Detecting Eating Disorders in Men and Women Athletes Identifying athletes at risk may require gender-specific tests.

Much research has examined disordered eating in athletes, but this work has mostly focused on women. The model of the female athlete triad (energy intake deficiency with or without disordered eating, menstrual disturbances, and bone loss) has been widely applied and found to be helpful for identifying women athletes at risk for an eating disorder. Theoretically, male athletes should also have a higher-than-normal risk for disordered eating because of the emphasis on body weight, shape, and size to successfully compete in individual sports. Thus, it might be assumed that similar traits would dispose male athletes to disordered eating. However, when researchers looked at 5 personality and psychological variables in male athletes—perfectionism, self-esteem, optimism, reasons for exercise, and concern about appearance—none of the variables significantly predicted disordered eating (Eat Behav. 2014; 15:615).

The researchers, led by Nick Galli at the University of Utah in Salt Lake City, theorized that pressure from society and sports to “look like” or “have an athletic appearance,” such as being lean and muscular, may lead to disordered eating. This was true in one study of female collegiate athletes who exercised to become more physically attractive, and also increased the likelihood that they would have symptoms of disordered eating patterns (Eat Disord. 2009; 17:302). The same emphasis on and concern with appearance might lead male collegiate athletes to become more dissatisfied with the size and shape of their bodies, a known risk for developing bulimic symptoms (Psychol Bull. 2002;128:125). 

A study group of 203 male athletes from three NCAA Division 1 colleges in the Mountain West, Southwest, and Midwest participated in the study. The men had a mean age of 20 years and a mean body mass index (BMI, mg/kg²) of 27.51. All were participants in 16 varsity sports ranging from football to wrestling. Most (roughly 75%) were classified as “ballgame” athletes, followed by “power,” “endurance,” “technical,” “aesthetic,” and “weight-dependent” (n=2) athletes. All completed a series of self-report questionnaires, including the 50-item Questionnaire for Eating Disorder Diagnosis (Q-EDD), the Multi-dimensional Perfectionism Scale, the Life Orientation Test-Revised, the Reasons for Exercise Inventory, and the Appearance Orientation Scale.

Nearly 20% of men showed symptoms of disordered eating

One-hundred and sixty-four of the male athletes (80.8%) were asymptomatic on the Q-EDD; and 39 (19.2%) were symptomatic. None met the Q-EDD cutoff for having an eating disorder. Personality and psychological variables could not significantly predict the male athletes’ Q-EDD grouping. These findings are in stark contrast to the research with female athletes, where, for example in one study that used psychological and personality predictors, 79.4% of the female athletes were correctly classified as either having or not having disordered eating patterns (Eat Disord. 2009; 17:320).

The authors concluded that risk variables need to be studied separately by gender to verify risk for disordered eating and eating disorders. Also, they feel a more helpful approach to measuring risk would be to measure variables that might be more relevant to male athletes, such as fear of stigmatization, low social support, and need for social approval, and to focus on other disordered eating patterns (drive for muscularity, drive for leanness, and anabolic steroid use).

Eating Disorders Review