Eating Disorders and Body Image Concerns Among Male Athletes

Many men are as obsessed as women with counting calories. They are preoccupied with their weight, diet frequently, exercise excessively, and binge and purge. Some subgroups of men have eating disorder rates higher than those of the general male population. One subgroup consists of men who participate in competitive athletics. Although there is increasing awareness of eating disorders in men, male athletes may continue to elude identification and be difficult to treat. Their subculture promotes the use of unhealthy measures, such as restrictive eating, binging and purging, and consuming steroids and other performance enhancing drugs. Professionals involved with the male athlete may not recognize these behaviors as problematic. In fact, they may not even look for the behaviors when dealing with men. Consequently, men’s eating disorders are missed and misdiagnosed. Male athletes face a combination of cultural, political, and financial pressures that is unique and represents an added risk factor that could have long-term irreversible effects. It is imperative that mental health professionals be aware of the unique-to-men risk factors associated with disordered eating. This article illustrates how eating disorders as well as body image dissatisfaction manifest themselves in male athletes, how difficult it can be to engage them in psychotherapy, and how clinicians can address these concerns.     

College Student Behavior: A Ten-Year Look

Abstract

Lester and Perez¹ have suggested that student behavior can be usefully construed in terms of a traditional-hedonic, implicit value system. They demonstrated that drug use and sexual activity provide simple behavioral anchors for this dimension, and observed an increasingly hedonic orientation among students. Ten years after their initial study, the student population at the same institution was again sampled using an anonymous questionnaire. The 1980 sample included 208 subjects, and these were compared with 688 subjects who responded to the 1970 survey. This comparison was supplemented by an intensive week-long study of 53 students within one campus living unit.

Significant increases in pre-college sexual activity were noted for both men and women. Marijuana use in high school also increased for both men and women during this period, while alcohol use increased only among women. Previously observed differences between male and female pre-college sexual activity and marijuana use had largely disappeared by 1980. Significant increases in sexual activity while in college were found for women but not for men. For men, overall marijuana and alcohol use in college did not change during the study period, but there was an increase in the frequent use of these drugs. Increases in all categories of marijuana use were noted among women, along with overall increases in their alcohol use. The significant differences between male and female marijuana use noted in the 1970 study were absent in 1980. The intensive week-long study revealed that alcohol use was part of the daily lives of one-third to two-thirds of the students sampled, although they reported interpersonal conflicts, absences from class, accidents, and injuries among the consequences of their drinking. A significant inverse relationship between sleep and alcohol use was observed among women, but not among men.

These data suggest that student behavior has become increasingly hedonic during the past ten years, with women in particular closing the gap which previously differentiated their behavior from that of their male peers. Institutions of higher learning must take these changes into account in the planning of academic programs, residential life, and health services.     

Personal, health, academic, and environmental predictors of stress for residence hall students

The authors studied contributors to stress among undergraduate residence hall students at a midwestern, land grant university using a 76-item survey consisting of personal, health, academic, and environmental questions and 1 qualitative question asking what thing stressed them the most. Of 964 students selected at random, 462 (48%) responded to the survey. The authors weighted data to reflect the overall university-wide undergraduate population (55% men, 12% minority or international, and 25% freshmen). Women and US citizens experienced greater stress than did men and non-US citizens, respectively. Frequency of experiencing chronic illness, depression, anxiety disorder, seasonal affective disorder, mononucleosis, and sleep difficulties were significant stress predictors. Although alcohol use was a positive predictor, drug use was a negative predictor of stress. Both a conflict and a satisfactory relationship with a roommate, as well as a conflict with a faculty or staff member, were also significant predictors of stress.     

Binge drinking in female college students: the association of physical activity, weight concern, and depressive symptoms

As an initial step in building gender-specific binge drinking intervention programs, the authors investigated the relation of potentially modifiable factors (physical activity level, weight concern, and depressive symptoms) to binge drinking while controlling for the effects of previously established correlates of binge drinking (tobacco and marijuana use, GPA, and perception of peer alcohol use). Four-hundred-twelve college women completed an in-class survey. Multivariate analyses revealed that tobacco and marijuana use, GPA, and physical activity were significantly associated with binge drinking, whereas tobacco use and perception of peers' alcohol use were associated with more frequent binge drinking. The findings suggested that the variables associated with any binge drinking and frequency of binge drinking may differ and that binge drinking can be associated with positive health behaviors (ie, greater physical activity) as well as risky health behaviors (eg, tobacco use).     

Dietary intake, body mass index, exercise, and alcohol: are college women following the dietary guidelines for Americans?

Study findings suggest that college women practice diet and health behaviors that contradict the 1995 Dietary Guidelines for Americans. To confirm this hypothesis, the authors surveyed the diet, exercise, and health habits of 60 female students enrolled in three university aerobics courses. They measured height and weight to calculate body mass index (BMI) and assessed physical activity, using the Self-Reported Physical Activity scale. To estimate food and nutrient intake, they used 3-day food records. Participants reported diets that were nutritionally adequate but exceeded national recommendations for fat, sugar, and sodium, and their reports of exercise habits suggested that the lifestyles of 66% of the respondents were sedentary. Although the students' mean BMIs suggested healthy weights, 25% of the women were classified as overweight. A majority of the participants were following at least 1 of the 7 dietary guidelines; however, no participant was adhering to all proposed behaviors.     

