Disordered Eating Attitudes in Relation to Anxiety Levels, Self-esteem and Body Image in Female Basketball Players

Athlete Body Image and Eating Disorders: A Systematic Review of Their Association and Influencing Factors

Body image and eating disorders pose significant challenges to the overall health of athletes. However, divergent findings exist regarding the potential association between athletes' body image and eating disorders. This systematic review aims to examine the relationship between these two variables and identify the modifiers of the association, such as gender, age, race, and exercise type. A search was conducted in five databases (Web of Science, PubMed, APA PsycINFO, ProQuest, and EBSCO), aiming to identify studies on athletes and involved body image and eating disorders in their conclusions. Ultimately, thirty-one studies were included for systematic evaluation. The results of the studies indicate that the relationship between athletes' body image and eating disorders is complex and inconclusive. In some types of sports, eating disorders can occur even when athletes are satisfied with their body image. Furthermore, female athletes, particularly young female athletes, and athletes involved in sports associated with leanness are more prone to eating disorders and body dissatisfaction. Due to limited resources in this type of research, there is a lack of comprehensive inclusivity across sports disciplines, genders, races, and levels of sports proficiency, which warrants further research.

Testing general sociocultural and coach-related appearance pressures as the factors associated with disordered eating in competitive female athletes participating in various sports

The aim of the present study was to test the sociocultural Petrie and Greenleaf's (2007) model of disordered eating (DE) in competitive female athletes. Specifically, we tested a model of general sociocultural and coach-related pressures towards body weight and appearance of female athletes as the factors associated with athletes' DE through the mediators such as internalization of appearance ideals and overweight preoccupation. 515 athletes participated in this study. The mean age of the sample was 19.0 ± 5.9 years. Athletes were provided with study measures on general sociocultural and coach-related appearance and body weight pressures, internalization of appearance ideals, overweight preoccupation and DE. Path analyses showed that general sociocultural pressures were associated with DE directly and through internalization of appearance ideals and overweight preoccupation. Pressures from coaches were associated with DE through overweight preoccupation and through the internalization of appearance ideals and overweight preoccupation. The models were invariant across body weight sensitivity in sports and age groups. These results inform DE prevention for female athletes. It is important to increase resistance to sociocultural pressures and pressures from coaches in DE prevention programmes for female competitive athletes of all ages and participating in sports irrespective of sports group (weight-sensitive or less weight-sensitive).

Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh

The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.

Practical Application and Methodological Considerations on the Basics of Sports Nutrition in Basketball: A Comprehensive Systematic Review of Observational and Interventional Studies

The current systematic review (PROSPERO registration no. CRD42022334707) of observational (OS) and interventional studies (IS) aimed at evaluating the state of scientific knowledge on the basics of sports nutrition, framing discipline-specific dietary recommendations, and indicating potential directions for future studies in various age, experience level, and able-bodied abilities groups of basketball players (BP). A systematic search of PubMed, SPORTDiscus, and Web of Science ended on 20 December 2022. Records were excluded if reporting studies on animals, sport disciplines other than basketball, or supplementation protocols other than those related to macronutrients and hydration manipulations. Risk of bias (RoB) was evaluated using Cochrane RoB_2 tools, 'JBI checklist for prevalence studies', and 'Quality assessment tool for before-after (pre-post) studies with no control group'. The relevant data was synthesized in tables and a narrative review was performed. Seventy-two records were included (2581 participants): 63 were on able-bodied BP (2433 participants) and 9 on para-athlete players (148 participants); 45 records were OS and 27 IS. The review disclosed widespread poor nutritional habits and knowledge and shortages in applying adequate nutritional and hydration practices in BP. Moreover, the systematic review revealed the lack of a sufficient number of investigations delivering reliable proof for framing discipline-specific and evidence-based recommendations on the basics of sports nutrition in basketball.

