Eating Disorder Risk and Pathogenic Behaviors Among Collegiate Student-Athletes

Context: Eating disorders (EDs) are a cluster of behavioral conditions characterized by uneasy thoughts and behaviors that grow into severe or persistent eating disturbances. The demands on student-athletes may create mental and physical stressors that increase the likelihood of EDs and disordered eating.Objective: To examine the ED risk through eating attitudes and behaviors in male and female student-athletes and across various sport types (endurance, aesthetic, power, ball or team, or technical sports).Design: Cross-sectional study.Setting: Collegiate athletics.Patients or Other Participants: National Collegiate Athletic Association Division I and II student-athletes (n = 2054; males = 631; females = 1423) from 40 institutions.Main Outcome Measure(s): Participants completed a web -based demographic survey and the Eating Attitudes Test-26 (EAT-26). Multiple x(2) analyses examined participants classified as at risk for EDs. Independent-samples t tests and a 1-way analyses of variance compared sex and sport type across EAT-26 totals and subscale (Dieting, Bulimia, and Oral Control) scores.Results: Overall, 25.3% (n = 520/2054) of student-athletes were classified as at risk for EDs. Differences were found between sex and ED risk (chi(2)(1,2054) = 32.9, P <= .01; 17.3% [n = 109/631] males, 28.9% [n = 411/1423] females) and across ED risk and sport type (chi(2)(4,2054) = 13.4, P = .01). When examining females only, we observed differences across ED risk and sport type (chi(2)(4,1423) = 13.4, P <= .01). No differences were evident across ED risk and sport type for males. Differences were seen between sex and binge eating (chi(2)(1,2054) = 6.8, P = .009), sex and diet pill use (chi(2)(1,2054) = 19.6, P <= .01), and sport type and diet pill use (chi(2)(4,2054)= 12.2, P = .016), excessive exercise (chi(2)(4,2054) = 32.1, P <= .01), and losing more than 20 lb (9 kg) in the last 6 months (chi(2)(4,2054) = 10.2, P <= .037).Conclusions: Student-athletes in the collegiate setting are at risk for EDs. Medical professionals, such as athletic trainers, need to be educated on the potential risk factors that may lead to EDs. Protocols for prevention, screening and recogni-tion, and referral should be developed for student-athletes at risk for EDs.