Pushing Beyond the Limits:
Disordered Eating, Compulsive Exercise, and Body Image Dissatisfaction in Collegiate Athletes
Keywords:
Disordered eating; compulsive exercise; body image dissatisfaction; collegiate athletes.Abstract
The objective of the study was to examine the prevalence of disordered eating and compulsive exercise in a sample of collegiate athletes; and to investigate the differences in athletes’ disordered eating, compulsive exercise, and body image by gender, sport type, and level of athletic participation. One-hundred twenty-eight NCAA Division I varsity and club athletes completed the eating disorders, compulsive exercise, and body image measures. Correlational analyses and t-tests were conducted to establish statistical significance for the relationships of interest. Eleven athletes (8.6%) reported clinical symptoms of disordered eating, while 40 athletes (31.3%) reported subclinical symptoms. Nineteen athletes (14.85%) scored above the clinical cut-off score for compulsive exercise. Female and lean-sport athletes reported greater disordered eating and body image dissatisfaction than male and non-lean sport athletes, respectively. The study findings and implications may aid coaches, athletic administration, and mental health professionals in promptly identifying at-risk athletes and helping them seek professional assistance.
References
-19 NCAA Division I manual. (2018). Overland Parks, KS: National Collegiate Athletic Association. https://www.ncaapublications.com/productdownloads/D119.pdf
Aardoom, J. J., Dingemans, A. E., Slof Op't Landt, M. C., & Van Furth, E. F. (2012). Norms and discriminative validity of the Eating Disorder Examination Questionnaire (EDE-Q). Eating Behaviors, 13(4), 305-309. doi: 10.1016/j.eatbeh.2012.09.002
Anderson, C., & Petrie, T. A. (2012). Prevalence of disordered eating and pathogenic weight control behaviors among NCAA Division I female collegiate gymnasts and swimmers. Research Quarterly for Exercise and Sport, 83(1), 120-124. doi: 10.1080/02701367.2012.10599833
Beals, K. A., & Hill, A. K. (2006). The prevalence of disordered eating, menstrual dysfunction, and low bone mineral density among US collegiate athletes. International Journal of Sport Nutrition and Exercise Metabolism, 16(1), 1-23. doi: 10.1123/ijsnem.16.1.1
Bernhardt, D. T., & Roberts, W. O. (2010). American Academy of Pediatrics. PPE: Preparticipation Physical Evaluation (4th ed.). American Academy of Pediatrics.
Birkenhead, K. L., & Slater, G. (2015). A review of factors influencing athletes’ food choices. Sports Medicine, 45(11), 1511-1522. doi: 10.1007/s40279-015-0372-1
Bonci, C. M., Bonci, L. J., Granger, L. R., Johnson, C. L., Malina, R. M., Milne, L. W., … Vanderbunt, E. M. (2008). National athletic trainers' association position statement: Preventing, detecting, and managing disordered eating in athletes. Journal of Athletic Training, 43(1), 80-108. doi: 10.4085/1062-6050-43.1.80
Bratland-Sanda, S., & Sundgot-Borgen, J. (2013). Eating disorders in athletes: Overview of prevalence, risk factors and recommendations for prevention and treatment. European Journal of Sport Science, 13(5), 499-508. doi: 10.1080/17461391.2012.740504
Broton, K. M., & Goldrick-Rab, S. (2017). Going without: An exploration of food and housing insecurity among undergraduates. Educational Researcher, 47(2), 121–133. https://files.eric.ed.gov/fulltext/EJ1171368.pdf
Bruin, A. P. D., Oudejans, R. R., Bakker, F. C., & Woertman, L. (2011). Contextual body image and athletes' disordered eating: The contribution of athletic body image to disordered eating in high performance women athletes. European Eating Disorders Review, 19(3), 201-215. doi: 10.1002/erv.1112
Calugi, S., Ricca, V., Castellini, G., Sauro, C. L., Ruocco, A., Chignola, E., El Ghoch, M., & Dalle Grave, R. (2017). The eating disorder examination: Reliability and validity of the Italian version. Eating and Weight Disorders, 20, 505-511. doi: 10.1007/s40519-016-0276-6
Carter, J. E., & Rudd, N. A. (2005). Disordered eating assessment for college student-athletes. Women in Sport and Physical Activity Journal, 14(1), 62-71. https://doi.org/10.1123/wspaj.14.1.62
Cash, T. F. (2000). MBSRQ users' manual. Old Dominion University.
