Prevalence and sport-related predictors of disturbed eating attitudes and behaviors: Moderating effects of sex and age

Examination of the Clinical Utility of Eating Disorder and Disordered Eating Screening Tools in Young Athletes: A Scoping Review

Background and Purpose

Many screening tools are used to identify eating disorders (ED) and disordered eating (DE) in individuals. The purpose of this scoping review was to identify the most commonly used ED/DE screening tools for young male and female athletes.

Study Design

Scoping Review.

Methods

Following the Johanna Briggs Institute scoping review guidelines, PubMed, CINAHL Complete, PsycInfo, SPORTdiscus, and Web of Science Core Collection databases were searched using keywords related to eating disorder, disordered eating, athletes, and screening. Included articles were randomized controlled trials, cohort studies, or cross-sectional studies published in English between 2011-2023; included primarily non-aesthetic athletes aged 14-24 years; and utilized an ED/DE screening tool for diagnostic purposes. Articles were excluded if analysis of ED/DE was a secondary purpose or < 20 athletes participated. Tools utilized and demographic and outcomes data were extracted and qualitatively analyzed.

Results

Thirty articles were included. The Eating Attitudes Test-26 (EAT-26), the Sick, Control, One, Fat, Food (SCOFF) questionnaire, and the Eating Disorder Inventory (EDI) were most used among all included articles. Three articles examined only males and used a variety of tools. Five articles utilized a tool specifically designed for athletes: the Eating Disorder Screen for Athletes (EDSA), Brief Eating Disorder in Athletes Questionnaire (BEDA-Q) or the ATHLETE questionnaire.

Discussion

While the EAT-26 is most used for diagnosing ED/DE risk within young athletes, clinical utility of screening tools for male athletes is varied. Combinations of tools utilized for examining ED/DE risk in athletes are not agreed upon. Continued research is needed to assess the clinical utility of screening tools that identify ED/DE risk specifically in athletes. Tool adjustment or development for male athletes may be necessary.

Level of Evidence

2a.

Adolescent girls' participation in sports is associated with lower negative effects of internalization of thin body ideals on self-objectification: findings from a cross-sectional study

PURPOSE

The aim of the present study was to test a partial sociocultural model of integrated tripartite influence and objectification theories in adolescent girls and to assess the moderating role of participation in sport.

METHODS

This study is part of a larger research that involved a sample of adolescent girls and boys from the 11^th grade. In the present study, data on 842 girls were analysed. The mean age of the sample was 16.9 ± 0.5 years. The adolescent girls completed online questionnaires assessing internalization of thin body ideals, disordered eating attitudes and behaviours, and self-objectification, as well as various aspects of participation in sports. To assess the primary hypotheses, moderated mediation models were tested.

RESULTS

Self-objectification mediated associations between internalization of thin body ideals and disordered eating attitudes and behaviours in adolescent girls. Participation in an achievement sport moderated the association between internalization of thin body ideals and self-objectification, but not between the latter and disordered eating attitudes and behaviours. Internalization of thin body ideals was not significantly associated with self-objectification in girls participating in achievement sport. The association between internalization of thin body ideals and self-objectification was stronger in adolescent girls not involved in any sports activities than in leisure-time exercisers.

CONCLUSION

It is important to promote involvement in sport for all adolescent girls, since it might help them to decrease the negative effect of internalization of thin body ideals on self-objectification and to value body functions over appearance. Decreasing self-objectification and teaching about body functionality might be an effective strategy in programmes aimed at decreasing disordered eating in adolescent girls participating in achievement sport.

LEVEL OF EVIDENCE

Level of evidence V, cross-sectional descriptive study.

Body Composition and Its Perception among Professional Female Volleyball Players and Fitness Athletes (Silesia, Poland)

Female athletes experience both sociocultural and sport-specific pressures of an ideal body and appearance and are vulnerable to dissatisfaction with their bodies. Among sport-specific pressures, the type of sport is a predictor of body image dissatisfaction. The study included 150 females: 50 volleyball players, 50 bodybuilding and fitness athletes, and 50 female students, who were the control group. Body composition and perception and evaluation of one's own body were assessed. BMI was similar in the study group of female athletes and the control group, but the bodybuilding and fitness athletes had the lowest body fat, while the control group had the highest. Perception of one's own body in the aspect of the evaluation of specific body parts was highest among bodybuilding and fitness athletes, while in the aspect of body condition, the best results were obtained by volleyball players. Most female volleyball players were dissatisfied with their current body weight, as were women in the control group, in contrast to female bodybuilding and fitness athletes, who were most often satisfied with their current body weight.

