Behind the athletic body: a clinical interview study of identification of eating disorder symptoms and diagnoses in elite athletes

Mia Beck Lichtenstein*, Karen Krogh Johansen, Eik Runge, Marina Bohn Hansen, Trine Theresa Holmberg, Kristine Tarp

*Kontaktforfatter for dette arbejde

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Eating disorders are more prevalent in athletes than in the general population and may have severe consequences for sports performance and health. Identifying symptoms can be difficult in athletes because restrictive eating and slim body images are often idealised in a sports setting. The Eating Disorders Examination Questionnaire (EDE-Q) and the SCOFF (Sick, Control, One stone, Fat and Food) questionnaire (SCOFF) are widely used generic instruments to identify symptoms of eating disorders. This study aimed to investigate the instruments' validity and explore eating disorder symptoms in a sample of athletes. A sample of 28 athletes (25 females) competing at a national level was interviewed based on the diagnostic criteria for eating disorders. We interviewed 18 athletes with a high score on EDE-Q and 10 with a low score. All interviews were transcribed and analysed from a general inductive approach. We identified 20 athletes with an eating disorder diagnosis, while 8 had no diagnosis. EDE-Q found 90% of the cases, while SCOFF found 94%. EDE-Q found no false-positive cases, while SCOFF found one. The qualitative results showed that most athletes reported eating concerns, restrictive eating, eating control (counting calories), weight concerns, body dissatisfaction (feeling fat and non-athletic), excessive exercise and health problems (eg, pain, fatigue). In conclusion, EDE-Q and SCOFF seem valid instruments to screen athletes' samples but may fail to find 6%-10% cases with eating disorders. Despite athletic bodies and normal body mass index, many athletes report severe eating problems and dissatisfaction with weight and body appearance. Implementation of regular screening may identify these symptoms at an early stage.

TidsskriftBMJ Open Sport and Exercise Medicine
Udgave nummer2
Antal sider14
StatusUdgivet - 1. jun. 2022

Bibliografisk note

Funding Information:
The project was partly funded by Team Denmark and The Danish Sport Federation (DIF).

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