higher stress than female athletes. The findings are important to coaches and sport managers in addressing personal issues among athletes. More research is needed to include athletes from other educational institutions and from national sport associations.
... 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. ...
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.
... Athletes are also vulnerable to disordered eating behavior with over 25% of female athletes (Greenleaf, Petrie, Carter, & Reel, 2009) and almost 20% of male athletes (Petrie, Greenleaf, Reel, & Carter, 2008) having subclinical symptom levels. Male and female athletes have consistently been found to be more likely to engage in binge drinking than their non-athlete peers (e.g., Leichliter, Meilman, Presley, & Cashin, 1998;Nelson & Wechsler, 2001;Wechsler, Davenport, Dowdall, Grossman, & Zanakos, 1997) with one study identifying that 75% of athlete participants engaged in high-risk drinking (i.e., 5 or more drinks on 1 occasion in the past 2 weeks) and 44% engaged in this behavior frequently (Brenner & Swanik, 2007). ...
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.
... 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). ...
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. ...
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 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. ...
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.
... 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 . ...
... 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). ...
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.
... 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). ...
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.
The Oxford Handbook of Sport and Performance Psychology includes the latest research and applied perspectives from leaders in the field of performance psychology, presenting sport and performance psychology from myriad perspectives. It looks at individual psychological processes in performance such as attention, imagery, superior performance intelligence, motivation, anxiety, confidence, cognition, and emotion. Articles also consider the social psychological processes in performance including leadership, teamwork, coaching, relationships, moral behavior, and gender and cultural issues. The book further examines human development issues in performance, such as the development of talent and expertise, positive youth development, the role of the family, the end of involvement transitions, and both youth and masters-level sport and physical activity programs. Finally, the text looks at interventions in sport and performance psychology and counseling of performers in distress including such important issues for all performers as: appearance- and performance-enhancing drug use, injuries, managing pain, eating and weight issues, burnout, and the role of physical activity in maintaining health. The articles collected here also cover the history of sport and performance psychology; the scope and nature of the field; ethical issues in sport and performance psychology; performance psychology in the performing arts and other non-sporting fields; perfectionism and performance; the role of the performance coach and of the sport psychologist with a coach and team; supervision; and a look ahead to the future of the field.
Introduction:
Iron plays a significant role in energy production. However, it is not uncommon for athletes to be diagnosed with iron deficiency (ID), suggesting a correlation between performance and iron regulation. As a result, the International Olympic Committee has recommended iron screenings during health evaluations for elite athletes. Furthermore, athletes participating in esthetic sports are at increased risk for suboptimal iron intake due to disordered eating. Therefore, the purpose of this study was to investigate the distribution of serum ferritin (SF) in a cohort of elite ballet dancers and determine associations between vitamin D, anthropometric measures, stress injury, and dietary preferences.
Methods:
Electronic health records of 40 elite ballet dancers (22 female, 18 male), age 19 to 38 years old, from the 2020 to 2021 pre-participation physical screening were examined. Chi squared comparisons were calculated to evaluate the association between SF and additional variables (ie, gender, age, height, weight, body mass index, vitamin D, stress injury history, and dietary preferences). SF values were compared to published normal and athletic population data.
Results:
58.97% of participants displayed normal or above SF values (>50 ng/ml), while 41.02% displayed minimal (<50 ng/ml) to depleted (<0.12/ng/ml) SF values. Approximately, 68% of the female dancers were ID and did not meet the minimal value needed for athletes. Females were more likely to have lower SF distributions (x2 [4] = 15.6377, P = .004) compared to male dancers. Additionally, dancers who reported dietary preferences (ie, vegetarian) were more likely to display lower SF distributions (x2[4] = 13.3366, P = .010).
Conclusion:
Over half of the female elite ballet dancers were ID which is consistent with current research. Females were at a significant higher risk compared to male dancers who reported dietary preferences. These findings suggest iron screenings should be considered in elite dancer populations.
PurposeThis longitudinal study investigated the potential enhancement of one physical and nine performance variables of New Zealand Rugby-Otago Rugby Football Union Academy college-age women student-athletes (NZORFUSA) using in-person- and non-video online-training (online) supervision.Methods
Recruited NZORFUSA followed a periodised training protocols over 70-weeks. During weeks 1–35 and weeks 53–70 (in-season), the NZORFUSA received 25-h of in-person supervision, participated in 15-h of team practice and game play each week. Over weeks 36–52 (off-season), due to the NZORFUSA returning home over the college summer break, NZORFUSA received online supervision. Performance assessments occurred on weeks 1, 31, 53 and 70. During each testing session, body weight, acceleration, anaerobic endurance, lower-body power, speed, and upper-body strength performance data were collected. Data from weeks 1–70 are presented in this paper; weeks 1–31 and 1–53 data were previously published.ResultsOver 70-weeks of in-person-, online-, and again in-person supervision, mean data showed a decrease in body weight [effect size, Cohen's d = 0.12, trivial; 95% confidence interval (CI): 29.4–127.7] and showed improvements in performance variables (large effect size, d = 1.49–4.33), including lower-body power (CI: 39.9–47.5), upper-body bench press strength (CI: 29.7–132.3) and anaerobic endurance; for the latter performance variable, to complete the 40 m repeat sprints needs less effort (CI: 81.3–95.5) with concurrent lower fatigue level being achieved (CI: 8.08–9.77).Conclusion
Physical and performance enhancement for Academy women student-athletes with in-person, online, and again in-person supervision over 70-weeks is attainable. Future longitudinal research is needed to assist performance enhancement for this cohort.
