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Heather A. Hausenblas and Albert V. Carron

Research shows inconclusive results pertaining to the comparison of eating disorder indices between athletes and nonathletes and among different subgroups of athletes. The purpose of this study was to meta-analytically review the literature on (a) bulimia nervosa indices, (b) anorexia nervosa indices, and (c) drive for thinness (a cardinal feature of both anorexia and bulimia) in male and female athletes. Results of 92 studies with 560 effect sizes (ES) revealed small ESs (range: −.01 to .30) in relation to group membership characteristics. Results for female athletes revealed small ESs for bulimia and anorexia indices, suggesting that female athletes self-reported more bulimic and anorexic symptomatology than control groups; nonsignificant group differences were evidenced for drive for thinness. Results for male athletes revealed small ESs on all three indices, suggesting that male athletes self-reported more eating disorder symptomatology than control groups. Moderator variables that might contribute to understanding the results are examined, and future research directions are presented.

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Jorunn Sundgot-Borgen

This study assessed the nutrient intake and eating behavior in Norwegian female elite athletes suffering from eating disorders (ED) who met the criteria for anorexia nervosa (AN), anorexia athletica (AA), or bulimia nervosa (BN). The subjects included 7 AN, 43 AA, 42 BN, and 30 controls. Three-day and 24-hr food records were used to assess energy and nutrient intake. Results revealed that a significant number of AN and AA athletes have diets too low in energy and nutrients, the mean intake for energy and CHO being lower than recommended for active females. A significant number did not reach the protein level recommended for athletes. In addition, there were low intakes of several micronutrients, most notably calcium, vitamin D, and iron. The energy and nutritional inadequacy, combined with the use of purging, are of major concern since the athletes in this study were relatively young. It is unknown whether the abnormal eating pattern is a consequence of ED or is typical of top level athletes.

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Katherine A. Beals and Melinda M. Manore

This study examined the prevalence of and relationship between the disorders of the female athlete triad in collegiate athletes participating in aesthetic, endurance, or team/anaerobic sports. Participants were 425 female collegiate athletes from 7 universities across the United States. Disordered eating, menstrual dysfunction, and musculoskeletal injuries were assessed by a health/medical, dieting and menstrual history questionnaire, the Eating Attitudes Test (EAT-26), and the Eating Disorder Inventory Body Dissatisfaction Subscale (EDI-BD). The percentage of athletes reporting a clinical diagnosis of anorexia and bulimia nervosa was 3.3% and 2.3%, respectively; mean (±SD) EAT and EDI-BD scores were 10.6 ± 9.6 and 9.8 ± 7.6, respectively. The percentage of athletes with scores indicating “at-risk” behavior for an eating disorder were 15.2% using the EAT-26 and 32.4% using the EDI-BD. A similar percentage of athletes in aesthetic, endurance, and team/anaerobic sports reported a clinical diagnosis of anorexia or bulimia. However, athletes in aesthetic sports scored higher on the EAT-26 (13.5 ± 10.9) than athletes in endurance (10.0 ± 9.3) or team/anaerobic sports (9.9 ± 9.0, p < .02); and more athletes in aesthetic versus endurance or team/anaerobic sports scored above the EAT-26 cut-off score of 20 (p < .01). Menstrual irregularity was reported by 31% of the athletes not using oral contraceptives, and there were no group differences in the prevalence of self-reported menstrual irregularity. Muscle and bone injuries sustained during the collegiate career were reported by 65.9% and 34.3% of athletes, respectively, and more athletes in aesthetic versus endurance and team/anaerobic sports reported muscle (p = .005) and/or bone injuries (p < .001). Athletes “at risk” for eating disorders more frequently reported menstrual irregularity (p = .004) and sustained more bone injuries (p = .003) during their collegiate career. These data indicate that while the prevalence of clinical eating disorders is low in female collegiate athletes, many are “at risk” for an eating disorder, which places them at increased risk for menstrual irregularity and bone injuries.