Drinking patterns, problems, and motivations among collegiate bisexual women

OBJECTIVE AND PARTICIPANTS: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). METHODS: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. RESULTS: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. CONCLUSIONS: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.     

Differences in health determinants between international and domestic students at a German university

The authors used a standardized questionnaire to survey 201 international and 193 German students at the University of Bielefeld, Germany, to determine differences in health practices between the 2 groups and to identify targets for health-promoting interventions. Multivariate logistic regression models revealed that long-term female international students (those whose duration of residency in Germany was more than 2 years) had lower levels of physical activity and alcohol consumption than their German counterparts and higher rates of smoking independently associated with international citizenship. Short-term international female students were less likely than German students to receive social support. Among men, long-term international student status was associated with daily smoking and inconsistent seat belt use, whereas short-term student status was associated with a lower rate of seat belt use, a higher level of perceived stress, and a healthier diet, compared with domestic students. Findings from the study could give rise to health-promotion activities for international students at German universities; additional studies at other European universities are necessary before making further recommendations.     

A Gender-based Examination of Past-year Recreational Gamblers

Background Most adults gamble recreationally yet few studies have systematically investigated for gender-related differences in recreational gamblers.Methods Logistic regression analyses were performed on data from a nationally representative sample of respondents from the 1998 Gambling Impact and Behavior Study. Results Female gamblers versus non-gamblers were more likely to report use of alcohol and drugs. Male gamblers versus non-gamblers were more likely to report alcohol use and abuse/dependence, any substance abuse/dependence, and lifetime incarceration. An analysis of gambling by gender group interaction effects did not identify significant differences in health-related measures. Male as compared with female gamblers reported beginning gambling earlier, experiencing higher past-year maximal losses and wins, and finding favorite and engaging in different types of gambling.Conclusions Despite heavier gambling in male as compared with female recreational gamblers, similar mental health functioning was observed in female and male past-year recreational gamblers. Types of gambling problematic for men and women are reflected in the gambling preferences of recreational gamblers.     

African American female basketball players: an examination of alcohol and drug behaviors

The use of drugs and alcohol by National Collegiate Athletic Association Division I African American female basketball players and their reasons for using these substances were examined. The investigation is part of a broader study investigating the use of alcohol, weight-loss products, tobacco, amphetamines, and anabolic steroids by female college athletes. Of the 50 athletes in this study, 72% reported having consumed alcoholic beverages, and 46% had engaged in binge drinking. Only 8% reported using either weight-loss or tobacco products, and there were no reports of using amphetamines or anabolic steroids. Usage patterns indicated that the athletes in the study were aware of the short-term negative effects of alcohol and tobacco; those respondents who did use these products greatly reduced their consumption during the competitive season. Factors found to influence use include social and peer influences and coaches' rules.     

Sexual Harassment,Psychological Distress,and Problematic Drinking Behavior Among College Students: An Examination of Reciprocal Causal Relations

Sexual harassment on college campuses is a frequent occurrence and serious public health concern. Victims of sexual harassment are at risk for many possible negative health consequences. In addition, certain psychological distress symptoms and/or alcohol use may put individuals at increased risk of being victims of sexual harassment. Data from more than 2,000 college students in the Midwestern United States were used to examine reciprocal causal effects of the relations between (a) experiencing sexual harassment and alcohol use and (b) experiencing sexual harassment and psychological distress symptoms, specifically depression and anger/hostility. Analyses were conducted separately for sexual harassment which occurs at school and which occurs in college students’ workplaces, and also separately for men and women. Results of cross-lagged panel models showed that there were reciprocal causal effects between sexual harassment and alcohol problems, depression, and anger. Discussion focuses on the overall patterns of results as well as the nuances within these findings.     

Student desires for a university drug education program

A questionnaire was designed to determine the type of drug education program most desired by undergraduate students attending a major university. The survey was to provide the basis for a comprehensive drug education program. The 101 item questionnaire elicited responses from 656 undergraduates in categories ranging from knowledge base to credible information sources. The analysis of student desires as they relate to program design is included in this article. The students strongly believed the university should provide a drug education program. In particular they desired a credit course dealing with both drugs and alcohol. They also wanted regularly published articles on drugs in school publications. The most credible knowledge sources were PhDs and MDs. Students also wanted contact with former drug users. More than half the students believed that values clarification and "coping skills" training would decrease their drug use. In general more women than men were likely to utilize such resources.     