Maternal Bonding as a Protective Factor for Orthorexia Nervosa Risk in Dietetics Students

This study aimed to determine the prevalence of the risk of orthorexia nervosa (ON) in dietetics students in Greece, and its relationship with diet, risk of eating disorder (ED), body mass index (BMI), body image flexibility, and parental attachment. The participants were 132 dietetics students, with a mean age of 22.94 ± 3.5 years, who completed a series of questionnaires that recorded sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); ON indicators as determined by the ORTO-15 questionnaire; body image flexibility, with the Body Image-Acceptance and Action Questionnaire (BI-AAQ-5); the risk for ED as assessed using the EAT-26; anxiety level according to the STAIT 6 instrument; and recollection of their parents' attitudes towards them during the first 16 years of life, with the Parental Bonding Instrument (PBI). ON risk appeared to be significantly associated with BMI (p = 0.002), exercise frequency (p = 0.023), anxiety level (p = 0.002), risk of ED (p < 0.001), body image inflexibility (p < 0.001), and inversely with the affectionate constraint of maternal bonding (p = 0.036). In conclusion, disordered eating behaviors and body shape concerns are prevalent among dietetics students, with parental attachment to the mother influencing their occurrence. Identification of potential ON and development of prevention mechanisms during childhood could help eliminate these concerns and improve the lives of dietetics students.

DETECTION OF EATING DISORDERS IN MALE AND FEMALE ARTISTIC GYMNASTS

The purpose of this study was to investigate the trend of eating disorders in competitive male and female artistic gymnasts. The study involved 23 male and 42 female gymnasts, aged 7-27, from sports clubs throughout Greece. The EAT-26 Diet Attitudes scale was used to investigate participants' eating habits. The data collection process included communication with sports organizations throughout Greece on the content and purpose of the research. After consultation, the questionnaire was due to the COVID-19 pandemic provided in an electronic form and also included the consent form for participation in the research. The results of the study indicated that eleven of the sixty-five gymnasts had a total score of >20 on the EAT-26, a rate higher among female gymnasts (~ 24%) compared to male gymnasts (~ 4.4%) (p <.05). Although female gymnasts develop more eating disorders and bulimia than male gymnasts, no significant differences were found in the subscales of the questionnaire (p > .05). Therefore, this finding in combination with the fact that most of the gymnasts were teenagers (15.23 ± 6.35 years old) requires particular importance and attention from coaches and the family environment.

Eating-disorder psychopathology in female athletes and non-athletes: A meta-analysis

OBJECTIVE

There is ongoing discussion about whether sports participation is a risk or protective factor for eating disorders (EDs). Research is mixed, with some studies suggesting that athletes have higher mean levels of ED psychopathology compared to nonathletes, while other studies suggest the opposite effect or no differences. The purpose of the current meta-analysis was to identify whether female athletes reported higher mean levels of ED psychopathology compared to nonathletes.

METHOD

Following PRISMA guidelines, we identified 56 studies that reported ED psychopathology for female athletes and nonathletes. A three-level random-effects model of between- and within-study variance was completed for the following outcome variables: overall ED psychopathology, body dissatisfaction, drive for thinness, restricting, and loss-of-control eating.

RESULTS

Athletes reported lower levels of body dissatisfaction compared to nonathletes (g = -.21, p < .0001). Athletes and nonathletes reported similar levels of overall ED psychopathology, drive for thinness, restricting, and loss-of-control eating on average. Sport type significantly moderated standardized mean difference effect sizes of ED psychopathology in athletes versus nonathletes. Effect sizes comparing levels of drive for thinness, restricting, and loss-of-control eating in athletes versus nonathletes were larger for studies with athletes participating in aesthetic/lean sports compared to nonaesthetic/nonlean sports.

DISCUSSION

Findings from this meta-analysis could inform future ED prevention and treatment in female athletes by providing further evidence that athletes in aesthetic/lean sports may report higher levels of ED psychopathology. Participating in nonaesthetic/nonlean sports may be a protective factor for experiencing less body dissatisfaction.

PUBLIC SIGNIFICANCE STATEMENT

The current meta-analysis summarized findings from 56 studies that assessed levels of disordered eating, body dissatisfaction, dietary restricting, and loss-of-control eating in female athletes and nonathletes. Athletes reported lower levels of body dissatisfaction compared to nonathletes, highlighting that participation in sport could have some protective factors. Athletes participating in sports that require weight categories (e.g., judo) and sports that emphasize thinness/leanness (e.g., gymnastics and distance running) had higher levels of disordered eating relative to athletes participating in other types of sports that do not emphasize thinness/leanness (e.g., volleyball and basketball).

