A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide.
Aerobic energy
Anorexia
Athletes
Eating disorders
Sport type
World region
Journal
Journal of eating disorders
ISSN: 2050-2974
Titre abrégé: J Eat Disord
Pays: England
ID NLM: 101610672
Informations de publication
Date de publication:
07 Feb 2024
07 Feb 2024
Historique:
received:
02
12
2023
accepted:
31
01
2024
medline:
8
2
2024
pubmed:
8
2
2024
entrez:
7
2
2024
Statut:
epublish
Résumé
The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence. Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors. The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes. Disordered eating (DE) refers to eating behaviors that limit food choices, reduce or exaggerate food intake, cause physical discomfort, create a sense of loss of control, or lead to negative emotions like shame or guilt. The DE label does not signify the presence of a diagnosed mental health disorder, but, rather, describes self-reported, regular eating patterns that psychiatrists consider to fall into the at-risk category for an eating disorder. In this review, we performed a search of academic databases to find all relevant studies that measured the frequency of self-reported DE in athletes. We analyzed 177 studies involving over 70,000 athletes in total. In this study, DE was defined as a score above cut-off on validated screening tests for problematic eating behaviors. Our goal was to estimate the prevalence of DE in athletes globally and to determine the factors that increase risk. We found that approximately 1 in 5 athletes (19%) endorsed DE behaviors such as, among others, restrictive dieting, bingeing, and purging. These behaviors were seen most commonly in indoor sports like gymnastics and less commonly in the context of outdoor sports. Rates were highest in female athletes, older athletes, athletes with high body mass index (BMI) scores, and those from Eastern countries and cultures. Australia had the highest rates (over 50%), while rates were lowest in Iceland. We suggest the development of screening tests specifically tailored and applicable to athletes. In addition, we recommend raising public awareness of the health effects of nutrition in sports.
Sections du résumé
BACKGROUND
BACKGROUND
The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence.
METHODS
METHODS
Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors.
RESULTS
RESULTS
The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I
CONCLUSION
CONCLUSIONS
The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes.
Disordered eating (DE) refers to eating behaviors that limit food choices, reduce or exaggerate food intake, cause physical discomfort, create a sense of loss of control, or lead to negative emotions like shame or guilt. The DE label does not signify the presence of a diagnosed mental health disorder, but, rather, describes self-reported, regular eating patterns that psychiatrists consider to fall into the at-risk category for an eating disorder. In this review, we performed a search of academic databases to find all relevant studies that measured the frequency of self-reported DE in athletes. We analyzed 177 studies involving over 70,000 athletes in total. In this study, DE was defined as a score above cut-off on validated screening tests for problematic eating behaviors. Our goal was to estimate the prevalence of DE in athletes globally and to determine the factors that increase risk. We found that approximately 1 in 5 athletes (19%) endorsed DE behaviors such as, among others, restrictive dieting, bingeing, and purging. These behaviors were seen most commonly in indoor sports like gymnastics and less commonly in the context of outdoor sports. Rates were highest in female athletes, older athletes, athletes with high body mass index (BMI) scores, and those from Eastern countries and cultures. Australia had the highest rates (over 50%), while rates were lowest in Iceland. We suggest the development of screening tests specifically tailored and applicable to athletes. In addition, we recommend raising public awareness of the health effects of nutrition in sports.
Autres résumés
Type: plain-language-summary
(eng)
Disordered eating (DE) refers to eating behaviors that limit food choices, reduce or exaggerate food intake, cause physical discomfort, create a sense of loss of control, or lead to negative emotions like shame or guilt. The DE label does not signify the presence of a diagnosed mental health disorder, but, rather, describes self-reported, regular eating patterns that psychiatrists consider to fall into the at-risk category for an eating disorder. In this review, we performed a search of academic databases to find all relevant studies that measured the frequency of self-reported DE in athletes. We analyzed 177 studies involving over 70,000 athletes in total. In this study, DE was defined as a score above cut-off on validated screening tests for problematic eating behaviors. Our goal was to estimate the prevalence of DE in athletes globally and to determine the factors that increase risk. We found that approximately 1 in 5 athletes (19%) endorsed DE behaviors such as, among others, restrictive dieting, bingeing, and purging. These behaviors were seen most commonly in indoor sports like gymnastics and less commonly in the context of outdoor sports. Rates were highest in female athletes, older athletes, athletes with high body mass index (BMI) scores, and those from Eastern countries and cultures. Australia had the highest rates (over 50%), while rates were lowest in Iceland. We suggest the development of screening tests specifically tailored and applicable to athletes. In addition, we recommend raising public awareness of the health effects of nutrition in sports.
Identifiants
pubmed: 38326925
doi: 10.1186/s40337-024-00982-5
pii: 10.1186/s40337-024-00982-5
doi:
Types de publication
Journal Article
Langues
eng
Pagination
24Informations de copyright
© 2024. The Author(s).
Références
Giel KE, Hermann-Werner A, Mayer J, Diehl K, Schneider S, Thiel A, et al. Eating disorder pathology in elite adolescent athletes. Int J Eat Disord. 2016;49:553–62.
pubmed: 26876906
doi: 10.1002/eat.22511
Levine MP, Smolak L. The prevention of eating problems and eating disorders: theories, research, and applications. Routledge; 2020.
