Eating Disorders in Female Athletes

Abstract

Disordered eating habits are prevalent among female athletes, especially in those involved in sports demanding low body weight. Whether this behavior is the consequence of environmental pressures in their sport environment or due to a certain personality-(possibly genetic?) profile similar to that seen in anorexic patients is controversial. PURPOSE: To test the hypothesis that athletes from aesthetic disciplines (AAs) are at higher risk for disordered eating than non-aesthetic athletes (NAAs) and share certain personality characteristics, such as perfectionism and obsessiveness, with non-athletic females suffering from anorexia nervosa. METHOD: A total of 458 girls and women aged 13–35 participated in the study: 111 AAs (mostly dancers), 68 non-aesthetic athletes (NAAs), 31 anorexics and 248 controls. All participants completed self-report measures of symptomatology, harm avoidance, perfectionism, obsessiveness, self-esteem, and self-rated facial attractiveness, and were screened for eating disorders. Those screening positively were interviewed and diagnosed using the SCID-IV. RESULTS: As expected the AN group showed a significantly higher level of general and eating pathology, as well as greater body dissatisfaction & drive for thinness than the other three groups. The NAA group exhibited greater body satisfaction and less drive for thinness than the three other groups. Surprisingly, and contrary to our hypothesis, the AA group did not differ from female controls on any scale and showed no signs of general symptomatology or disturbed attitudes towards eating or weight. However, significantly more AAs (11.7%) than NAAs (5.8%) and controls (4.4%) had a lifetime diagnosis of “Eating disorders not otherwise specified” (EDNOS). The eating attitudes and behavior of the 13 AAs with a lifetime history of EDNOS fell intermediately between those of the anorexic women and the controls, whereas their personality profile resembled that of the controls. CONCLUSIONS: Most of the athletes, including AAs demonstrate remarkable overall psychological health and resilience, and low rates of lifetime anorexia and bulimia nervosa. However, a subgroup of AAs suffers from EDNOS without reporting that they ever received appropriate treatment for it. These results seem to support the notion that “anorexia athletica” is a specific diagnostic entity, to be viewed as a subclinical, environmentally influenced eating disorder with a favorable prognosis, unaccompanied by the personality traits generally underlying anorexia nervosa.