Weight Pressures and Eating Disorder Symptoms among Adolescent Female Gymnasts of Different Performance Levels in Greece

This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test (EAT-26), the Weight-Pressures in Sport-Females (WPS-F), the Social Desirability Scale (SDS) and provided information on their training. It was found that 16.3% of competitive gymnasts and 7.4% of non-competitive gymnasts scored ≥20 in EAT-26, indicating disordered eating behavior. Competitive gymnasts scored higher than non-competitive in the total score of EAT-26 (p = 0.027), as well as in the total score of WPS-F, the sport and coaches weight pressures sub-scale and the appearance and performance weight pressures sub-scale (p < 0.001). Multiple regression analyses indicated that sport and coaches weight pressures, appearance and performance weight pressures and body mass index accounted for 30.3% of the variance of EAT-26 in competitive gymnasts, while the appearance and performance weight pressures sub-scale accounted for 16.3% of the variance of EAT-26 in non-competitive gymnasts. Sport and coaches weight pressures are associated with ED in competitive gymnasts, while body appearance and performance demands correlate with ED in female gymnasts irrespective of competitive level.

Body image and its association with depression, anxiety, and self-esteem among college going students: A study from Northeast India

Background:

Body image is conceptualized as a subjective perception of an individual one's own body and on how he/she is seen by others, and its distortion can lead to poor self-esteem and affect psychological adjustment among the youth. The objectives of the study were to assess body image and to see the association with depression, anxiety, and self-esteem among students.

Materials and Methods:

A cross-sectional correlational study was conducted among undergraduate students in Shillong, Meghalaya. The researcher used random sampling as for the selection of college. The Krejcie and Morgan (1970) sampling method was used to determine the sample size by a table using the sample size formula for the finite population. A total of 384 respondents were selected for the study, out of which 358 were included for the final analysis. Sociodemographic datasheet, Multidimensional Body-Self Relations Questionnaire–Appearance Scales, Rosenberg Self-Esteem Scale, Beck Depression Inventory-II, and Hamilton Anxiety Rating Scale were administered.

Results:

Regression analysis showed self-esteem and anxiety contribute significantly to the prediction of body image satisfaction among students (F[4353] = 3.816, P = 0.001), accounting for a 15.1% variance.

Conclusion:

Significant proportion of students were dissatisfied with their body image. Furthermore, a study reported that body image influences psychological well-being. There is a need for preventive measures and making these young people aware of the importance of both physical and mental health.

Disordered Eating Attitudes, Anxiety, Self-Esteem and Perfectionism in Young Athletes and Non-Athletes

Eating disorders are associated with short and long-term consequences that can affect sports performance. The purposes of this study were to investigate whether female athletes, particularly gymnasts and footballers, exhibit more eating problems compared to female non-athletes, and to identify individual personality characteristics including anxiety, self-esteem, and perfectionism as possible contributors to eating disorder risk. In a sample of 120 participants, 80 adolescent female athletes were compared to a control condition of 40 non-athletes (mean age 17.2 ± 2.82). Participants responded to a questionnaire package to investigate the presence of disordered eating (SCOFF) and psychological variables in relation to disordered eating symptoms or eating disorder status. Subsequently, anthropometric measures were obtained individually by trained staff. There were statistically significant differences between conditions. One of the most important results was the score in SCOFF (Mann-Whitney = 604, p < 0.05; Cohen's d = 0.52, r = 0.25), being higher in control than in the gymnast condition. These results suggest that non-athlete female adolescents show more disturbed eating behaviours and thoughts than female adolescents from aesthetic sport modalities and, therefore, may have an enhanced risk of developing clinical eating disorders.

BUSCA PELA MUSCULARIDADE, HUMOR E TRANSTORNOS ALIMENTARES EM ATLETAS DO SEXO MASCULINO

RESUMO Introdução: Parece que a busca pela muscularidade pode ter relação com os transtornos alimentares (TA) em atletas do sexo masculino. Todavia, de acordo com nosso conhecimento, não existem estudos sobre esse tema. Objetivo: Analisar a relação da busca pela muscularidade e estado de humor com os transtornos alimentares nessa população. Métodos: Participaram do estudo 112 competidores de diversas modalidades esportivas, pertencentes a federações do sudeste brasileiro. Utilizou-se o Eating Attitudes Test (EAT-26), Drive for Muscularity Scale (DFM) e a Escala de Humor de Brunel (BRUMS) para avaliar, respectivamente, os comportamentos alimentares de risco de TA, a busca pela muscularidade e o estado de humor. Resultados: Os achados dos modelos de regressão hierárquica não demonstraram relação da busca pela muscularidade (p > 0,05) e do estado de humor (p > 0,05) com os transtornos alimentares. Todavia, os resultados indicaram diferença de busca pela muscularidade em razão das classificações do EAT-26 (p < 0,05), fato que não foi revelado para o estado de humor (p > 0,05). Conclusão: Concluiu-se que tanto o estado de humor quanto a busca pela muscularidade não se relacionaram com os transtornos alimentares em atletas do sexo masculino.