Influence of organised sports practice during adolescence on health of adult women with special emphasis on participation in aesthetic sports

This study aimed to assess the differences in psychosocial health and cardiometabolic risk during adulthood in women based on previously organised sport (OS) participation during adolescence and current activity levels, with emphasis on participation in aesthetic sports. The study included 1947 women aged 18-55 years who were categorised into four groups: 355 aesthetic athletes during adolescence, 494 non- aesthetic athletes during adolescence, 791 non-athletes during adolescence with similar current levels of physical activity (PA) to OS groups and 307 currently inactive non-athletes during adolescence. Participants answered questionnaires regarding sport participation, psychosocial health and cardiometabolic risk. The results show that non-athletes during adolescence who are currently inactive reported significantly lower psychosocial health and higher cardiometabolic risk scores. Women with currently homogenous PA levels (χ² = 0.514) reported similar physical quality of life (QoL), exercise addiction, anxiety and depression symptoms regardless of participation in OS during adolescence (P > .05), except aesthetic athletes who reported the worst sleep and mental QoL. Very high training volumes in aesthetic athletes did not influence psychological outcomes and cardiometabolic risk in adulthood compared to lower training volumes. In conclusion, the effects of PA during adulthood appear to be powerful enough to induce beneficial adaptations in health outcomes that match those observed in women who participate in OS during adolescence, except for aesthetic sports participants, who show a high risk of lower quality of sleep in adulthood. PA should be promoted in adults and especially women who have not participated in OS during adolescence.

Examining Body Appreciation and Disordered Eating in Adolescents of Different Sports Practice: Cross-Sectional Study

This cross-sectional study aimed to examine the associations between body appreciation, body functionality and disordered eating in a large adolescent sample of different levels and types of sports practice. Method: The sample consisted of 1412 adolescents (59.8% were girls). The ages ranged from 15 to 18 years old, with a mean age of 16.9 (SD = 0.5) for girls and 17.0 (SD = 0.4) for boys. Participants completed an anonymous questionnaire assessing the nature of sports participation, body appreciation, body functionality, self-esteem, body dissatisfaction, internalisation of sociocultural beauty ideals and disordered eating. A two-way ANOVA was employed to test the differences in body image concerns, body appreciation, perceived physical fitness and disordered eating behaviours in gender groups and groups of different sport types and levels. Multiple linear regression analyses were performed to predict disordered eating behaviours of different study variables. Results: Participants of leisure and competitive sports reported greater body appreciation, self-esteem and lower body dissatisfaction compared to non-participants. No differences in body appreciation and disordered eating were observed in adolescents involved in weight-sensitive and less weight-sensitive sports. Body appreciation and body functionality were associated with lower disordered eating in adolescent girls not participating in sports, leisure exercisers and participants of competitive sport as well as in boys participating in competitive sports, controlling for body mass index. Adolescent boys demonstrated greater body appreciation compared to girls. Conclusions: The results of this study support the knowledge of the protective role of positive body image preventing dysfunctional eating in adolescent girls of various sports practice and in competitive sports involved boys. Disordered eating prevention and clinical treatment programs for adolescents of different physical activity might benefit from including education about body appreciation and functionality.

Body Image and Disturbed Eating Attitudes and Behaviors in Sport-Involved Adolescents: The Role of Gender and Sport Characteristics

Disordered eating in adolescents who participate in sports is an issue of great concern. However, very few studies have examined the prevalence of sport-related determinants of disturbed eating attitudes and behaviours (DEABs) in sport-involved adolescents. The present study aims to assess body image and DEABs in the sample of adolescents involved in a sport of different characteristics (competitive sport, leisure sport; weight-sensitive and less-weight-sensitive sport) and to compare the results with those of the controls. A total sample of 732 adolescents (437 (59.4%) were female) participated in the study. The participants ranged in age from 16 to 19 years (mean = 17.2, SD = 0.6). Study participants completed a questionnaire assessing sports characteristics, body image, disordered eating, and health-compromising eating behaviours. Analysis of covariance was used to test the differences of major study variables between controls and weight-sensitive and less-weight-sensitive leisure and competitive sports groups. There was no significant difference observed in DEABs between the sports groups. Competitive athletes reported more satisfaction with body image than controls. The girls participating in weight-sensitive leisure sports reported higher overweight preoccupation and greater DEABs compared to those participating in less-weight-sensitive leisure sports. Boys participating in weight-sensitive leisure sports reported a greater drive for muscularity-related behaviour compared to those participating in less-weight-sensitive leisure sports. There was no observed interaction between gender and weight sensitivity in the competitive sports group. Adolescents involved in a competitive sport demonstrated greater body image satisfaction and did not seem to present a greater risk for DEABs than controls. Special prevention attempts for lowering body image concerns and DEABs should be addressed for adolescents participating in a weight-sensitive leisure sports.