Athletes with eating disorders: clinical-psychopathological features and gender differences

Eating disorders are mental illnesses which can affect anyone and may also be seen in athletes, where studies normally look at differences between athletes and non-athletes. However, there has been a lack of research comparing specific gender differences in athletes who have an eating disorder. This study looked at the differences not only between the groups, but also within the groups, in terms of eating disorder behaviors, psychological factors and personality. The findings were that in the athlete group, females had higher dissatisfaction with their body and had a higher desire to be thin. Female athletes were also more anxious and had more suicidal thoughts compared to male athletes.

BACKGROUND: Eating disorders (EDs) in the athlete population are often discussed in terms of comparing with non-athlete samples, however little is known regarding their gender clinical differences. Therefore, this study aimed to compare clinical and psychopathological features among athletes with an eating disorder (ED+A), non-athletes with an eating disorder (ED-A) and healthy controls (HCs), in addition to observing gender differences.

METHODS: The sample consisted of 192 participants, all were age and gender matched, ED+A n = 64, ED-A n = 64 and HCs n = 64, with each group consisting of 50 females and 14 males. And each participant completed a face-to-face interview and various self-report questionnaires regarding personality traits (Temperament and Character Inventory-Revised), eating (Eating Disorder Inventory - 2) and general psychopathology (Symptom Checklist 90 - Revised), as well as relevant clinical indexes (lifetime suicidal attempts/ideation and sport activities conducted).

RESULTS: In the ED+A group females had significantly higher eating and general psychopathology compared to males, especially body dissatisfaction (BD) and drive for thinness (DT) (p <.001). Overall, ED+A males had the lowest BD across the 3 groups. In terms of personality traits, ED+A females had significantly higher harm avoidance and lower self-directedness compared to their male counterparts. Lastly, suicidal ideation was significantly higher in ED+A females compared to males.

CONCLUSIONS: These results suggest that it may be imperative to better understand the risk factors in the athletic realm which may lead to the development of EDs, and which factors may be protective as well. It may also be helpful to encourage trainers to include preventive and screening strategies for athletes.