Kutz AM, Marsh AG, Gunderson CG, Maguen S, Masheb RM. Eating disorder screening: a systematic review and meta-analysis of diagnostic test characteristics of the SCOFF. J Gen Intern Med. 2020;35:885–93.
pubmed: 31705473
doi: 10.1007/s11606-019-05478-6
Culbert KM, Racine SE, Klump KL. Research Review: What we have learned about the causes of eating disorders: a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry. 2015;56:1141–64.
pubmed: 26095891
doi: 10.1111/jcpp.12441
Alhaj OA, Fekih-Romdhane F, Sweidan DH, Saif Z, Khudhair MF, Ghazzawi H, et al. The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. 2022. https://doi.org/10.1007/s40519-022-01452-0 .
Fekih-Romdhane F, Daher-Nashif S, Amthal ·, Alhuwailah H, Haifa ·, Saleh M, et al. The prevalence of feeding and eating disorders symptomology in medical students: an updated systematic review, meta-analysis, and meta-regression. 2022;27:1991–2010
Esmaeil Mousavi Asl, Behzad Mahaki, Yousef Asmari Bardezard, Youkhabeh Mohammadian. Eating Disorders Screening Tools: The Psychometric Properties of the Persian version of Eating Attitude Test. 2020. https://doi.org/10.4103/ijpvm.IJPVM_355_19 .
Azhar Shah S, Safian N. Eating disorder screening tools for athletes: A systematic review of literature focusing on scales developed in the last 10 years (2011–2021). 2022. https://doi.org/10.1080/19357397.2022.2095179 .
Sander W. Measures of Information. Handbook of Measure Theory. 2002;:1523–65.
Mathisen TF, Hay P, Bratland-Sanda S. How to address physical activity and exercise during treatment from eating disorders: a scoping review. Curr Opin Psychiatry. 2023;36:427–37.
pubmed: 37435847
pmcid: 10552818
doi: 10.1097/YCO.0000000000000892
Quesnel D, Disorders MC-… E, 2023 undefined. Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review. jeatdisord.biomedcentral.com.
Cisneros A, Quesnel DA, Robert-McComb JJ. A modern understanding of the models of energy deficits in athletes. In: The Active Female: Health Issues throughout the Lifespan. 2023.
Foster L, Lundh LG, Daukantaité D. Disordered eating in a 10-year perspective from adolescence to young adulthood: Stability, change, and body dissatisfaction as a predictor. Scand J Psychol. 2023. https://doi.org/10.1111/sjop.12950 .
doi: 10.1111/sjop.12950
pubmed: 37491950
Gusfa OMS-IV D, Mancine OMS-IV R, Kennedy S do, Bashir DA, Saffarian M do. The relationship between disordered eating behaviors and injury rates in adolescent athletes. 2021. https://doi.org/10.1002/eat.23642 .
Petisco-Rodríguez C, Sánchez-Sánchez LC, Fernández-García R, Sánchez-Sánchez J, García-Montes JM. Disordered eating attitudes, anxiety, self-esteem and perfectionism in young athletes and non-athletes. Int J Environ Res Public Health. 2020;17:1–18.
doi: 10.3390/ijerph17186754
Berger U, Wick K, Hölling H, Schlack R, Bormann B, Brix C, et al. Screening of disordered eating in 12 year old girls and boys: Psychometric analysis of the German versions of SCOFF and EAT-26. European Psychiatry. 2011;26.
Neumark-Sztainer D, Levine M, Paxton S, Smolak L, Piran N, Wertheim E. Prevention of body dissatisfaction and disordered eating: What next? Eat Disord. 2006;14:265–85.
pubmed: 16873144
doi: 10.1080/10640260600796184
Smolak L, Levine MP. The Wiley handbook of eating disorders. John Wiley & Sons; 2015.
Eichstadt M, Luzier J, Cho D, Weisenmuller C. Eating Disorders in Male Athletes. 2020. https://doi.org/10.1177/1941738120928991 .
doi: 10.1177/1941738120928991
Ghazzawi HA, Alhaj OA, Nemer LS, Amawi AT, Trabelsi K, Jahrami HA. The Prevalence of “at Risk” Eating Disorders among Athletes in Jordan. Sports. 2022;10:182.
pubmed: 36422951
pmcid: 9693192
doi: 10.3390/sports10110182
Smolak L, Murnen SK, Ruble AE. Female athletes and eating problems: a meta-analysis. Int J Eat Disord. 2000;27:371–80.
pubmed: 10744843
doi: 10.1002/(SICI)1098-108X(200005)27:4<371::AID-EAT1>3.0.CO;2-Y
Fortes L de SDS, Kakeshita IS, Almeida SS, Gomes AR, Ferreira MECC. Eating behaviours in youths: A comparison between female and male athletes and non-athletes. 2014;24:e62–8.
Mancine RP, Gusfa DW, Moshrefi A, Kennedy SF. Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type - A systematic review. Journal of Eating Disorders. 2020;8.
de Bruin APK, Oudejans RRD. Athletes’ body talk: The role of contextual body image in eating disorders as seen through the eyes of elite women athletes. J Clin Sport Psychol. 2018;12:675–98.
doi: 10.1123/jcsp.2018-0047
van de Schoot R, de Bruin J, Schram R, Zahedi P, de Boer J, Weijdema F, et al. An open source machine learning framework for efficient and transparent systematic reviews. Nat Mach Intell. https://doi.org/10.1038/s42256-020-00287-7 .
Byrne S, Mclean N. Eating disorders in athletes: a review of the literature.
Ghazzawi HA, Hussain MA, Raziq KM, Alsendi KK, Alaamer RO, Jaradat M, et al. Exploring the Relationship between Micronutrients and Athletic Performance: A Comprehensive Scientific Systematic Review of the Literature in Sports Medicine. Sports. 2023;11.
