Risk and trigger factors for the development of eating disorders in female elite athletes

TLDR

The study investigated risk factors and triggers for eating disorders among female elite athletes. The authors surveyed 603 Norwegian elite female athletes (ages 12–35) across six sports categories, classified risk using the Eating Disorder Inventory, and interviewed 103 at‑risk athletes and 30 matched controls. Among the at‑risk athletes, 92 met criteria for an eating disorder, with higher prevalence in leanness‑or‑weight‑dependent sports; compared to controls, they began training and dieting earlier, perceived puberty as too early, and were triggered by prolonged dieting, weight fluctuations, sudden training increases, and traumatic events such as injury or loss of a coach.

Abstract

This study examined risk factors and triggers for eating disorders in female athletes. Subjects included were all of the elite female athletes in Norway (N = 603), ages 12–35 yr, representing six groups of sports: technical, endurance, aesthetic, weight dependent, ball games, and power sports. The Eating Disorder inventory was used to classify individuals at risk for eating disorders. Of the 117 athletes defined as at risk, 103 were administered a structured clinical interview for eating disorders. A comparison group was also interviewed, consisting of 30 athletes chosen at random from a pool not at risk and matched to the at-risk subjects on age, community of residence, and sport. Ninety-two of the at-risk athletes met criteria for anorexia nervosa, bulimia nervosa, or anorexia athletica. The prevalence of eating disorders was higher in sports emphasizing leanness or a specific weight than in sports where these are less important. Compared with controls, eating disordered athletes began both sportsspecific training and dieting earlier, and felt that puberty occurred too early for optimal performance. Trigger factors associated with the onset of eating disorders were prolonged periods of dieting, frequent weight fluctuations, a sudden increase in training volume, and traumatic events such as injury or loss of a coach.