Eating disorder risks and awareness among female elite cyclists: an anonymous survey

BMC Sports Science, Medicine and Rehabilitation - Tập 14 Số 1
C Koppenburg1, Franziska Saxer2, W Vach2, Dietmar Lüchtenberg1, A Goesele3
1Department of Sport Sciences, University of Konstanz, Postfach 30, D-78457, Konstanz, Germany
2Basel Academy for Quality and Research in Medicine, Steinenring 6, CH- 4051, Basel, Switzerland
3Crossklinik Basel, Bundesstr. 1, CH-4054, Basel, Switzerland

Tóm tắt

Abstract Background Eating disorders (EDs) are an increasingly recognized concern in professional sports. Previous studies suggests that both female gender and endurance sports put athletes at risk. Female elite cyclists are hence of specific interest. The present study aimed at evaluating the distribution of the individual risk of ED in this group. Further the association between individual risk and both the awareness for the topic ED and the deviation from “normal” weight was depicted. Methods Female cyclists registered with the Union Cycliste Internationale were contacted via email or facebook and asked to complete a survey comprising age, weight, the Eating-Attitude-Test (EAT-26), and questions regarding ED awareness. The observed distribution of the EAT-26 score was compared to results from previous studies in normal subjects and athletes. The distribution of the ED awareness was described and ED awareness was correlated with the EAT-26 score. Both the deviation from ideal weight and the body mass index (BMI) were correlated with the EAT-26 score. Results Of the 409 registered athletes 386 could be contacted, 122 completed the questionnaire. Age ranged from 20-44yrs, BMI from 17.0 to 24.6 kg/m2. In the EAT-26, 39 cyclists (32.0%) scored above 20 points indicating a potential benefit from clinical evaluation, 34 cyclists (27.9%) scored 10–19 points suggesting disordered eating. Sixteen athletes (13.2%) had been treated for an ED. About 70% of athletes had been pressured to lose weight. The mean EAT-26 score was above the average observed in normal female populations. It was also above the average observed in many female athlete populations, but lower than in other leanness focussed sports. More than 80%of athletes perceived elite cyclists at risk for developing ED. Increased ED awareness and deviation from the ideal weight were associated with higher EAT-26 scores, but not the body mass index. Conclusion Female cyclists are at risk of developing ED and they are aware of this risk. To improve their health and well-being, increased efforts to support elite cyclists and their teams in preventive activities and early detection are crucial.

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Tài liệu tham khảo

Tiggemann M. Body image across the adult life span: Stability and change. Body Image. 2004;1(1):29–41.

Chin SNM, Laverty AA, Filippidis FT. Trends and correlates of unhealthy dieting behaviours among adolescents in the United States, 1999–2013. BMC Public Health. 2018;18(1):439.

Pilgrim K, Bohnet-Joschko S. Selling health and happiness how influencers communicate on Instagram about dieting and exercise: mixed methods research. BMC Public Health. 2019;19(1):1054.

Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: Overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci. 2013;13(5):499–508.

Joy E, Kussman A, Nattiv A. 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. Br J Sports Med. 2016;50(3):154–62.

Prnjak K, Jukic I, Tufano JJ. Perfectionism. Body Satisfaction and Dieting in Athletes: The Role of Gender and Sport Type. Sports. 2019;7(8):181.

Uriegas NA, Torres-McGehee TM, Smith AB, Emerson DM, Pritchett K. Examination of Eating Disorder Risk among Recreational Athletes. Med Sci Sport Exerc. 2019;51(6S):779–9.

Hopkinson RA, Lock J. Athletics, perfectionism, and disordered eating. Eat Weight Disord. 2004;9(2):99–106.

Almenara CA, Machackova H, Smahel D. Sociodemographic, attitudinal, and behavioral correlates of using nutrition, weight loss, and fitness websites: An online survey. J Med Internet Res. 2019;21(4):e10189.