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Jessyca N. Arthur-Cameselle and Molly Curcio

participants often turn to recovery after a realization that the ED had compromised their quality of life. More recent studies have revealed similar findings. For example, for 14 women (ages 23–26) who had recovered from Bulimia Nervosa (BN), turning points included self-realizations, opening up to others

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Jorunn Sundgot-Borgen

This study examined the prevalence of eating disorders (ED) and the possible difference between ED symptoms and true ED by using questionnaires as compared with an interview and clinical evaluation in Norwegian elite female athletes (n=522) from 35 sports and nonathletic controls (n=448). In addition to the 117 athletes classified as "at risk" to develop ED, 90 subjects were randomly chosen, comprising 30 athletic controls, 30 at-risk nonathletes, and 30 nonathletic controls. All weIe interviewed and clinically examined. A significantly higher number of athletes (18%) than controls (5%) were found to actually suffer from ED, particularly athletes competing in sports in which leanness or a specific weight were considered important. When results from the screening study were compared to those from the interviews and clinical examinations, a significant underreporting of ED among athletes was demonstrated. The athletes also reported the use of other pathogenic methods in the screening study compared to what they reported in the interview. Nonathletes more correctly reported the use of pathogenic methods but overreported the prevalence of ED. Thus the issue of using questionnaires alone or in combination with personal interview/clinical examination merits further investigation.

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Jennifer Moshak

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K. Jason Crandall and Patricia A. Eisenman

Binge eating disorder (BED) is a relatively new eating disorder that involves recurrent binge eating without compensatory purging behaviors such as using laxatives, excessive physical activity, and/or dietary restraint. Individuals diagnosed with BED exhibit both psychological and physiological problems that are distinct from bulimia nervosa and non-BED obese individuals. There has been little to no research examining the effects of physical activity on BED treatment. Since current BED treatment strategies have been less than successful, physical activity may be a positive addition to BED treatment. Therefore the objectives of this paper are 1) to raise the awareness of exercise professionals as to. the existence of BED, 2) explore the mechanisms that might support the utilization of physical activity as an adjunct treatment strategy for BED and 3) to prompt more interest among researchers and practitioners relative to using physical activity interventions with BED clients.

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Sharon R. Guthrie, Cathy Ferguson, and Dixie Grimmett

This research examined the nutritional practices and body images of 13 competitive women bodybuilders living in southern California and in the Midwest. Data collection included both structured interviews and survey methods. Findings indicate nutritional health and positive body image among this sample of women. None of the bodybuilders had anorexia nervosa or bulimia nervosa, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987) criteria, were binge eaters or used pathogenic weight control measures. Instead, they reported significant improvement in their nutritional attitudes and behaviors after beginning bodybuilding training. These data suggest a relationship between participating in competitive bodybuilding and other behaviors related to nutrition and self-perception.

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Diane E. Taub and Rose Ann Benson

Since most research on eating disorders among athletes has focused on college-age samples, the present investigation examines the adolescent competitive swimmer. Three areas related to weight and eating habits were explored: general concerns about weight, use of weight control techniques, and tendencies toward anorexia nervosa and bulimia nervosa and associated behavioral/personal characteristics. Previous research has found females to be at greater risk than males, thus gender comparisons were undertaken. Questionnaires were completed by 85 adolescent competitive swimmers attending a nationally known summer swim camp at a large midwestern university. Consistent with the cultural norm of thinness for women, young female swimmers desired weight loss more than their male counterparts did. In terms of actual pathogenic weight control techniques or eating disorder tendencies, however, few significant gender differences were found. Neither male nor female adolescent swimmers were particularly susceptible to eating disorders or pathogenic weight control techniques.

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Zella E. Moore, Raquel Ciampa, Jaime Wilsnack, and Elizabeth Wright

Eating disorders are serious clinical issues that can have severe physical and psychological ramifications. Although prevalence rates of anorexia nervosa and bulimia nervosa are low in the general population, it has been reported that prevalence rates are higher among individuals involved in the athletic milieu. Unfortunately, based on the demands of the sport environment, these individuals may be significantly less likely to seek treatment for these disorders, thus may experience dangerous short- and long-term consequences. Yet, even when such athletes do seek help, they often receive psychological treatments that have not been demonstrated to be efficacious among methodologically sound research studies. This article clarifies the current state of eating disorder treatment efficacy so that practitioners working with eating disordered athletic clientele can adopt more ethical and effective treatment practices.