The purpose of this study was to investigate the trend of eating disorders in competitive male and female artistic gymnasts. The study involved 23 male and 42 female gymnasts, aged 7-27, from sports clubs throughout Greece. The EAT-26 Diet Attitudes scale was used to investigate participants' eating habits. The data collection process included communication with sports organizations throughout Greece on the content and purpose of the research. After consultation, the questionnaire was due to the COVID-19 pandemic provided in an electronic form and also included the consent form for participation in the research. The results of the study indicated that eleven of the sixty-five gymnasts had a total score of >20 on the EAT-26, a rate higher among female gymnasts (~ 24%) compared to male gymnasts (~ 4.4%) (p <.05). Although female gymnasts develop more eating disorders and bulimia than male gymnasts, no significant differences were found in the subscales of the questionnaire (p > .05). Therefore, this finding in combination with the fact that most of the gymnasts were teenagers (15.23 ± 6.35 years old) requires particular importance and attention from coaches and the family environment.
Eating disorders are mental health disorders with extensive whole-body consequences. The prevalence and incidence of eating disorders are greater in female athletes, and these disorders are often associated with menstrual dysfunction and low bone mineral density (BMD)—an overall constellation of symptoms known as the Female Athlete Triad. More recently, the Male Athlete Triad has been defined similarly as low energy availability, hypogonadotropic hypogonadism, and low BMD. In active, athletic individuals, the “Triad” increases the risk of bone stress injuries. In addition to bone injury, eating disorders can adversely affect other systems, including the cardiovascular, gastrointestinal, endocrine, and renal systems. Moreover, eating disorders are often accompanied by other mental health disorders such as depression, anxiety, and post-traumatic stress disorder. Multidisciplinary care is the gold standard for treatment, and at a minimum should include a physician, dietitian, and mental health professional experienced in eating disorder care. In the sports setting, athletic trainers play a key role in early identification, engagement in care, and return to sport. Return to sport guidelines for athletes affected by the Female Athlete Triad have been defined and can be used as a guide to return athletes across genders to sport.KeywordsAnorexia nervosaBulimia nervosaOligo-amenorrheaBone stress injuriesEarly interventionMultidisciplinary care
We conducted a qualitative evaluation of Bodies in Motion (BIM), a dissonance, mindful self-compassion-based program that addresses the unique experiences and needs of female athletes with respect to their bodies and their well-being. Using semi-structured interviews, 12 collegiate female athletes (retired 2 – 6 years) reflected and provided feedback on the enduring impact of BIM on their body image, relationship to food and exercise, and overall psychological well-being. Through thematic analysis, we found that these retired athletes, extending from their initial program learning, reported increased awareness of sport and societal messages and their impact on body image, shifted perspectives in their view of themselves and their bodies, and used learned skills to manage body image in their lives. Further, with the passage of time, athletes emphasized how what they had learned in BIM remained essential as they navigated challenging life transitions, such as their retirement from collegiate sports. Our findings indicate that the benefits female athletes report accruing in the immediate aftermath of BIM remain with them, even growing and becoming more salient as they continue to reflect on the program and its impact on their body awareness and how they navigate their lives as women and former athletes.
In 2016, an NCAA multidisciplinary task force published a consensus document outlining best practices for addressing student-athletes mental wellness. However, despite their recommendations and the growing development of mental health services for college student-athletes, no published literature exists reviewing the existing models of collegiate sport psychology programs. This article serves to address that gap by providing a general overview of common models, followed by an in-depth description of a successful sport psychology model at a Power Five, Division I athletic program. Considerations and recommendations for other institutions, including barriers to student-athlete wellness, availability of university resources, and advantages and disadvantages of the models, will be discussed.
Concerns and processes regarding one’s identity and “self” are arguably a central component of existential concerns within humankind. This chapter briefly introduces self-related constructs before looking at how they have been applied to specific domains of psychopathology in recent empirical and theoretical works. First, it has been argued that self-construct is a central concern driving obsessive-compulsive disorder (OCD), with those with obsessions having an ambivalent or feared view of self. Second, within the OCD-related disorder of hoarding disorder, it has been argued that perceptions of self and others intertwined with the meaning of objects contribute to the incredible challenge that those with the disorder have in discarding objects. Finally, within depression and eating disorders, the focus has recently been shone on social identity processes, whereby one’s sense of self is dynamic and influenced by one’s contemporaneous self-categorisation as a group member. In depression, a loss of social identity has been argued to trigger pathology, whereas in eating disorders, it has been argued that social identification with particular groups may increase the risk of pathology.KeywordsSelfSocial identityObsessive-compulsive disorderHoardingDepressionEating disorders
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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)
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.
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.
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)
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)
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)
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)
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)
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)
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.
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.
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.
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.
This meta-analysis of eating disorder prevention programs found that intervention effects ranged from an absence of any effects to reductions in current and future eating pathology. Certain effects persisted as long as 2 years and were superior to minimal-intervention control conditions. Larger effects occurred for selected (vs. universal), interactive (vs. didactic), and multisession (vs. single session) programs; for programs offered solely to females and to participants over age 15; for programs without psychoeducational content; and for trials that used validated measures. The results identify promising prevention programs and delineate sample, format, and design features that are associated with larger effects, but they suggest the need for improved methodological rigor and statistical modeling of trials and enhanced theoretical rationale for interventions.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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)
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)
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)
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)
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)
What are Eating Disorders?Prevalence and Measurement of Eating DisordersRisk FactorsInterventionConclusion
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.
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.
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.