Bergeron MF, Mountjoy M, Armstrong N, Chia M, Côté J, Emery CA, et al. International Olympic Committee consensus statement on youth athletic development. Br J Sports Med. 2015;49:843–51.
pubmed: 26084524
doi: 10.1136/bjsports-2015-094962
Whitehead J, Slater G, Wright H, Martin L, O’Connor H, Mitchell L. Disordered eating behaviours in female physique athletes. Eur J Sport Sci. 2020;20:1206–14.
pubmed: 31771429
doi: 10.1080/17461391.2019.1698659
Michou M, Costarelli V. Perceived stress in relation to socioeconomic and lifestyle characteristics in Greece: a cross-sectional study. Int J Home Econ. 2021;14:108–15.
Rosendahl J, Bormann B, Aschenbrenner K, Aschenbrenner F, Strauss B. Dieting and disordered eating in German high school athletes and non-athletes. Scand J Med Sci Sports. 2009;19:731–9.
pubmed: 18627556
doi: 10.1111/j.1600-0838.2008.00821.x
Chapa DAN, Johnson SN, Richson BN, Bjorlie K, Won YQ, Nelson S V., et al. Eating-disorder psychopathology in female athletes and non-athletes: a meta-analysis. International Journal of Eating Disorders. 2022;55.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, The PRISMA, et al. statement: an updated guideline for reporting systematic reviews. Syst Rev. 2020;2021:10.
Consensus Statement International Olympic Committee Consensus Statement Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS)) International Olympic Committee Injury and Illness Epidemiology Consensus Group* †. https://doi.org/10.1177/2325967120902908 .
Regional groups of Member States | Department for General Assembly and Conference Management. https://www.un.org/dgacm/en/content/regional-groups . Accessed 3 Jan 2024.
Wells G, Shea B, O’Connell D, Peterson J. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa, ON: Ottawa Hospital Research Institute. 2000.
Doi SA. Rendering the Doi plot properly in meta-analysis. Int J Evid Based Healthc. 2018;16:242–3.
pubmed: 30507720
doi: 10.1097/XEB.0000000000000158
Furuya-Kanamori L, Barendregt JJ, Doi SAR. A new improved graphical and quantitative method for detecting bias in meta-analysis. Int J Evid Based Healthc. 2018;16:195–203.
pubmed: 29621038
doi: 10.1097/XEB.0000000000000141
Chamari K, Padulo J. ‘Aerobic’ and ‘Anaerobic’ terms used in exercise physiology: a critical terminology reflection. Sports Med Open. 2015;1.
Thompson SG, Higgins JPT. How should meta-regression analyses be undertaken and interpreted? Stat Med. 2002;21.
Karrer Y, Halioua R, Mötteli S, Iff S, Seifritz E, Jäger M, et al. Disordered eating and eating disorders in male elite athletes: A scoping review. BMJ Open Sport and Exercise Medicine. 2020;6.
Okano G, Holmes RA, Mu Z, Yang P, Lin Z, Nakai Y. Disordered eating in Japanese and Chinese female runners, rhythmic gymnasts and gymnasts. Int J Sports Med. 2005;26:486–91.
pubmed: 16037893
doi: 10.1055/s-2004-821058
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;35:1745–51.
Köse G, Tayfur M, Karayigit R. BMI, Physical activity, sleep quality, eating attitudes, emotions: which one is affected by mindful eating? Progress in Nutrition. 2021;23.
Mountjoy M, Sundgot-Borgen J, Burke L, Ackerman KE, Blauwet C, Constantini N, et al. International Olympic Committee (IOC) Consensus statement on relative energy deficiency in sport (red-s): 2018 update. Int J Sport Nutr Exerc Metab. 2018;28:316–31.
pubmed: 29771168
doi: 10.1123/ijsnem.2018-0136
Åkesdotter C, Kenttä G, Eloranta S, Håkansson A, Franck J. Prevalence and comorbidity of psychiatric disorders among treatment-seeking elite athletes and high-performance coaches. BMJ Open Sport Exerc Med. 2022;8: e001264.
pubmed: 35444812
pmcid: 8966548
doi: 10.1136/bmjsem-2021-001264
Brown KN, Wengreen HJ, Beals KA. Knowledge of the female athlete triad, and prevalence of triad risk factors among female high school athletes and their coaches. J Pediatr Adolesc Gynecol. 2014;27:278–82.
pubmed: 25023979
doi: 10.1016/j.jpag.2013.11.014
Al-Jumayan AA, Al-Eid NA, AlShamlan NA, AlOmar RS. Prevalence and associated factors of eating disorders in patrons of sport centers in Saudi Arabia. J Family Community Med. 2021;28:94–102.
pubmed: 34194273
pmcid: 8213099
doi: 10.4103/jfcm.jfcm_113_21
Breton É, Dufour R, Côté SM, Dubois L, Vitaro F, Boivin M, et al. Developmental trajectories of eating disorder symptoms: A longitudinal study from early adolescence to young adulthood. J Eat Disord. 2022;10.
Peláez-Fernández MA, Ruiz-Lázaro PM, Labrador FJ, Raich RM. Validación del Eating Attitudes Test como instrumento de cribado de trastornos de la conducta alimentaria en población general. Med Clin (Barc). 2014;142:153–5.
pubmed: 23830549
doi: 10.1016/j.medcli.2013.03.018
Stice E, Telch CF, Rizvi SL. Erratum: Development and validation of the eating disorder diagnostic scale. A brief self-report measure of anorexia, bulimia, and binge-eating disorder (Psychological Assessment (2000) 12:2 (123-131)). Psychological Assessment. 2000;12.