Eating disorders risk and its relation to self-esteem and body image in Iranian university students of medical sciences

INTRODUCTION AND OBJECTIVES

Eating disorders are rapidly increasing in young adults. But, a few studies have examined the risk of eating disorders and body image in university students of non-Western societies. The current study aimed to assess eating disorders risk in relation to body image and self-esteem among Iranian university students.

METHOD

The participants were 430 students from Tabriz, between April and May 2015. The 26-item Eating Attitude Test (EAT-26), Multidimensional Body-Self Relations Questionnaire (MBSRQ) and Rosenberg's Self-Esteem Questionnaires were used. EAT-26 score of 20 or more was considered as eating disorders risk cutoff.

RESULTS

Majority of the students (68 %) were females. The overall eating disorders risk was 9.5 % (7.5 and 10.5 % in men and women, respectively). Further, the prevalence of poor body image and low self-esteem was 34.2 and 16 %, respectively. Neither of the gender differences was statistically significant (p > 0.05). In simple logistic regression, there were significant associations between self-esteem, body image, parental education and eating disorders risk (p < 0.025). But, after adjustments for gender, age, Body Mass Index (BMI) and marital status, only self-esteem (OR = 0.37, 95 % = 0.16-0.87) and mother's education level (OR = 2.78, 95 % = 1.30-5.93) were predictors of eating disorders risk.

CONCLUSIONS

The findings revealed that low self-esteem and mother's higher education may increase eating disorders risk and the predictive role of body image possibly is by other mediators such as self-esteem. This warrants awareness improvement and developing appropriate interventions targeting self-esteem and self-respect of students.

Comparison of disordered eating symptoms and emotion regulation difficulties between female college athletes and non-athletes

The purpose of the study was to compare the prevalence of disordered eating between female college athletes and non-athletes and explore emotion regulation as a potential mediator of the link between participation in athletics and disordered eating symptoms. Data for this cross-sectional study came from 527 college students in a mid-western state of the USA in fall of 2013 (376 non-athletes and 151 athletes). Disordered eating symptoms and emotion regulation were assessed utilizing the Eating Attitudes Test and the Difficulties with Emotion Regulation Scale in a survey-based format. The prevalence of disordered eating was higher in non-athletes (16.5%, vs. 6.6%; X(2)=62.8; p<.05). Non-athletes reported more signs and symptoms of disordered eating than athletes (p<.01). A linear regression approach indicated a statistically significant indirect effect (0.63, CI95=0.18, 1.20) of athletic-status on disordered eating via emotion regulation; however, this effect did not reach practical significance. Our findings show that female athletes in our sample were somewhat protected from disordered eating compared to non-athletes, but the mechanism of this relationship is unclear. A further in-depth examination of other factors, such as self-esteem and body satisfaction, that may have contributed to this finding is warranted utilizing a large sample of female college students and athletes representing a variety of sports.

Eating behaviours in youths: A comparison between female and male athletes and non-athletes

This study compared the different factors associated with eating behaviors among young female and male athletes and non-athletes. A total of 580 female and male athletes and 362 female and male non-athletes between 10 and 19 years old participated. We used the subscales of the Eating Attitudes Test (EAT-26) to evaluate the factors associated with unhealthy eating behaviors. We found higher scores for females on the diet subscale compared with males, regardless of athletic group (P < 0.05). Non-athlete youths scored higher on this subscale compared with male athletes (P < 0.05). Our findings indicate higher scores for female athletes with regard to the bulimia and preoccupation with food subscale compared with other the groups (P < 0.05). Moreover, we observed that non-athlete males were more likely to engage in binge eating compared with athletes of the same sex (P < 0.05). Finally, females had higher scores on the oral self subscale than males, regardless of athletic group (P < 0.05). We concluded that the factors associated with eating behaviors differ with regard to sex and group.