McCully SN, Don BP, Updegraff JA. Using the internet to help with diet, weight, and physical activity: Results from the health information national trends survey (HINTS). J Med Internet Res. 2013;15(8):e148.

Ladher N. Nutrition science in the media: You are what you read. BMJ. 2016;353:i1879.

Wells KR, Jeacocke NA, Appaneal R, Smith HD, Vlahovich N, Burke LM, Hughes D. The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport. Br J Sports Med. 2020;54(21):1247–58.

Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867–82.

Pilgrim K, Bohnet-Joschko S. Selling health and happiness how influencers communicate on Instagram about dieting and exercise: mixed methods research. BMC Public Health. 2019;19:1054.

Stice E, Marti N, Durnat S. Risk Factors for Onset of Eating Disorders: Evidence of Multiple Risk Pathways from an 8-Year Prospective Study. Behav Res Ther. 2011;49(10):622–7.

Sundgot-Borgen J. Risk and trigger factors for the development of eating disorders in female elite athletes. Med Sci Sport Exerc. 1994;26(4):414–9.

Currie A. Sport and eating disorders - Understanding and managing the risks. Asian J Sports Med. 2010;1(2):63–8.

Biesecker AC, Martz DM. Impact of coaching style on vulnerability for eating disorders: An analog study. Eat Disord. 1999;7(3):235–44.

Sundgot-Borgen J, Torstveit MK. Prevalence of Eating Disorders in Elite Athletes Is Higher Than in the General Population. Clin J Sports Med. 2004;14(1):25–32.

Patterson RE, Wang KT, Slaney RB. Multidimensional perfectionism, depression and relational health in women with eating disturbances. Eat Behav. 2012;13(3):226–32.

Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, et al. The enigma of male eating disorders: A critical review and synthesis. Clin Psychol Rev. 2017;57:1–11.

Dominé F, Berchtold A, Akré C, Michaud PA, Suris JC. Disordered Eating Behaviors: What About Boys? J Adolesc Heal. 2009;44(2):111–7.

Bardone-Cone AM. Self-oriented and socially prescribed perfectionism dimensions and their associations with disordered eating. Behav Res Ther. 2007;45(8):1977–86.

Schwarz HC, Gairrett RL, Aruguete MS, Gold ES. Eating attitudes, body dissatisfaction, and perfectionism in female college athletes. North Am J Psychol. 2005;7(3):345–52.

DeBate RD, Wethington H, Sargent R. Sub-clinical eating disorder characteristics among male and female triathletes. Eat Weight Disord. 2002;7(2):210–20.

Bachner-Melman R, Zohar AH, Ebstein RP, Elizur Y, Constantini N. How anorexic-like are the symptom and personality profiles of aesthetic athletes? Med Sci Sports Exerc. 2006;38(4):628–36.

Schtscherbyna A, Soares EA, de Oliveira FP, Ribeiro BG. Female athlete triad in elite swimmers of the city of Rio de Janeiro, Brazil. Nutrition. 2009;25(6):634–9.

Wyon MA, Hutchings KM, Wells A, Nevill AM. Body Mass Index, Nutritional Knowledge, and Eating Behaviors in Elite Student and Professional Ballet Dancers. Clin J Sport Med. 2014;24(5):390–6.

Prather H, Hunt D, McKeon K, Simpson S, Meyer EB, Yemm T, Fractures. et al. Are Elite Female Soccer Athletes at Risk for Disordered Eating Attitudes, Menstrual Dysfunction, and Stress. PM R. 2016;8(3):208–13.

Neves CM, Filgueiras Meireles JF, Berbert de Carvalho PH, Schubring A, Barker-Ruchti N, Caputo Ferreira ME. Body dissatisfaction in women’s artistic gymnastics: A longitudinal study of psychosocial indicators. J Sports Sci. 2017;35(17):1745–51.

Michael MK, Joubert L, Witard OC, Joubert L. Assessment of Dietary Intake and Eating Attitudes in Recreational and Competitive Adolescent Rock Climbers: A Pilot Study. Front Nutr. 2019;6:64.