Robbeson JG, Kruger HS, Wright HH. Disordered eating behavior, body image, and energy status of female student dancers. Int J Sport Nutr Exerc Metab. 2015;25:344–52.
pubmed: 25675418
doi: 10.1123/ijsnem.2013-0161
Gulliver A, Griffiths KM, Mackinnon A, Batterham PJ, Stanimirovic R. The mental health of Australian elite athletes. J Sci Med Sport. 2015;18:255–61.
pubmed: 24882147
doi: 10.1016/j.jsams.2014.04.006
Muros JJ, Ávila-Alche Á, Knox E, Zabala M. Likelihood of suffering from an eating disorder in a sample of Spanish cyclists and triathletes. J Eat Disord. 2020;8.
Rogers MA, Appaneal RN, Hughes D, Vlahovich N, Waddington G, Burke LM, et al. Prevalence of impaired physiological function consistent with relative energy deficiency in Sport (RED-S): an Australian elite and pre-elite cohort. Br J Sports Med. 2021;55:38–45.
pubmed: 33199358
doi: 10.1136/bjsports-2019-101517
Lichtenstein MB, Melin AK, Szabo A, Holm L. The Prevalence of exercise addiction symptoms in a sample of national level elite athletes. Front Sports Act Living. 2021;3.
Kontele I, Children TV-, 2021 undefined. Nutritional risks among adolescent athletes with disordered eating. mdpi.com. 2010. https://doi.org/10.3390/children8080715 .
Dipla K, Kraemer RR, Constantini NW, Hackney AC. Relative energy deficiency in sports (RED-S): elucidation of endocrine changes affecting the health of males and females. Hormones. 2021;20:35–47.
pubmed: 32557402
doi: 10.1007/s42000-020-00214-w
Abbott W, Brett A, Brownlee TE, Hammond KM, Harper LD, Naughton RJ, et al. The prevalence of disordered eating in elite male and female soccer players. Eat Weight Disord. 2021;26:491–8.
pubmed: 32107745
doi: 10.1007/s40519-020-00872-0
Alwan N, Moss SL, Davies IG, Elliott-Sale KJ, Enright K. Weight loss practices and eating behaviours among female physique athletes: Acquiring the optimal body composition for competition. PLoS ONE. 2022;17:1.
doi: 10.1371/journal.pone.0262514
Anderson C, Petrie TA. Prevalence of disordered eating and pathogenic weight control behaviors among NCAA division I female collegiate gymnasts and swimmers. Res Q Exerc Sport. 2012;83:120–4.
pubmed: 22428420
doi: 10.1080/02701367.2012.10599833
Armento AM, VanBaak KD, Seehusen CN, Howell DR. Differences in Training and Health Characteristics Between Trail Ultrarunners and Shorter Distance Runners. Wilderness Environ Med. 2023;34:182–6.
pubmed: 36764885
doi: 10.1016/j.wem.2022.12.002
Barrack MT, Rauh MJ, Barkai H-S, Nichols JF. Dietary restraint and low bone mass in female adolescent endurance runners 1–3. 2008.
Barrack MT, Domino S, Gray VB, Cotter JA, Rauh MJ, Nichols JF. Support for inadvertent undereating in female adolescent athletes with clinical indicators of low energy availability. J Sci Med Sport. 2023;26:285–90.
pubmed: 37248163
doi: 10.1016/j.jsams.2023.04.003
Beals KA, Hill AK. The prevalence of disordered eating, menstrual dysfunction, and low bone mineral density among US Collegiate Athletes. 2006.
Beals KA, Beals KA, Manore MM. Disorders of the Female Athlete Triad / 281 Disorders of the Female Athlete Triad Among Collegiate Athletes. 2002.
Katherin A. Beals. Eating Behaviors, nutritional status, and menstrual function in elite female adolescent volleyball players.
Matthew D. Beekley, Robert Byrne, Trudy Yavorek, Kelli Kidd, Janet Wolff, Michael Johnson. Incidence, prevalence, and risk of eating disorder behaviors in military academy cadets.
Borgelt S, Burmeister JM. Disordered eating in collegiate English equestrian athletes in aesthetic and nonaesthetic disciplines. Eat Behav. 2022;46.
Borowiec J, Banio-Krajnik A, Malchrowicz-Mośko E, Kantanista A. Eating disorder risk in adolescent and adult female athletes: the role of body satisfaction, sport type, BMI, level of competition, and training background. BMC Sports Sci Med Rehabil. 2023;15.
Brook EM, Tenforde AS, Broad EM, Matzkin EG, Yang HY, Collins JE, et al. Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes. Scand J Med Sci Sports. 2019;29:678–85.
pubmed: 30644600
doi: 10.1111/sms.13385
Brown K, Yates M, Meenan M, Brown AF. Increased female athlete triad knowledge among collegiate dancers following a brief educational video intervention. J Dance Med Sci. 2020;24:161–7.
pubmed: 33218369
doi: 10.12678/1089-313X.24.4.161
Burrows M, Shepherd H, Bird S, Macleod K, Ward B. The components of the female athlete triad do not identify all physically active females at risk. J Sports Sci. 2007;25:1289–97.
pubmed: 17786682
doi: 10.1080/02640410601129714
Byrne S, Mclean N. Elite Athletes: Effects of the pressure to be thin.
Carvalhais A, Araújo J, Natal Jorge R, Bø K. Urinary incontinence and disordered eating in female elite athletes. J Sci Med Sport. 2019;22:140–4.
pubmed: 30098973
doi: 10.1016/j.jsams.2018.07.008
Chatterton JM, Petrie TA. Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes. Eat Disord. 2013;21:328–41.
pubmed: 23767673
doi: 10.1080/10640266.2013.797822
Checa Olmos JC, Monserrat Hernández M, Belmonte García T, Jiménez Rodríguez D, Rodríguez Martínez A, Berenguel Martínez P, et al. Social and individual factors associated with eating disorders in young athletes: effects on concentration and fatigue. Sports. 2023;11.
