DETECTION OF EATING DISORDERS IN MALE AND FEMALE ARTISTIC GYMNASTS
DOI:
https://doi.org/10.52165/sgj.14.3.421-433Keywords:
Eating disorders, Artistic gymnastics, Aesthetic sports, Puberty, Neurogenic bulimia, Neurogenic anorexiaAbstract
The purpose of this study was to investigate the trend of eating disorders in competitive male and female artistic gymnasts. The study involved 23 male and 42 female gymnasts, aged 7-27, from sports clubs throughout Greece. The EAT-26 Diet Attitudes scale was used to investigate participants' eating habits. The data collection process included communication with sports organizations throughout Greece on the content and purpose of the research. After consultation, the questionnaire was due to the COVID-19 pandemic provided in an electronic form and also included the consent form for participation in the research. The results of the study indicated that eleven of the sixty-five gymnasts had a total score of >20 on the EAT-26, a rate higher among female gymnasts (~ 24%) compared to male gymnasts (~ 4.4%) (p <.05). Although female gymnasts develop more eating disorders and bulimia than male gymnasts, no significant differences were found in the subscales of the questionnaire (p > .05). Therefore, this finding in combination with the fact that most of the gymnasts were teenagers (15.23 ± 6.35 years old) requires particular importance and attention from coaches and the family environment.
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Abell, S. C., & Richards, M. H. (1996). The relationship between body shape satisfaction and self-esteem: An investigation of gender and class differences. Journal of Youth and Adolescence, 25, 691-703. DOI: https://doi.org/10.1007/BF01537361
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM –IV). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publications. DOI: https://doi.org/10.1176/appi.books.9780890425596
Anderson, C. M., Petrie, T. A., & Neumann, C. S. (2012). Effects of sport pressures on female collegiate athletes: A preliminary longitudinal investigation. Sport, Exercise, and Performance Psychology, 1(2), 120–134. DOI: https://doi.org/10.1037/a0026587
Ata, R. N., Ludden, A. B., & Lally, M. M. (2006). The Effects of Gender and Family, Friend, and Media Influences on Eating Behaviors and Body Image During Adolescence. Journal of Youth and Adolescence, 36(8), 1024 - 1037. DOI: https://doi.org/10.1007/s10964-006-9159-x
Bardone-Cone, A. M., Abramson, L. Y., Vohs, K. D., Heatherton, T. F., & Joiner, T. E. (2006). Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status. Behaviour Research and Therapy, 44 (1), 27–42. DOI: https://doi.org/10.1016/j.brat.2004.09.009
Bardone-Cone, A. M., Wonderlich, S. A., Frost, R. O., Bulik, C. M., Mitchell, J. E., Uppala, S., & Simonich, H. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27(3), 384 – 405. DOI: https://doi.org/10.1016/j.cpr.2006.12.005
Biro, F. M., Striegel-Moore, R. H., Franko, D. L., Padgett, J., & Bean, J. A. (2006). Self-Esteem in Adolescent Females. Journal of Adolescent Health, 39(4), 501–507. DOI: https://doi.org/10.1016/j.jadohealth.2006.03.010
Buschman, B. (2002). Female athlete triad: Education is the key. ASCM’s Certified News, 12, 1–5.