Chatterton, J. M., & Petrie, T. A. (2013). Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes. Eating Disorders, 21(4), 328-341. doi: 10.1080/10640266.2013.797822
Clifford, T., & Blyth, C. (2019). A pilot study comparing the prevalence of orthorexia nervosa in regular students and those in university sports teams. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 24(3), 473-480. doi: 10.1007/s40519-018-0584-0
Currie, A. (2010). Sport and eating disorders - understanding and managing the risks. Asian Journal of Sports Medicine, 1(2), 63-68. doi: 10.5812/asjsm.34864
Dalle Grave, R., Calugi, S., & Marchesini, G. (2008). Compulsive exercise to control shape or weight in eating disorders: prevalence, associated features, and treatment outcome. Comprehensive Psychiatry, 49(4), 346-352. doi: 10.1016/j.comppsych.2007.12.007
Darcy, A. M., Hardy, K. K., Lock, J., Hill, K. B., & Peebles, R. (2013). The Eating Disorder Examination Questionnaire (EDE-Q) among university men and women at different levels of
athleticism. Eating Behaviors, 14(3), 378-381. doi: 10.1016/j.eatbeh.2013.04.002
DiPasquale, L. D., & Petrie, T. A. (2013). Prevalence of disordered eating: A Comparison of male and female collegiate athletes and nonathletes. Journal of Clinical Sport Psychology, 7(3), 186-197.
El Ghoch, M., Soave, F., Calugi, S., & Dalle Grave, R. (2013). Eating disorders, physical fitness and sport performance: A systematic review. Nutrients, 5(12), 5140-5160. doi: 10.3390/nu5125140
Fairburn, C. G., & Beglin, S. J. (2008). Eating Disorder Examination Questionnaire (6.0). In Cognitive Behavior Therapy and Eating Disorders. Guilford Press.
Galli, N., A. Petrie, T., Greenleaf, C., J. Reel, J., & E. Carter, J. (2014). Personality and psychological correlates of eating disorder symptoms among male collegiate athletes. Eating Behaviors, 15(4), 615-618. https://doi.org/10.1016/j.eatbeh.2014.08.007
Goodwin, H., Haycraft, E., Taranis, L., & Meyer, C. (2011). Psychometric evaluation of the compulsive exercise test (CET) in an adolescent population: Links with eating psychopathology. European Eating Disorders Review, 19(3), 269-279. doi: 10.1002/erv.1109
Greenleaf, C., Petrie, T. A., Carter, J., & Reel, J. J. (2009). Female collegiate athletes: Prevalence of eating disorders and disordered eating behaviors. Journal of American College Health, 57(5), 489-495. doi: 10.3200/JACH.57.5.489-496.
Hinton, P. S., Sanford, T. C., Davidson, M. M., Yakushko, O. F., & Beck, N. C. (2004). Nutrient intakes and dietary behaviors of male and female collegiate athletes. International Journal of Sport Nutrition and Exercise Metabolism, 14(4), 389-405. doi: 10.1123/ijsnem.14.4.389
Holm-Denoma, J. M., Scaringi, V., Gordon, K. H., Van Orden, K. A., & Joiner, T. E. (2009). Eating disorder symptoms among undergraduate varsity athletes, club athletes, independent exercisers, and nonexercisers. International Journal of Eating Disorders, 42(1), 47-53. doi: 10.1002/eat.20560
Joy, E., Kussman, A., & Nattiv, A. (2016). 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British Journal of Sports Medicine, 50(3), 154-162. http://dx.doi.org/10.1136/bjsports-2015-095735
Kantanista, A., Glapa, A., Banio, A., Firek, W., Ingarden, A., Malchrowicz-Mośko, E., … Maćkowiak, Z. (2018). Body image of highly trained female athletes engaged in different types of sport. BioMed Research International, 2018, 1–8. doi: 10.1155/2018/6835751
Kato, K., Jevas, S., & Culpepper, D. (2011). Body image disturbances in NCAA Division I and III female athletes. The Sport Journal, 14(1), 1-2.