Cobb KL, Bachrach LK, Greendale G, Marcus R, Neer RM, Nieves J, et al. Disordered eating, menstrual irregularity, and bone mineral density in female runners. Med Sci Sports Exerc. 2003;35:711–9.
pubmed: 12750578
doi: 10.1249/01.MSS.0000064935.68277.E7
Coelho GM de O, Farias MLF de, Mendonça LMC de, Mello DB de, Lanzillotti HS, Ribeiro BG, et al. The prevalence of disordered eating and possible health consequences in adolescent female tennis players from Rio de Janeiro, Brazil. Appetite. 2013;64:39–47.
Lori Cox, Chrisopher Lantz, Jerry Mayhew. The role of social physique anxiety and other variables in predicting eating behaviors in college students.
de Borja C, Holtzman B, McCall LM, Carson TL, Moretti LJ, Farnsworth N, et al. Specific dietary practices in female athletes and their association with positive screening for disordered eating. J Eat Disord. 2021;9:1.
doi: 10.1186/s40337-021-00407-7
Dervish RA, Wilson LJ, Curtis C. Investigating the prevalence of low energy availability, disordered eating and eating disorders in competitive and recreational female endurance run. Eur J Sport Sci. 2023;23:869–76.
pubmed: 35582863
doi: 10.1080/17461391.2022.2079423
Devrim A, Bilgic P, Hongu N. Is there any relationship between body image perception, eating disorders, and muscle dysmorphic disorders in male bodybuilders? Am J Mens Health. 2018;12:1746–58.
pubmed: 30003837
pmcid: 6142149
doi: 10.1177/1557988318786868
Doyle-Lucas AF, Akers JD, Davy BM. Energetic efficiency, menstrual irregularity, and bone mineral density in elite professional female ballet dancers.
Escobar-Molina R, Rodríguez-Ruiz S, Gutiérrez-García C, Franchini E. Weight loss and psychological-related states in high-level judo athletes. Int J Sport Nutr Exerc Metab. 2015;25:110–8.
pubmed: 25029701
doi: 10.1123/ijsnem.2013-0163
Ferrand C, Brunet E. Perfectionism and risk for disordered eating among young french male cyclists o f high performance1. Owens & Haase; 2004.
Filaire E, Larue J, Rouveix M. Eating behaviours in relation to emotional intelligence. Int J Sports Med. 2011;32:309–15.
pubmed: 21165809
doi: 10.1055/s-0030-1269913
Flatt RE, Thornton LM, Fitzsimmons-Craft EE, Balantekin KN, Smolar L, Mysko C, et al. Comparing eating disorder characteristics and treatment in self-identified competitive athletes and non-athletes from the National Eating Disorders Association online screening tool. Int J Eat Disord. 2021;54:365–75.
pubmed: 33252150
doi: 10.1002/eat.23415
Gibson C, Hindle C, McLay-Cooke R, Slater J, Brown R, Smith B, et al. Body image among elite rugby union players. J Strength Cond Res. 2019;33:2217–22.
pubmed: 31343602
doi: 10.1519/JSC.0000000000002312
Goltz FR, Stenzel LM, Schneider CD. Disordered eating behaviors and body image in male athletes. Rev Bras Psiquiatr. 2013;35:237–42.
pubmed: 24142083
doi: 10.1590/1516-4446-2012-0840
Godoy-Izquierdo D, Díaz I. Inhabiting the Body(ies) in female soccer players: the protective role of positive body image. Front Psychol. 2021;12:718836.
pubmed: 34630229
pmcid: 8497972
doi: 10.3389/fpsyg.2021.718836
Gouttebarge V, Kerkhoffs GMMJ. A prospective cohort study on symptoms of common mental disorders among current and retired professional ice hockey players. Phys Sportsmed. 2017;45:252–8.
pubmed: 28576114
doi: 10.1080/00913847.2017.1338497
Gouttebarge V, Johnson U, Rochcongar P, Rosier P, Kerkhoffs G. Symptoms of common mental disorders among professional football referees: a one-season prospective study across Europe. Phys Sportsmed. 2017;45:11–6.
pubmed: 27741403
doi: 10.1080/00913847.2017.1248796
Gouttebarge V, Jonkers R, Moen M, Verhagen E, Wylleman P, Kerkhoffs G. The prevalence and risk indicators of symptoms of common mental disorders among current and former Dutch elite athletes. J Sports Sci. 2017;35:2148–56.
pubmed: 27894209
doi: 10.1080/02640414.2016.1258485
Greenleaf C, Petrie T, Carter J, Reel J. Female collegiate athletes: prevalence of eating disorders and disordered eating behaviors. J Am Coll Health. 2009;57:489–96.
pubmed: 19254889
doi: 10.3200/JACH.57.5.489-496
Hauck C, Schipfer M, Ellrott T, Cook B. The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes. Eat Weight Disord. 2020;25:1573–82.
pubmed: 31654288
doi: 10.1007/s40519-019-00794-6
Hoch AZ, Papanek P, Szabo A, Widlansky ME, Schimke JE, Gutterman DD. Association between the female athlete triad and endothelial dysfunction in dancers. 2011.
Hoch AZ, Pajewski NM, Moraski L, Carrera GF, Wilson CR, Hoffmann RG, et al. Prevalence of the female athlete Triad in high school athletes and sedentary students. Clin J Sport Med. 2009;19:421–8.
pubmed: 19741317
pmcid: 2848387
doi: 10.1097/JSM.0b013e3181b8c136
Lock J, Hopkinson RA, Lock J. Athletics, perfectionism, and disordered eating. 2004.