Byrne, S., & McLean, N. (2001). Eating disorders in athletes: A review of the literature. Journal of Science and Medicine in Sport, 4(2), 145-159. DOI: https://doi.org/10.1016/S1440-2440(01)80025-6
Clark, J. E. (2007). On the Problem of Motor Skill Development. Journal of Physical Education, Recreation & Dance, 78(5), 39–44. DOI: https://doi.org/10.1080/07303084.2007.10598023
Cook, B. J., & Hausenblas, H. A. (2011). Eating disorder-specific health-related quality of life and exercise in college females. Quality of Life Research, 20(9), 1385–1390. DOI: https://doi.org/10.1007/s11136-011-9879-6
Cover, K., Hanna, M., Ross, & Barnes, M. (2012). A review and proposed treatment approach for the young athlete at high risk for the female athlete triad. ICAN: Infant, Child & Adolescent Nutrition, 4, 21– 27. DOI: https://doi.org/10.1177/1941406411430986
Costarelli, V., & Stamou, D. (2009). Emotional intelligence, body image and disordered eating attitudes in combat sport athletes. Journal of Exercise Science & Fitness, 7(2), 104 - 111. DOI: https://doi.org/10.1016/S1728-869X(09)60013-7
Costarelli, V., Demetzi, M., & Stamou, D. (2009). Disordered eating attitudes in relation to body image and emotional intelligence in young women. Journal of Human Nutrition and Dietetics, 22(3), 239 – 245. DOI: https://doi.org/10.1111/j.1365-277X.2009.00949.x
Currie, A., & Morse, E. D. (2005). Eating disorders in athletes: Managing the risks. Clinical Sports Medicine, 2, 871–883. DOI: https://doi.org/10.1016/j.csm.2005.05.005
Dallas, G., Dallas, C., Simatos, E., Simatos, J. (2016). Nutritional status and dietary assessment of elite female artistic and rhythmic gymnasts – A case study. Science of Gymnastics Journal, 8(3), 255-269.
Davis, M. (1992). The Role of the Amygdala in Fear and Anxiety. Annual Review of Neuroscience, 1 (1), 353–375. DOI: https://doi.org/10.1146/annurev.ne.15.030192.002033
Douka A., Grammatopoulou E., Skordilis E., Koutsouki D. (2009). Factor analysis and cut-off score of the 26-item eating attitudes test in a Greek sample. Biology of Exercise, 5(1), 51–68. DOI: https://doi.org/10.4127/jbe.2009.0025
Engel, S. G., Johnson, C., Powers, P. S., Crosby, R. D., Wonderlich, S. A., Wittrock, D. A., & Mitchell, J. E. (2003). Predictors of disordered eating in a sample of elite Division I college athletes. Eating Behaviors, 4(4), 333 – 343. DOI: https://doi.org/10.1016/S1471-0153(03)00031-X
Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361 (9355), 407-416. DOI: https://doi.org/10.1016/S0140-6736(03)12378-1
Francisco, R., Narciso, I., & Alarcão, M. (2012). Specific predictors of disordered eating among elite and non-elite gymnast and ballet dancers. International Journal of Sport Psychology, 43, 479-502.
Freund, K. M., Graham, S. M., Lesky, L. G., & Moskowitz, M. A. (1993). Detection of bulimia in a primary care setting. Journal of General Internal Medicine, 8(5), 236 – 242. DOI: https://doi.org/10.1007/BF02600088
Friestad, C., & Rise, J. (2004). A longitudinal study of the relationship between body image, self-esteem and dieting among 15–21-year-olds in Norway. European Eating Disorders Review, 12(4), 247 – 255. DOI: https://doi.org/10.1002/erv.570
Fitzsimmons-Craft, E. E., Harney, M. B., Koehler, L. G., Danzi, L. E., Riddell, M. K., & Bardone-Cone, A. M. (2012). Explaining the relation between thin ideal internalization and body dissatisfaction among college women: The roles of social comparison and body surveillance. Body Image, 9(1), 43 – 49. DOI: https://doi.org/10.1016/j.bodyim.2011.09.002
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine, 12 (4), 871 - 878. DOI: https://doi.org/10.1017/S0033291700049163
Garner, D. M., & Garfinkel, P. (1982). Eating Attitudes Test (EAT-26). Retrieved 09/13/2002 from http://www.eatingdisorders-toledo. com/cgi-bin/test.cfm DOI: https://doi.org/10.1037/t19098-000
