Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type – a systematic review

Abstract

Background Disordered Eating (DE) shows a strong association with athletics and can lead to several negative mental and physical health effects. Traditionally, sports have been grouped based upon whether or not the sport emphasizes leanness as a competing factor. Due to sociocultural factors, risk for DE may also be associated with the sport type. The aim of this review is to critically analyze the available research and data in this field to consider the relationship between DE and sport type to see which factors influence prevalence among athletes Method A systematic review was completed using keywords specific to DE and sport types. Articles were either excluded due to lack of specification of athlete type or failure to use a standardized screening tool or interview for data collection. Results 6 out of 7 studies found a significant increase in DE rates among lean sport types. When classifying by sport type reports were less consistent, but show non-lean sports also have increased rates of DE. Conclusion There are variations in prevalence of DE behaviors depending on athlete type. It is important to identify the risk for DE early in athletes so emphasis can be placed on treatment options to nullify progression to an eating disorder, lower negative impacts on an athlete’s performance, and prevent other negative health effects. Using sport groups is important to clinical practice as well as research, as certain sports may have a higher risk for development of DE.

Findings from a web content analysis of resources targeting sporting coaches aimed at educating or upskilling on eating disorders and disordered eating in athletes

“…Variations in DE within the athletic population can be mostly attributed to sex differences, type of sport (e.g. aesthetic, endurance, ball sports or weight dependent) and level of sport (pre-elite or elite) [ 7 , 10 – 12 ]. Interestingly, some control populations do report higher prevalence of ED and DE than athletes [ 13 , 14 ], which may be due to athlete populations under-reporting EDs and DE due to the belief that their restrictive behaviours are the norm [ 15 ].…”

Inhabiting the Body(ies) in Female Soccer Players: The Protective Role of Positive Body Image

“…In athletes, body-related pressures are higher than in the general population, since sportswomen have also to face the tensions arising from the pressures for results, the belief that low weight leads to better performance, the reality that weight and appearance are sometimes relevant for athletic performance (e.g., weightclasses and aesthetic sports), the constant visibility of the body (e.g., uniforms) and the continuous scrutiny of the body (e.g., coaches, public weigh-ins, weight control strategies, fans or the sports press). Therefore, the risk for disordered eating and EDs is considerably higher among athletes compared to non-athletes (Dilyara and Zuzanna, 2016;Joy et al, 2016;Díaz et al, 2018;Mancine et al, 2020), particularly in sports emphasising weight and appearance. One of the most extensive and cited reviews (Bratland-Sanda and Sundgot-Borgen, 2013) indicates prevalence rates of subclinical eating pathologies and manifestations of altered behaviours among female athletes of 20-62%, and of clinical EDs of 6-45%.…”

“…Research on body image and eating pathology is extensive in aesthetic sports, in which a slim, small and slender body is valued and required not only because it is stereotypically associated with better performance, but also because athletes' bodies are noticeable (e.g., outfits) and appearance is a component in the evaluation of athletes' performance. Among sportswomen in these modalities, a high risk of eating pathology has been reported (e.g., Kong and Harris, 2014;Neves et al, 2017;de Bruin and Oudejans, 2018;Kantanista et al, 2018;Teixidor-Batlle et al, 2019;Mancine et al, 2020). There is also abundant research on body image in endurance, weight-classes and power sports (e.g., Folscher et al, 2015;Rodríguez et al, 2015;de Bruin and Oudejans, 2018;Kantanista et al, 2018;Mathisen and Sundgot-Borgen, 2019;Stoyel et al, 2021).…”

Nutritional Risks among Adolescent Athletes with Disordered Eating

“…Disordered eating prevalence is higher among adolescent elite athletes compared to their non-athlete peers and it may affect athletes of any gender, sport type or level of competition [16,17]. It is estimated that up to 45% of adolescent athletes develop disordered eating attitudes, especially females in aesthetic and weight-sensitive sports [16,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”