Hulley AJ, Hill AJ. Eating disorders and health in elite women distance runners. 2001.
Janout V, Janoutová G. Eating disorders risk groups in the czech republic-cross-sectional epidemiologic pilot study.
Balas J, Augste C, Bratland-Sanda S, Joubert L. Prevalence of amenorrhea in elite female competitive climbers.
Joubert LM, Gonzalez GB, Larson AJ. Prevalence of disordered eating among international sport lead rock climbers. Front Sports Act Living. 2020;2:86.
pubmed: 33345077
pmcid: 7739584
doi: 10.3389/fspor.2020.00086
Junge A, Hauschild A. Behind the curtain: prevalence of symptoms of depression, generalised anxiety and eating disorders in 147 professional dancers from six opera houses or state theatres. Sports Med Open. 2023. https://doi.org/10.1186/s40798-023-00638-9 .
doi: 10.1186/s40798-023-00638-9
pubmed: 37777697
pmcid: 10542047
Kampouri D, Kotopoulea-Nikolaidi M, Daskou S, Giannopoulou I. Prevalence of disordered eating in elite female athletes in team sports in Greece. Eur J Sport Sci. 2019;19:1267–75.
pubmed: 30880593
doi: 10.1080/17461391.2019.1587520
Karlson KA, Becker B, Merkur ‡amanda. Prevalence of eating disordered behavior in collegiate lightweight women rowers and distance runners. 2001.
Karlsson E, Alricsson M, Melin A. Symptoms of eating disorders and low energy availability in recreational active female runners. BMJ Open Sport Exerc Med. 2023;9:e001623.
pubmed: 37485001
pmcid: 10357753
doi: 10.1136/bmjsem-2023-001623
Kennedy SF, Ley AF, Fugate BN, Hayek A. Factors associated with disordered eating behaviors among triathletes. Spartan Med Res J. 2017;2:5958.
pubmed: 33655111
pmcid: 7746024
doi: 10.51894/001c.5958
Kristjánsdóttir H, Sigurðardóttir P, Jónsdóttir S, Þorsteinsdóttir G, Saavedra J. Body image concern and eating disorder symptoms among elite icelandic athletes. Int J Environ Res Public Health. 2019;16:2728.
pubmed: 31370175
pmcid: 6696614
doi: 10.3390/ijerph16152728
Lauder TD. The female athlete triad: prevalence in military women. 1999.
Lauder TD;, Williams MV;, Campbell CS;, Davis GD;, Sherman RA. Abnormal eating behaviors in military women.
Marshall D, Harber VJ, Marshall JD, Harber V. Body dissatisfaction and drive for thinness in high performance field hockey athletes. 1996.
Rodríguez AM, Salar NV, Carretero CM, Gimeno EC, Collado ER. Eating disorders and diet management in contact sports; EAT-26 questionnaire does not seem appropriate to evaluate eating disorders in sports. Nutr Hosp. 2015;32:1708–14.
Martinovic D, Tokic D, Martinovic L, Vilovic M, Vrdoljak J, Kumric M, et al. Adherence to mediterranean diet and tendency to orthorexia nervosa in professional athletes. Nutrients. 2022;14:237.
pubmed: 35057417
pmcid: 8779465
doi: 10.3390/nu14020237
McLester CN, Hardin R, Hoppe S. Susceptibility to eating disorders among collegiate female student-athletes. J Athl Train. 2014;49:406–10.
pubmed: 24762233
pmcid: 4080598
doi: 10.4085/1062-6050-49.2.16
Meng K, Qiu J, Benardot D, Carr A, Yi L, Wang J, et al. The risk of low energy availability in Chinese elite and recreational female aesthetic sports athletes. J Int Soc Sports Nutr. 2020;17:1.
doi: 10.1186/s12970-020-00344-x
Michaels C, Holman A, Teramoto M, Bellendir T, Krautgasser-Tolman S, Willick SE. Descriptive analysis of mental and physical wellness in collegiate dancers. J Dance Med Sci. 2023;27:173–9.
pubmed: 37264604
doi: 10.1177/1089313X231178091
Monthuy-Blanc J, Maïano C, Therme P. Prévalence des symptômes de troubles du comportement alimentaire chez des danseuses classiques et des joueuses de basket-ball ne pratiquant pas à un haut niveau: une étude exploratoire et contrôlée auprès d’adolescentes fran. Rev Epidemiol Sante Publique. 2010;58:415–24.
pubmed: 21094000
doi: 10.1016/j.respe.2010.07.003
Nichols JF, Rauh MJ, Lawson MJ, Ji M, Barkai H-S. Prevalence of the female athlete triad syndrome among high school athletes. 2006.
Nieves JW, Ruffing JA, Zion M, Tendy S, Yavorek T, Lindsay R, et al. Eating disorders, menstrual dysfunction, weight change and DMPA use predict bone density change in college-aged women. Bone. 2016;84:113–9.
pubmed: 26746778
doi: 10.1016/j.bone.2015.12.054
O’Connell S. Disordered eating is not associated with musculoskeletal injury in university athletes. Appl Physiol Nutr Metab. 2024;49:87–92.
pubmed: 37639728
doi: 10.1139/apnm-2023-0244
Patrick O’Connor, Richard Lewis, Elsiabeth Kirchner. Eating disorder symptoms in female college gymnasts.