Garner, D. M., Olmsted M. P, Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34. DOI: https://doi.org/10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6
Garner, D. M., Olmsted, M. P., Polivy, J., & Garfinkel, P. E. (1984). Comparison Between Weight-Preoccupied Women and Anorexia Nervosa. Psychosomatic Medicine, 46(3), 255 – 266. DOI: https://doi.org/10.1097/00006842-198405000-00007
Garner, D. M., Rosen, L.W., & Barry, D. (1998). Eating Disorders Among Athletes: Research and Recommendations. Child and Adolescent Psychiatric Clinics of North America, 7(4), 839–857. DOI: https://doi.org/10.1016/S1056-4993(18)30215-3
Georgopoulos, N. A., Markou, K. B., Theodoropoulou, A., Benardot, D., Leglise, M., & Vagenakis, A. G. (2002). Growth Retardation in Artistic Compared with Rhythmic Elite Female Gymnasts. The Journal of Clinical Endocrinology & Metabolism, 87(7), 3169 – 3173. DOI: https://doi.org/10.1210/jcem.87.7.8640
Gleason, J. H., Alexander, A. M., & Somers, C. L. (2000). Later adolescents’ reactions to three types of childhood teasing: Relations with self-esteem and body image. Social Behavior & Personality, 28, 472-480. DOI: https://doi.org/10.2224/sbp.2000.28.5.471
Greenleaf, C., Petrie, T. A., Carter, J., & Reel, J. J. (2009). Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors. Journal of American College Health, 57(5),489 – 496. DOI: https://doi.org/10.3200/JACH.57.5.489-496
Harris, M. B., & Greco, D. (1990). Weight control and weight concern in competitive female gymnasts. Journal of Sport and Exercise Psychology, 12, 427-433. DOI: https://doi.org/10.1123/jsep.12.4.427
Hausenblas, H., & Carron, A. (1999). Eating disorder indices and athletes: An integration. Journal of Sport and Exercise Psychology, 21, 230 - 258. DOI: https://doi.org/10.1123/jsep.21.3.230
Hewitt, P. L., Flett, G. L., & Ediger, E. (1995). Perfectionism traits and perfectionistic self-presentation in eating disorder attitudes, characteristics, and symptoms. International Journal of Eating Disorders, 18(4), 317–326. DOI: https://doi.org/10.1002/1098-108X(199512)18:4<317::AID-EAT2260180404>3.0.CO;2-2
Heywood, S., & McCabe, M. P. (2006). Negative Affect as a Mediator between Body Dissatisfaction and Extreme Weight Loss and Muscle Gain Behaviors. Journal of Health Psychology, 11(6), 833–844. DOI: https://doi.org/10.1177/1359105306069077
Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., & Agras, W. S. (2004). Coming to Terms with Risk Factors for Eating Disorders: Application of Risk Terminology and Suggestions for a General Taxonomy. Psychological Bulletin, 130(1), 19–65. DOI: https://doi.org/10.1037/0033-2909.130.1.19
Jansen, A. (2001). Towards effective treatment of eating disorders: nothing is as practical as a good theory. Behaviour research and therapy, 39(9), 1007-1022. DOI: https://doi.org/10.1016/S0005-7967(01)00010-9
Kato, K., Jevas, S., & Culpepper, D. (2011). Body image disturbances in NCAA Division I and III female athletes. The Sport Journal, 14(1).
Kaye, W. (2008). Neurobiology of anorexia and bulimia nervosa. Physiology & Behavior, 94(1), 121–135. doi:10.1016/j.physbeh.2007.11.037 DOI: https://doi.org/10.1016/j.physbeh.2007.11.037
Kerr, G., Berman, E., & de Souza, M. J. (2006). Disordered eating in women's gymnastics: Perspectives of athletes, coaches, parents, and judges. Journal of Applied Sport Psychology, 18(1), 28–43. DOI: https://doi.org/10.1080/10413200500471301
Keys, A., Brozek, J., Henschel, A., Mickelsen, O Taylor, H.L. (1950). The Biology of Human Starvation. The University of Minnesota Press, Minneapolis, MN. DOI: https://doi.org/10.5749/j.ctv9b2tqv
Krane, V., Stiles-Shipley, J. A., Waldron, J., Michalenok, J. (2001). Relationships among body satisfaction, social physique anxiety, and eating behaviors in female athletes and exercisers. Journal of Sport Behavior, 24(3), 247-264.
