BackgroundThis study aimed to determine the psychometric properties of the Compulsive Exercise Test (CET) among an adult sample of patients with eating disorders.MethodThree hundred and fifty six patients and 360 non-clinical control women completed the CET and the Eating Disorders Examination questionnaire (EDE-Q).ResultsA confirmatory factor analysis revealed that the clinical data showed a moderate fit to the previously published five factor model derived from a community sample (Taranis L, Touyz S, Meyer C, Eur Eat Disord Rev 19:256-268, 2011). The clinical group scored significantly higher than the non-clinical group on four of the five CET subscales, and logistic regression analysis revealed that the CET could successfully discriminate between the two groups. A Receiver Operating Curve analysis revealed that a cut-off score of 15 on the CET resulted in acceptable values of both sensitivity and specificity.ConclusionsThe CET appears to have a factor structure that is acceptable for use with an adult sample of patients with eating disorders. It can identify compulsive exercise among patients with eating disorders and a cut-off score of 15 is acceptable as indicating an appropriate cut-off point.

1This study assessed the 5 factor structure of the Compulsive Exercise Test and explored the 2 relationship between compulsive exercise and eating psychopathology in athletes. 3Confirmatory and exploratory factor analyses of the Compulsive Exercise Test were 4 conducted with 689 competitive athletes (aged 18 to 35 years). Convergent validity with the 5 Eating Disorders Examination Questionnaire was explored. The 5 factor structure showed a 6 poor fit; an alternative 3 factor structure is proposed. Exercising for weight control and to 7 avoid a negative mood were strongly associated with eating psychopathology. Implications 8 for using the Compulsive Exercise Test with athletes are discussed. 9

A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. Results: Track and field coaches reported using physical, social and performance indicators 7 to identify disordered eating in their athletes. Coaches also monitored their athletes' eating 8 attitudes and behaviors. Weight loss (both observed and objectively monitored) was 9 considered to be a key indicator of disordered eating. Coaches placed a high level of 10 importance on weight for performance, and an "ideal" female athlete body. Previous 11 experiences of detecting disordered eating and a close relationship with the athlete facilitated 12 the identification of disordered eating. Athlete secrecy and masking behaviors, difficulties in 13 communication and coaches' stereotypical beliefs were found to complicate the identification 14 process. 15Conclusions: This study highlights the need for additional information, advice and guidance 16 for track and field coaches to improve their knowledge and confidence in identifying 17 disordered eating among their athletes. 18

Little is known about the evolution of female athlete body image into retirement. In this study, 218 retired athletes from aesthetic sports answered a series of closed and open ended questions regarding bodily changes since retirement. Years since retirement was unrelated to current weight status (e.g., underweight, normal weight), what they were doing about current weight (e.g., lose weight), and satisfaction with current weight (all p's > .69). Overall, 74.3% thought they were normal weight, yet 55% were dissatisfied with their weight and 59.6% were trying to lose weight. A rigorous thematic analysis of the qualitative data yielded 4 core themes that characterized participants' experiences: 1) A move towards the feminine ideal; 2) Feeling fat, flabby and ashamed; 3) A continued commitment to a former self; and 4) Conflicting ideals: The retired female athlete paradox. Perceived muscle loss was considered indicative of either increased fat (dissatisfaction) or increased femininity (satisfaction). For some retired athletes, the satisfaction brought on by newfound femininity was complicated by a coinciding and conflicting commitment to a muscular athletic physique. Practical applications include strategies for sport psychologists to better support athletes in coping with the body changes that occur on retirement from elite sport.

This study aimed to explore how track and field coaches respond to athletes with eating problems. Eleven experienced coaches participated in semi-structured interviews exploring their responses to, and challenges faced when, working with athletes with eating problems.The analysis revealed three themes relating to the strategies employed by coaches. The first theme indicated a supportive approach, where coaches were proactive in seeking support and in reducing training at the early stages of an eating problem. The second theme outlined an avoidant approach, characterised by coach reluctance to be involved in managing eating problems, and a lack of confidence in their knowledge of eating disorders. The third theme involved a confrontational approach, where coaches employed strict rules and engaged in coercion to persuade athletes to seek treatment. All of the coaches reported facing challenges in persuading athletes to seek treatment and were frustrated by a lack of available support.The study highlights the importance of providing resources and support services where coaches can seek advice. Coach education packages can utilise the findings to highlight the strengths and limitations of different coach strategies, and to reinforce the importance of their role in identification and intervention when eating problems in athletes are suspected.

Background: It has been well documented that athletes are at an increased risk of developing disordered eating attitudes and behaviours. Over the last two decades, researchers have focused their attention on how teammates may influence athletes' eating attitudes and behaviours. Objective: To systematically review the literature relating to teammate influences on athletes' eating attitudes and behaviours. Method: A systematic literature search of the SPORTDiscus, PsycINFO and MEDLINE databases was conducted. Qualitative and quantitative studies were included if they met the following inclusion criteria: (1) examined the relationship between teammate influence and eating attitudes and/or behaviours; (2) sampled actively training athletes; (3) written in English; and (4) published in a peer-reviewed academic journal. Results: Twenty-four studies were included (n = 13 quantitative, n = 11 qualitative). Included studies were found to be of good or reasonable quality. Mechanisms of influence were categorised as (1) Teammate support (e.g., supportive teammate friendships, promotion of healthy eating practices, vigilance against disordered eating), and (2) Teammate pressure (e.g., conflicting teammate friendships, critical comments and appearance conversations, maladaptive team norms, and competitive comparisons). Conclusion: Teammates are an important source of influence on athlete eating attitudes and behaviours and these influences can be protective against, or engender an increased risk for, disordered eating. Additional, prospective research is required to enhance understanding of the mechanisms of teammate influences and to inform the development of interventions to reduce disordered eating among athletes.

23Clinical eating disorders are common among athletes; however research has yet to explore the process

Objective: This systematic review aimed to evaluate the nature of interventions addressing eating psychopathology in athletes, identify the characteristics of successful interventions, and review the efficacy of interventions at reducing or preventing eating psychopathology. Method: SPORTDiscus, MEDLINE, and PsycINFO were searched to identify studies addressing eating psychopathology in athletes, which included an outcome measure of disordered eating.Results: Seventeen studies (11 randomised controlled trials, six nonrandomised trials) reporting data on 13 interventions were included. The methodological quality was observed to be generally low. All interventions (11 implemented in North America) were delivered face to face in groups with variable duration and intensity. Thirteen studies reported significant reductions in athletes' eating psychopathology following the intervention, with seven reporting sustained effects (small to moderate). Successful interventions were characterised by higher intervention dosage, higher retention, and incorporated a focus on self-esteem and self-efficacy. Conclusion: The complex nature of interventions, combined with a lack of evaluation data and poor methodological quality, limits the scaling and refinement of many interventions. Future research should explore other modes of delivery, collect evaluation data, and adhere to clearer study reporting. Doing this will consequently improve the development and delivery of effective eating psychopathology interventions offered to athletes more widely.