O’Leary TJ, Coombs CV, Perrett C, Double RL, Keay N, Wardle SL, et al. Menstrual function, eating disorders, low energy availability, and musculoskeletal injuries in British servicewomen. Med Sci Sports Exerc. 2023;55:1307–16.
pubmed: 36893306
doi: 10.1249/MSS.0000000000003154
Pallotto IK, Sockol LE, Stutts LA. General and sport-specific weight pressures as risk factors for body dissatisfaction and disordered eating among female collegiate athletes. Body Image. 2022;40:340–50.
pubmed: 35144072
doi: 10.1016/j.bodyim.2022.01.014
Peklaj E, Reščič N, Koroušic´ Seljak B, Rotovnik Kozjek N. Is RED-S in athletes just another face of malnutrition? Clin Nutr ESPEN. 2022;48:298–307.
Pensgaard AM, Oevreboe TH, Ivarsson A. Mental health among elite athletes in Norway during a selected period of the COVID-19 pandemic. BMJ Open Sport Exerc Med. 2021;7.
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 Health. 2006;38:689–95.
pubmed: 16730597
doi: 10.1016/j.jadohealth.2005.07.003
Petrie TA, Greenleaf C, Reel JJ, Carter JE. An examination of psychosocial correlates of eating disorders among female collegiate athletes. Res Q Exerc Sport. 2009;80:621–32.
pubmed: 19791649
doi: 10.1080/02701367.2009.10599601
Pettersen I, Hernaes E, Skårderud F. Pursuit of performance excellence: a population study of Norwegian adolescent female cross-country skiers and biathletes with disordered eating. https://doi.org/10.1136/bmjsem-2016 .
Poucher ZA, Tamminen KA, Sabiston CM, Cairney J. A longitudinal examination of changes in mental health among elite Canadian athletes. J Sports Sci. 2022;40:733–41.
pubmed: 34930103
doi: 10.1080/02640414.2021.2015908
Prather H, Hunt D, McKeon K, Simpson S, Meyer EB, Yemm T, et al. Are elite female soccer athletes at risk for disordered eating attitudes, menstrual dysfunction, and stress fractures? PM and R. 2016;8:208–13.
pubmed: 26188245
doi: 10.1016/j.pmrj.2015.07.003
Pritchett K, Difolco A, Glasgow S, Pritchett R, Williams K, Stellingwerff T, et al. Risk of low energy availability in national and international level paralympic athletes: an exploratory investigation. Nutrients. 2021;13:1–12.
doi: 10.3390/nu13030979
Rauh MJ, Nichols JF, Barrack MT. Relationships among injury and disordered eating, menstrual dysfunction, and low bone mineral density in high school athletes: a prospective study.
Ravaldi C, Vannacci A, Zucchi T, Mannucci E, Cabras PL, Boldrini M, et al. Eating disorders and body image disturbances among ballet dancers, gymnasium users and body builders. Psychopathology. 2003;36:247–54.
pubmed: 14571054
doi: 10.1159/000073450
Ravi S, Ihalainen JK, Taipale-Mikkonen RS, Kujala UM, Waller B, Mierlahti L, et al. Self-reported restrictive eating, eating disorders, menstrual dysfunction, and injuries in athletes competing at different levels and sports. Nutrients. 2021;13.
Reinking MF, Alexander LE. by the national athletic trainers. Association, Inc; 2005.
Reinking MF. Exercise-related leg pain in female collegiate athletes: the influence of intrinsic and extrinsic factors. Am J Sports Med. 2006;34:1500–7.
pubmed: 16636349
doi: 10.1177/0363546506287298
Riebl SK, Subudhi AW, Broker JP, Schenck K, Berning JR. The prevalence of subclinical eating disorders among male cyclists. J Am Diet Assoc. 2007;107:1214–7.
pubmed: 17604754
doi: 10.1016/j.jada.2007.04.017
Roberts TA, Glen J, Kreipe RE. Disordered eating and menstrual dysfunction in adolescent female athletes participating in school-sponsored sports.
Rousselet M, Guérineau B, Paruit MC, Guinot M, Lise S, Destrube B, et al. Disordered eating in French high-level athletes: association with type of sport, doping behavior, and psychological features. Eat Weight Disord. 2017;22:61–8.
pubmed: 27838862
doi: 10.1007/s40519-016-0342-0
Rouveix M, Bouget M, Pannafieux C, Champely S, Filaire E. Eating attitudes, body esteem, perfectionism and anxiety of judo athletes and nonathletes. Int J Sports Med. 2007;28:340–5.
pubmed: 17024652
doi: 10.1055/s-2006-924334
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;25:634–9.
pubmed: 19230616
doi: 10.1016/j.nut.2008.11.029
Sharps FRJ, Wilson LJ, Graham CAM, Curtis C. Prevalence of disordered eating, eating disorders and risk of low energy availability in professional, competitive and recreational female athletes based in the United Kingdom. Eur J Sport Sci. 2022;22:1445–51.
pubmed: 34121611
doi: 10.1080/17461391.2021.1943712
Smith A, Emerson D, Winkelmann Z, Potter D, Torres-Mcgehee T. Prevalence of eating disorder risk and body image dissatisfaction among ROTC cadets. Int J Environ Res Public Health. 2020;17:1–13.
doi: 10.3390/ijerph17218137
Sophia B, Kelly P, Ogan D, Larson A. Olympic marathon trials.
Staal S, Sjödin A, Fahrenholtz I, Bonnesen K, Melin AK. Low RMRratio as a surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk. Int J Sport Nutr Exerc Metab. 2018;28:412–8.
pubmed: 29405782
doi: 10.1123/ijsnem.2017-0327
Stackeová D, Barešová T, Přibylová B. A pilot study of a modification EAT-26 questionnaire for screening pathological eating behavior in competitive athletes. Front Psychol. 2023;14(1):166129.