Krentz, E. M., & Warschburger, P. (2011). Sports-related correlates of disordered eating in aesthetic sports. Psychology of Sport and Exercise, 12(4), 375–382. DOI: https://doi.org/10.1016/j.psychsport.2011.03.004
Markey, M. A., & Vander Wal, J. S. (2007). The role of emotional intelligence and negative affect in bulimic symptomatology. Comprehensive Psychiatry, 48(5), 458–464. DOI: https://doi.org/10.1016/j.comppsych.2007.05.006
Martinsen, M., & Sundgot-Borgen, J. (2013). Higher prevalence of eating disorders among adolescent elite athletes than controls. Medicine & Science in Sports & Exercise, 45(6), 1188-1197. DOI: https://doi.org/10.1249/MSS.0b013e318281a939
Morgenthal, A. P. (2002). Female athlete triad. Journal of Chiropractic Medicine, 1(3), 97-106. DOI: https://doi.org/10.1016/S0899-3467(07)60011-1
Michou, M., & Costarelli, V. (2011). Disordered eating attitudes in relation to anxiety levels, self-esteem and body image in female basketball players. Journal of Exercise Science & Fitness, 9(2), 109-115. DOI: https://doi.org/10.1016/S1728-869X(12)60006-9
Milligan, B., & Pritchard, M. E. (2006). The relationship between gender, sport, self-esteem and eating disordered behaviors in Division I athletes. Athletic Insight, 8, 9–43.
Muscat, A. C., & Long, B. C. (2008). Critical Comments About Body Shape and Weight: Disordered Eating of Female Athletes and Sport Participants. Journal of Applied Sport Psychology, 20(1), 1–24. DOI: https://doi.org/10.1080/10413200701784833
Nattiv, A., Loucks, A. B., Manore, M. M., Sanborn, C. F., Sundgot-Borgen, J., Warren, M. P. (2007). The female athlete triad. Special communications: position stand. Medicine & Science in Sports Exercise, 39(10), 1867–1882. DOI: https://doi.org/10.1249/mss.0b013e318149f111
Nagel, M. (2003). The relationship of the female athlete triad with psych cognitive functions and balance. Journal of Exercise Science & Fitness, 1, 116–124.
Nordin, S., Harris, G., & Cumming, J. (2003). Disturbed eating in young, competitive gymnasts: Differences between three gymnastics disciplines. European Journal of Sport Science, 3, 1-14. DOI: https://doi.org/10.1080/17461390300073502
O’Dea, J. A. (2009). Self-perception score from zero to ten correlates well with standardized scales of adolescent self-esteem, body dissatisfaction, eating disorders risk, depression, and anxiety. International Journal of Adolescent Medicine and Health, 21, 509–17. DOI: https://doi.org/10.1515/IJAMH.2009.21.4.509
Otis, C. L. (1992). Exercise-associated amenorrhea. Clinics in Sports Medicine, 11(2), 351 - 362. DOI: https://doi.org/10.1016/S0278-5919(20)30536-6
Presnell, K., Bearman, S.K., & Stice, E. (2004). Risk factors for body dissatisfaction in adolescent boys and girls: A prospective study. International Journal of Eating Disorders, 36(4), 389–401. DOI: https://doi.org/10.1002/eat.20045
Parks, P. S., & Read, M. H. (1997). Adolescent male athletes: Body image, diet, and exercise. Adolescence, 32(127), 593–602.
