Toward understanding of coaches’ role in athletes’ eating pathology: A systematic review and ecological application to advance research

Abstract

Eating pathology has harmful effects on athletes’ health and wellbeing, in addition to hindering their sport performance. Coaches have been identified as having a key role in the onset and maintenance of eating pathology among athletes. The purpose of this systematic review was to synthesize current knowledge of coach-specific behaviors and practices associated with athletes’ eating pathology across multiple spheres of influence and interaction using an ecological systems theory approach. A total of 36 studies (quantitative, n = 21; qualitative, n = 13; mixed-method, n = 2) were included. Findings underscored athletes’ perceptions of how their coaches influence their eating pathology, namely through factors related to the prevailing sport ethic, quality and characteristics of coach-athlete relationships, and specific behaviors and practices including coaches’ comments about athletes’ bodies, diet prescription and advice from coaches, weighing and body measurement by coaches, and food monitoring by coaches. Conclusions drawn from the systematic review are further considered in light of the populations sampled, quality of the research studies conducted, and gaps in current literature. Specific recommendations for future research are provided, including proposed study designs, inclusion of populations underrepresented in the literature, and the need to focus future research on the study of coaches, rather than continued focus on athletes’ perception of coaches’ role, in order to generate the knowledge needed that positions coaches as targeted agents of change to mitigate eating pathology among athletes.