Jorunn Sundgot-Borgen. Prevalence of eating disorders in elite female athletes jorunn sundgot-borgen. 1993.
Jorunn Sundgot-Borgen. Risk and trigger factors for the development of eating disorders in female elite athletes. 1993.
Sundgot-Borgen J, Torstveit MK. Prevalence of eating disorders in elite athletes is higher than in the general population. 2004.
Sundgot-Borgen J, Fasting K, Brackenridge C, Torstveit MK, Berglund B. Sexual harassment and eating disorders in female elite athletes ± a controlled study.
Syed J, Jamil A, Namroz N, Shakeel M, Malik A, Kanwal S, et al. Prevalence of risk factors of the female athlete triad among young elite athletes of Pakistan. Int J Sports Phys Ther. 2022;17:210–7.
pubmed: 35136690
pmcid: 8805100
doi: 10.26603/001c.31641
Teixidor-Batlle C, Ventura C, Andrés A. Eating disorder symptoms in elite Spanish athletes: prevalence and sport-specific weight pressures. Front Psychol. 2021;11:3612.
doi: 10.3389/fpsyg.2020.559832
Tenforde AS, DeLuca S, Wu AC, Ackerman KE, Lewis M, Rauh MJ, et al. Prevalence and factors associated with bone stress injury in middle school runners. PM and R. 2022;14:1056–67.
pubmed: 34251763
doi: 10.1002/pmrj.12673
Terry PC, Lane AM, Warren L. Eating attitudes, body shape perceptions and mood of elite rowers.
Thein-Nissenbaum JM, Rauh MJ, Carr KE, Loud KJ, Mcguine TA. Associations between disordered eating, menstrual dysfunction, and musculoskeletal injury among high school athletes. J Orthop Sports Phys Ther. 2011;41:60–9.
pubmed: 21212503
doi: 10.2519/jospt.2011.3312
Thein-Nissenbaum JM, Carr KE, Hetzel S, Dennison E. Disordered eating, menstrual irregularity, and musculoskeletal injury in high school athletes: a comparison of oral contraceptive pill users and nonusers. Sports Health. 2014;6:313–20.
pubmed: 24982703
pmcid: 4065553
doi: 10.1177/1941738113498852
A. THiel, h. Gottfriend, F.W. Hesse. Subclinical eating disorders in male athletes.
Thompson SH. Characteristics of the female athlete triad in collegiate cross-country runners. J Am Coll Health. 2007;56:129–36.
pubmed: 17967758
doi: 10.3200/JACH.56.2.129-136
Thompson A, Petrie T, Anderson C. Eating disorders and weight control behaviors change over a collegiate sport season. J Sci Med Sport. 2017;20:808–13.
pubmed: 28416353
doi: 10.1016/j.jsams.2017.03.005
Torres-McGehee TM, Green JM, Leeper JD, Leaver-Dunn D, Richardson M, Bishop PA. Body image, anthropometric measures, and eating-disorder prevalence in auxiliary unit members. 2009.
Torres-McGehee TM, Monsma E v, Gay JL, Minton DM, Mady-Foster AN. Prevalence of eating disorder risk and body image distortion among national collegiate athletic association division I varsity equestrian athletes. 2011.
Torres-McGehee TM, Uriegas NA, Hauge M, Monsma EV, Emerson DM, Smith AB. Eating disorder risk and pathogenic behaviors among collegiate student-athletes. J Athl Train. 2023;58:803–12.
pubmed: 37459386
doi: 10.4085/1062-6050-0539.22
Torstveit MK, Sundgot-Borgen J. The female athlete triad: are elite athletes at increased risk? Med Sci Sports Exerc. 2005;37:184–93.
pubmed: 15692312
doi: 10.1249/01.MSS.0000152677.60545.3A
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;18:108–18.
pubmed: 17490455
doi: 10.1111/j.1600-0838.2007.00657.x
Uriegas NA, Winkelmann ZK, Pritchett K, Torres-McGehee TM. Examining eating attitudes and behaviors in collegiate athletes, the association between orthorexia nervosa and eating disorders. Front Nutr. 2021;8:763838.
pubmed: 34859033
pmcid: 8632486
doi: 10.3389/fnut.2021.763838
Uriegas NA, Moore K, Torres-McGehee TM. Prevalence and association of exercise dependence and eating disorder risk in collegiate student-athletes. J Athl Train. 2023;58:813–20.
pubmed: 36827616
doi: 10.4085/1062-6050-0553.22
Arzu Vardar S, Vardar E, Durmus Altun G, Kurt C, Öztürk L. Prevalence of the female athlete triad in edirne, TURKEY. 2005.
Vardar E, Vardar SA, Kurt C. Anxiety of young female athletes with disordered eating behaviors. Eat Behav. 2007;8:143–7.
pubmed: 17336783
doi: 10.1016/j.eatbeh.2006.03.002
Janet Walberg, Cutting Johnston. Menstrual function and eating behavior in female recreational weight lifters and competitive body builders.
Waryasz G, Gil JA, Chiou D, Eberson C, Waryasz GR, Ferreira B; K, et al. Investigation of the injury rate of female fitness competitors.
Wheeler GD, Wall SR, Belcastro AN, Conger P, Cumming DC. Are anorexic tendencies prevalent in the habitual runner? 1986.
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.
pubmed: 25841217
doi: 10.1016/j.eatbeh.2015.03.008
Wu AC, Rauh MJ, DeLuca S, Lewis M, Ackerman KE, Barrack MT, et al. Running-related injuries in middle school cross-country runners: prevalence and characteristics of common injuries. PM R. 2022;14:793–801.
pubmed: 34053194
doi: 10.1002/pmrj.12649