Pate, R. R. (1993). Physical activity assessment in children and adolescents. Critical Reviews in Food Science and Nutrition, 33, 321-326. DOI: https://doi.org/10.1080/10408399309527627
Petrie, T. A., & Greenleaf, C. A. (2007). Eating disorders in sport: From theory to research to intervention. In G. Tenenbaum & R. C. Eklund (Eds.), Handbook of sport psychology, 352–378. John Wiley & Sons, Inc. DOI: https://doi.org/10.1002/9781118270011.ch16
Petrie, T. A., Greenleaf, C., Reel, J. J., & Carter, J. E. (2009). An Examination of Psychosocial Correlates of Eating Disorders Among Female Collegiate Athletes. Research Quarterly for Exercise and Sport, 80(3), 621–632. DOI: https://doi.org/10.1080/02701367.2009.10599601
Pugliese, M. T., Lifshitz, F., Grad, G., Fort, P., & Marks-Katz, M. (1983). Fear of Obesity. New England Journal of Medicine, 309 (9), 513 – 518. DOI: https://doi.org/10.1056/NEJM198309013090901
Robinson, T. L., Snow-Harter, C., Taaffe, D. R., Gillis, D., Shaw, J., & Marcus, R. (1995). Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea. Journal of Bone and Mineral Research, 10(1), 26–35. DOI: https://doi.org/10.1002/jbmr.5650100107
Rooks, Y., & Corwell, B. N. (2006). Female athlete triad. Current Opinion in Orthopaedics, 17, 149–154. DOI: https://doi.org/10.1097/01.bco.0000192885.51273.0e
Rome, E. S., Ammerman, S., Rosen, D. S., et al. (2003). Children and adolescents with eating disorders: the state of the art. Pediatrics, 111, 98–108. DOI: https://doi.org/10.1542/peds.111.1.e98
Rosen, L. W., McKeag, D. B., Hough, D. O., & Curley, V. (1986). Pathogenic Weight-Control Behavior in Female Athletes. The Physician and Sportsmedicine, 14(1), 79 –86. DOI: https://doi.org/10.1080/00913847.1986.11708966
Rosen, L.W., & Hough, D.O. (1988). Pathogenic Weight-Control Behaviors of Female College Gymnasts. The Physician and Sportsmedicine, 16 (9), 140–144. DOI: https://doi.org/10.1080/00913847.1988.11709603
Sample, I. (2000). Tiny tumblers are stealing the show. New Scientist, 176, 22-55.
Salbach, H., Klinkowski, N., Pfeiffer, E., Lehmkuhl, U., & Korte, A. (2007). Body image and attitudinal aspects of eating disorders in rhythmic gymnasts. Psychopathology, 40 (6), 388-393. DOI: https://doi.org/10.1159/000106469
Selby, C. L. B., & Reel, J. J. (2011). A Coach’s Guide to Identifying and Helping Athletes with Eating Disorders. Journal of Sport Psychology in Action, 2(2), 100–112. DOI: https://doi.org/10.1080/21520704.2011.585701
Shanmugam, V., Jowett, S., & Meyer, C. (2013). Eating psychopathology amongst athletes: The importance of relationships with parents, coaches and teammates. International Journal of Sport and Exercise Psychology, 11(1), 24–38. DOI: https://doi.org/10.1080/1612197X.2012.724197
Smolak, L., Murnen, S. K., & Ruble, A. E. (2000). Female athletes and eating problems: a meta-analysis. International journal of eating disorders, 27(4), 371- 380 DOI: https://doi.org/10.1002/(SICI)1098-108X(200005)27:4<371::AID-EAT1>3.0.CO;2-Y
Stice, E. (2002). Risk factors for eating pathology: Recent advances and future directions. In Stiegel-Moor, R. & Smolac, L. (Eds.), eating disorders: Innovative directions in research and practice. Washington, D.C.: American Psychological Association.
Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology. Journal of Psychosomatic Research, 53(5), 985–993. DOI: https://doi.org/10.1016/S0022-3999(02)00488-9
Stoutjestic, D. & Jevne, R. (1993). Eating disorders among high performance athletes. Journal of youth and Adolescence, 22(3), 271-28. DOI: https://doi.org/10.1007/BF01537792
Sudi, K., Öttl, K., Payerl, D., Baumgartl, P., Tauschmann, K., & Müller, W. (2004). Anorexia athletica. Nutrition, 20(7), 657-661. DOI: https://doi.org/10.1016/j.nut.2004.04.019
Sundgot-Borgen, J. (1993). Prevalence of eating disorders in elite female athletes. International journal of sport nutrition, 3(1), 29 - 40. DOI: https://doi.org/10.1123/ijsn.3.1.29
Sundgot-Borgen, J. (1994). Risk and trigger factors for the development of eating disorders in female elite athletes. Medicine & Science in Sports & Exercise, 26(4), 414 – 419. DOI: https://doi.org/10.1249/00005768-199404000-00003
Sundgot-Borgen, J., & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 25-32. DOI: https://doi.org/10.1097/00042752-200401000-00005
Swoap, R. A., & Murphy, M. (1995). Eating attitudes and weight management in athletes. In S. M. Murphy (Ed.), Sport psychology interventions, Champaign, IL: Human Kinetics. 307-329.
Thein-Nissenbaum, J. M., Rauh, M. J., Carr, K. E., Loud, K. J., McGuine, T. A. (2011b). Associations between disordered eating, menstrual dysfunction, and musculoskeletal injury among high school athletes. Journal of Orthopedic & Sports Physical Therapy, 41(2), 60-69. DOI: https://doi.org/10.2519/jospt.2011.3312
Thiel, A., Gottfried, H., & Hesse, F. W. (1993). Subclinical eating disorders in male athletes. Acta Psychiatrica Scandinavica, 88(4), 259–265. DOI: https://doi.org/10.1111/j.1600-0447.1993.tb03454.x
Thomas, J., O'Hara, L.,Tahboub-Schulte, S., Grey, I., Chowdhury, N. (2018). Holy anorexia: Eating disorders symptomatology and religiosity among Muslim women in the United Arab Emirates. Psychiatry Research, 260, 495-499. DOI: https://doi.org/10.1016/j.psychres.2017.11.082
Thompson, R. A., & Sherman, R. T. (2010). Eating disorders in sport. New York. NY: Routledge. DOI: https://doi.org/10.4324/9780203879856
Tietjen-Smith, T., Mercer, J. (2008). The female athlete triad: A statement of the problem. Journal of Sports and Recreation, 2, 1–6.
Torstveit, M. K., Rosenvinge J. H., Sundgot-Borgen J. (2008). Prevalence of eating disorders and the predictive power of risk models in female elite athletes: A controlled study. Scandinavian Journal of Medicine and Science in Sports, 18, 108-118. DOI: https://doi.org/10.1111/j.1600-0838.2007.00657.x
Troop, N. A., Murphy, F., Bramon, E., & Treasure, J. L. (2000). Disgust sensitivity in eating disorders: A preliminary investigation. International Journal of Eating Disorders, 27, 446 – 451 DOI: https://doi.org/10.1002/(SICI)1098-108X(200005)27:4<446::AID-EAT9>3.0.CO;2-W
Vohs, K. D., Bardone, A. M., Joiner, T. E., Abramson, L.Y., Heatherton, T.F. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: A model of bulimic symptom development. Journal of Abnormal Psychology, 108(4), 695–700. DOI: https://doi.org/10.1037/0021-843X.108.4.695
Yeager, K. K., Agostini, R., Nattiv, A., & Drinkwater, B. (1993). The female athlete triad: Disordered eating, amenorrhea, and osteoporosis. Medicine and Science in Sports and Exercise, 25, 775-777. DOI: https://doi.org/10.1249/00005768-199307000-00003
Waldrop, J. (2005). Early Identification and Intervention for Female Athlete triad. Journal of Pediatric Health Care, 19(4), 213-220. DOI: https://doi.org/10.1016/j.pedhc.2005.02.008
Walsh, J. M. E., Wheat, M. E., & Freund, K. (2000). Detection, evaluation, and treatment of eating disorders. Journal of General Internal Medicine, 15(8), 577–590. DOI: https://doi.org/10.1046/j.1525-1497.2000.02439.x
Weinberg, R. S. & Gould, D. (1995). Substance abuse and eating disorders. Foundations of Sport and Exercise Psychology, 415-427. Champaign, IL: Human Kinetics.