"I don't need a flat tummy; I just want to run fast" - self-understanding and bodily identity of women in competitive and recreational sports

A systematic review and meta-synthesis of qualitative research investigating disordered eating and help-seeking in elite athletes

OBJECTIVE

Elite athletes are at elevated risk for disordered eating and eating disorders; however, little is known about risk and maintaining factors, or barriers and facilitators of help-seeking in this cohort. This systematic review synthesized qualitative findings regarding possible risk and maintaining factors for disordered eating, as well as barriers to and facilitators of help-seeking in elite athletes.

METHOD

We conducted a search for qualitative studies that included experiences with body image concerns or disordered eating in elite athletes. A systematic search of CINAHL, PsychINFO, MEDLINE, and Scopus databases identified 828 articles, with 87 retained after title and abstract screening, and 38 included in the review. Quality appraisal was conducted using the checklist for appraising qualitative research (CASP). Data were extracted from each article, including demographic information (e.g., biological sex, age, sport type, level of competition, current, or former athlete) and the text under the "results" or "findings" section. Meta-themes were identified using inductive thematic meta-synthesis.

RESULTS

The extracted data indicated that most studies sampled female athletes from the United States and UK. Eight meta-themes were identified: (1) the power imbalance; (2) hyperfocus on body, food, and exercise; (3) rigidity; (4) the athlete's balance; (5) the athlete identity; (6) overvaluation and oversimplification; (7) shame, fear, and stigma; and (8) knowledge, education, and self-identification.

DISCUSSION

These findings highlighted gaps in the demographic representation of specific groups in this research (e.g., males, para-athletes, and ethnic diversity) and propose hypotheses of how sport pressure might contribute to athletes' experiences with disordered eating.

PUBLIC SIGNIFICANCE

Disordered eating and body image concerns are prevalent and can have debilitating impacts for elite athletes; however, help-seeking is rare for this population. It remains unclear what factors contribute to disordered eating and/or inhibit help-seeking among elite athletes versus the general population. Understanding athletes' perspectives will inform the modification of prevention and treatment strategies to address athlete-specific factors.

An Analysis of Women’s Fitness Demands and Their Influencing Factors in Urban China

The “Healthy China 2030” plan states that it is necessary to formulate and implement physical health intervention plans for special groups, including women. Based on questionnaire data from women in seven Chinese cities, our research analyzed the status quo of women’s fitness, its influencing factors, and the differences in and characteristics of different types of women’s fitness demands from four aspects: demography, fitness motivation, fitness behavior, and fitness demands, so as to provide a reference for the promotion of women’s fitness. A total of 3473 valid samples were completed. The questionnaire included five age groups: there were 146 in the “20–29 years old” group, 829 in the “30–39 years old” group, 1088 in the “40–49 years old” group, 1105 in the “50–59 years old” group and 305 in the “60 years old and above” group. The questionnaire used in this study was a self-made questionnaire. The contents of the questionnaire included age, occupation, educational level, family circumstances, and health status, women’s fitness behavior, fitness motivation and fitness demands. The results show that the current situation of urban women’s fitness in China is characterized by low frequency and short duration of exercise. The internal factors affecting women’s fitness demands include fitness motivation and fitness behavior. The external factors affecting their fitness demands are social environment and family environment. The differences in women’s fitness demands mainly come from women’s occupation, monthly income, and family stage.