Klenck, C. (2014). Best practices for athletics departments. In G. Brown (Ed.). Mind, body and sport: Understanding and supporting student-athlete mental wellness (pp. 101-103). Indianapolis, IN: National Collegiate Athletic Association.
Kong, P., & Harris, L. M. (2014). The sporting body: Body image and eating disorder symptomatology among female athletes from leanness focused and nonleanness focused sports. The Journal of Psychology, 149(2), 141–160. doi: 10.1080/00223980.2013.846291
Krebs, P. A., Dennison, C. R., Kellar, L., & Lucas, J. (2019). Gender differences in eating disorder risk among NCAA Division I cross country and track student-athletes. Journal of Sports Medicine, 2019, 1-5. doi: 10.1155/2019/5035871
Martinsen, M., Bratland-Sanda, S., Eriksson, A. K., & Sundgot-Borgen, J. (2010). Dieting to win or to be thin? A study of dieting and disordered eating among adolescent elite athletes and non-athlete controls. British Journal of Sports Medicine, 44(1), 70-76. doi: 10.1136/bjsm.2009.068668
Martinsen, M., & Sundgot-Borgen, J. (2013). Higher prevalence of eating disorders among adolescent elite athletes than controls. Medicine & Science in Sports & Exercise, 45(6), 1188-1197. doi: 10.1249/MSS.0b013e318281a939
McLester, C. N., Hardin, R., & Hoppe, S. (2014). Susceptibility to eating disorders among collegiate female student–athletes. Journal of Athletic Training, 49(3), 406-410.
doi: 10.4085/1062-6050-49.2.16
Meeusen, R., Duclos, M., Foster, C., Fry, A., Gleeson, M., Nieman, D., … Urhausen, A. (2013). Prevention, diagnosis and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science (ECSS) and the American College of Sports Medicine (ACSM). European Journal of Sport Science, 13(1), 1-24.
doi: 10.1249/MSS.0b013e318279a10a.
Milligan, B., & Pritchard, M. (2006). The relationship between gender, type of sport, body dissatisfaction, self-esteem and disordered eating behaviors in Division I athletes. Athletic Insight: The Online Journal of Sport Psychology, 8(1), 32-46.
Moore, M. (2017). Stepping outside of their comfort zone: Perceptions of seeking behavioral health services amongst college athletes. Journal of Issues in Intercollegiate Athletics, Special Issue, 130-144.
National Collegiate Athletic Association [NCAA] (2016). NCAA GOALS Study of the student-athlete experience. Findings from the NCAA GOALS study. San Antonio, TX: 2016 NCAA Convention.
