Abstract
The purpose of this study was to investigate the prevalence of self-reported restrictive eating, current or past eating disorder, and menstrual dysfunction and their relationships with injuries. Furthermore, we aimed to compare these prevalences and associations between younger (aged 15–24) and older (aged 25–45) athletes, between elite and non-elite athletes, and between athletes competing in lean and non-lean sports. Data were collected using a web-based questionnaire. Participants were 846 female athletes representing 67 different sports. Results showed that 25%, 18%, and 32% of the athletes reported restrictive eating, eating disorders, and menstrual dysfunction, respectively. Higher rates of lean sport athletes compared with non-lean sport athletes reported these symptoms, while no differences were found between elite and non-elite athletes. Younger athletes reported higher rates of menstrual dysfunction and lower lifetime prevalence of eating disorders. Both restrictive eating (OR 1.41, 95% CI 1.02–1.94) and eating disorders (OR 1.89, 95% CI 1.31–2.73) were associated with injuries, while menstrual dysfunction was associated with more missed participation days compared with a regular menstrual cycle (OR 1.79, 95% CI 1.05–3.07). Our findings indicate that eating disorder symptoms and menstrual dysfunction are common problems in athletes that should be managed properly as they are linked to injuries and missed training/competition days.
Highlights
Athletes may feel pressure to alter their weight in order to improve performance or subjective appearance, which can lead to dieting, restrictive and disordered eating, or even a clinical eating disorder [1]
We found that menstrual dysfunction was more common in lean sport athletes compared with non-lean sport athletes, which is consistent with previous studies [8,31,39]
While previous studies have been conducted in adolescent athletes [11,12,13], our study showed that the association between eating disorders and injuries applies in older athletes, which suggests that increasing age does not protect athletes from injuries associated with restrictive eating and eating disorders
Summary
Athletes may feel pressure to alter their weight in order to improve performance or subjective appearance, which can lead to dieting, restrictive and disordered eating, or even a clinical eating disorder [1]. Clinical eating disorders and disordered eating, especially restrictive eating, are often associated with low energy availability, which may result in suppression of the hypothalamus–pituitary–ovarian axis and further lead to menstrual dysfunction [3]. Disordered eating, eating disorders, and menstrual dysfunction are common among female athletes [4,5,6]. De Souza and colleagues [5] reported that the prevalence of disordered eating in female collegiate and elite athletes varies from 6% to 42%, while eating disorder prevalence among female athletes ranges from 2% to 33% [4]. The prevalence of menstrual dysfunction in female athletes is reported to vary from 9% to
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