Wilmore JH. Eating Disorders in the young athlete. In: Bar-Or O, editor. The Encyclopaedia of Sports Medicine. London: Blackwell Science, IOC Medical Commission; 1996.

Garner DM, Rosen LW, Barry D. Eating disorders among athletes: Research and recommendations. Child Adolesc Psychiatr Clin N Am. 1998;7(4):839–57.

Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med. 1982;12(4):871–8.

Sundgot-Borgen J. Prevalence of eating disorders in elite female athletes. Int J Sport Nutr. 1993;3(1):29–40.

Pugliese MT, Lifshitz F, Grad G, Fort P, Marks-Katz M. Fear of Obesity: A Cause of Short Stature and Delayed Puberty. N Engl J Med. 1983;309(9):513–8.

Pernick Y, Nichols JF, Rauh MJ, Kern M, Ji M, Lawson MJ, et al. Disordered eating among a multi-racial/ethnic sample of female high-school athletes. J Adolesc Heal. 2006;38(6):689–95.

Stiles-Shields C, Rienecke Hoste R, Doyle M, Le Grange P. D. A Review of Family-Based Treatment for Adolescents with Eating Disorders. Rev Recent Clin Trials. 2012;7(2):133–40.

Mintz LB, O’Halloran MS. The Eating Attitudes Test: validation with DSM-IV eating disorder criteria. J Pers Assess. 2000;74(3):489–503.

Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979;9(2):273–9.

Dotti A, Lazzari R. Validation and reliability of the Italian EAT-26. Eat Weight Disord. 1998;3(4):188–94.

Patton GC, Johnson-Sabine E, Wood K, Mann AH, Wakeling A. Abnormal eating attitudes in London schoolgirls - a prospective epidemiological study: Outcome at twelve month follow-up. Psychol Med. 1990;20(2):383–94.

Kong P, Harris LM. The sporting body: Body image and eating disorder symptomatology among female athletes from leanness focused and nonleanness focused sports. J Psychol Interdiscip Appl. 2015;149(2):141–60.

Wollenberg G, Shriver LH, Gates GE. Comparison of disordered eating symptoms and emotion regulation difficulties between female college athletes and non-athletes. Eat Behav. 2015;18:1–6.

Worobey J. Eating attitudes and temperament of normal and overweight college students. Eat Behav. 2002;3(1):85–92.

Bernhardt D, Roberts W. PPE: preparticipation physical evaluation. 4th ed. Elk Grove Village: American Academy of Pediatrics; 2010.

Souza MJ, De, Nattiv A, Joy E, Misra M, Williams NI, Mallinson RJ, et al. 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad. Curr Sports Med Rep. 2014;13(4):219–32.

Intermountain Health Care. Management of Eating Disorders. 2013. Available from: https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=522882792.

Torstveit MK, Rosenvinge JH, Sundgot-Borgen J. Prevalence of eating disorders and the predictive power of risk models in female elite athletes: a controlled study. Scand J Med Sci Sports. 2008;18(1):108–18.

Smink FR, van Hoeken D, Hoek HW. Epidemiology, course, and outcome of eating disorders. Curr Opin Psychiatry. 2013;26(6):543–8.

Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW, et al. National athletic trainers’ association position statement: Preventing, detecting, and managing disordered eating in athletes. J Athl Train. 2008;43(1):80–108.

Sundgot-Borgen J, Meyer NL, Lohman TG, Ackland TR, Maughan RJ, Stewart AD, et al. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. Br J Sports Med. 2013;47(16):1012–22.

Thomas DT, Erdman KA, Burke LM. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Acad Nutr Diet. 2016;116(3):501–28.

Mehta J, Thompson B, Kling JM. The female athlete triad: It takes a team. Cleve Clin J Med. 2018;85(4):313–20.

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BMC Sports Science, Medicine and Rehabilitation

Tập 14 Số 1

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