National Collegiate Athletic Association [NCAA] (2018). NCAA recruiting facts. https://ncaaorg.s3.amazonaws.com/compliance/recruiting/NCAA_RecruitingFactSheet.pdf
Nattiv, A., Loucks, A. B., Manore, M. M., Sanborn, C. F., Sundgot-Borgen, J., & Warren, M. P. (2007). American College of Sports Medicine position stand. The female athlete triad. Medicine & Science in Sports & Exercise, 39(10), 1867-1882. doi: 10.1249/mss.0b013e318149f111
Granholm, C. (2020). History. The National Intramural-Recreational Sports Association. https://nirsa.net/nirsa/about/history/
Petrie, T. A., Greenleaf, C., Reel, J., & Carter, J. E. (2008). Prevalence of disordered eating behaviors among male collegiate athletes. Psychology of Men & Masculinity, 9(4), 267-277. https://doi.org/10.1037/a0013178
Pettersen, I., Hernæs, E., & Skårderud, F. (2016). Pursuit of performance excellence: A population study of Norwegian adolescent female cross-country skiers and biathletes with disordered eating. BMJ Open Sport & Exercise Medicine, 2(1), e000115. doi: 10.1136/bmjsem-2016-000115
Plateau, C. R., Shanmugam, V., Duckham, R. L., Goodwin, H., Jowett, S., Brooke-Wavell, K. S., … Meyer, C. (2014). Use of the Compulsive Exercise Test with athletes: Norms and links with eating psychopathology. Journal of Applied Sport Psychology, 26(3), 287-301. doi: 10.1080/10413200.2013.867911
Poll, K. L., Holben, D., Valliant, M., & Joung, H. D. (2020). Food insecurity is associated with disordered eating behaviors in NCAA division 1 male collegiate athletes. Journal of American College Health, 68(2), 105-109. doi: 10.1080/07448481.2018.1529035
Power, K., Kovacs, S., Butcher-Poffley, L., Wu, J., & Sarwer, D. (2020). Disordered eating and compulsive exercise in collegiate athletes: Applications for sport and research. The Sport Journal, 21, 1-29.
Reas, D. L., Wisting, L., Kapstad, H., & Lask, B. (2011). Convergent validity of the eating disorder examination and the Eating Disorder Examination-Questionnaire among university women in Norway. European Eating Disorders Review, 19, 357–361. doi: 10.1002/erv.1068
Rose, J. S., Vaewsorn, A., Rosselli-Navarra, F., Wilson, G. T., & Weissman, R. S. (2013). Test-retest reliability of the Eating Disorder Examination-Questionnaire (EDE-Q) in a college sample. Journal of Eating Disorders, 1, 42. doi: 10.1186/2050-2974-1-42
Sanford-Martens, T. C., Davidson, M. M., Yakushko, O. F., Martens, M. P., & Hinton, P. (2005). Clinical and subclinical eating disorders: An examination of collegiate athletes. Journal of Applied Sport Psychology, 17(1), 79-86. https://doi.org/10.1080/10413200590907586
Sundgot-Borgen, J., & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25- 32. doi: 10.1097/00042752-200401000-00005
Sundgot-Borgen, J., & Torstveit, M. K. (2010). Aspects of disordered eating continuum in elite high-intensity sports. Scandinavian Journal of Medicine & Science in Sports, 20, 112-121. doi: 10.1111/j.1600-0838.2010.01190.x
Taranis, L., Touyz, S., & Meyer, C. (2011). Disordered eating and exercise: Development and preliminary validation of the compulsive exercise test (CET). European Eating Disorders Review, 19(3), 256-268. doi: 10.1002/erv.1108
Thiemann, P., Legenbauer, T., Vocks, S., Platen, P., Auyeung, B., & Herpertz, S. (2015). Eating disorders and their putative risk factors among female German professional athletes. European Eating Disorders Review, 23(4), 269-276. doi: 10.1002/erv.2360
Thompson, R. (2014). Eating disorders. In G. Brown (Ed.). Mind, body and sport: Understanding and supporting student-athlete mental wellness (pp. 25-28). Indianapolis, IN: National Collegiate Athletic Association.
Thompson, R. A., & Sherman, R. T. (2010). Eating disorders in sport. Taylor & Francis.
VanHeest, J. L., Rodgers, C. D., Mahoney, C. E., & De Souza, M. J. (2014). Ovarian suppression impairs sport performance in junior elite female swimmers. Medicine & Science in Sports & Exercise, 46(1), 156-166. doi: 10.1249/MSS.0b013e3182a32b72
Wolanin, A., Hong, E., Marks, D., Panchoo, K., & Gross, M. (2016). Prevalence of clinically elevated depressive symptoms in college athletes and differences by gender and sport. British Journal of Sports Medicine, 50(3), 167-171. doi: 10.1136/bjsports-2015-095756