Tobacco, depression, and lifestyle choices in the pivotal early college years

The author explored the correlates of tobacco use among 18- and 19-year-old students at a major midwestern university. A sample of 203 randomly selected freshmen and sophomore students completed a survey that included questions about tobacco use, other drug use, mental health issues, eating disorders, stress, smoking environment, and healthy lifestyles. The prevalence rate for tobacco use was 29% for the past year and 32% for the past month. Multivariate analyses suggested that students with a lifetime diagnosis of depression or treatment for depression were 7 times as likely as other students to use tobacco. In addition, marijuana and alcohol use and weekend exposure to smoke increased the likelihood of being a tobacco user. Stress and diet behaviors were found not to be significantly associated with tobacco use. Implications for health promotion among high school and college populations are drawn from the study findings.     

Knowledge,attitudes, and behavior related to condom use and STDs in a high risk population

Since the mid‐1980s, the incidence of sexually transmitted diseases (STDs) among Blacks has increased dramatically nationwide, particularly in Philadelphia and other major urban areas. One approach to this public health problem is to prevent the further transmission of disease through the use of condoms during sexual activity. To provide a basis for condom‐promotion programs within a high risk Black urban community, we explored condom use behavior and the relationship between condom use and variables related to demographic characteristics, knowledge, attitudes, perceived risk and concern about STDs, and STD history. A household survey was conducted of a stratified, quota sample of 925 male and female adolescent and adult residents in North and West Philadelphia. These areas have the highest rate of STDs in the city and among the highest rates in the country. The survey revealed a trichotomy among respondents with respect to condom use: approximately one‐third of the sample used condoms consistently; one‐third used them intermittently, and one‐third never used condoms. Consistent condom users tended to use condoms with both steady and casual partners; less frequent condom users tended to use condoms with partners who could be considered higher risk: new partners and casual partners. Although condom use rates did not vary as a function of age among males, women under age 20 were far more likely to use condoms than were other female age groups. Knowledge about STDs and prevention was not found to predict condom use. Negative attitudes toward condoms were related to non‐use, with the exception of women who used condoms in perceived high risk situations despite negative attitudes.     

Drinking Patterns,Problems, and Motivations Among Collegiate Bisexual Women

Objective and Participants: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). Methods: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. Results: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. Conclusions: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.     

A study of the relationship between protective behaviors and drinking consequences among undergraduate college students

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses.     

Normative beliefs as risk factors for involvement in unhealthy weight control behavior

OBJECTIVE: The authors' aim in this study was to determine, after adjustment for the effects of body mass index and sociodemographic measures, whether sex-specific weight control norms would have significant independent relationships with the weight control behavior of college women and men. PARTICIPANTS: The authors used an anonymous questionnaire to assess a sample of 470 college students, aged 18 to 26 years, attending either a 2- year community college or a 4-year public university. METHODS: To calculate body mass index, the authors objectively measured the height and weight of each participant. They conducted separate discriminant function analyses for women and men. RESULTS: The discriminant function analyses clearly indicated that weight control norms of same-sex, close friends were the best discriminators of involvement in weight control. CONCLUSIONS: The findings indicate that perceived peer norms may be important but overlooked risk factors for engaging in unhealthy weight control practices. The authors discuss the implications of these findings in the context of student health promotion.     

Personality,Sexuality, and Substance Use as Predictors of Sexual Risk Taking in College Students

Sexual risk taking among college students is common and can lead to serious consequences, such as unintended pregnancies and sexually transmitted infections. This study utilized responses from 310 undergraduate psychology students aged 18 to 23 to examine personality, sexuality, and substance use predictors of sexual risk behaviors over a six-month period. Data were collected from 2005 to 2006 at a medium-sized Midwestern U.S. university. Results indicated that greater alcohol and recreational drug use, higher extraversion, and lower agreeableness were related to sexual risk taking in men. For women, greater alcohol and drug use, higher sexual excitation, and lower sexual inhibition were predictive of sexual risk taking. Among women, but not men, sensation seeking was found to mediate the relationship between the four significant substance use, personality, and sexuality variables and sexual risk taking. Implications for sexual risk behavior prevention and intervention programming are discussed.     

Drug use and mental well being among a sample of undergraduate and graduate college students.

Stress related disorders in college students are widespread and largely preventable. Students do not have the preventative skills necessary to manage stress in their lives and, because of the inability to cope, students may turn to alcohol and drugs to alleviate the pressures they are experiencing. The purpose of this study was to describe the association between stress and alcohol and drug use. A total of 772 undergraduate and graduate students from a small, elite, private university were randomly selected from 4000 students to complete two anonymous questionnaires. The Core Alcohol and Drug Survey identified the frequency and consequences of alcohol and drug use, and the General-Well Being Schedule was used to assess subjective well being and mental health status. The results of this study revealed that, for this sample of students, health behaviors such as using drugs recreationally and drinking alcohol played an associative role with general well being. A significant relationship was also found between student participation in intramural or club sports and positive mental well being.     

Body image,self-esteem,and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention

Abstract

Objective: To examine associations between two body image constructs (body appreciation and body satisfaction) and five health behaviors (diet, physical activity, weight management, tobacco exposure, and alcohol intake) associated with risk for chronic disease, controlling for self-esteem. Participants: Three hundred and forty-four college students enrolled at a large, public university in the southeastern US. Methods: Students completed an online survey composed of measures of body appreciation, body satisfaction, self-esteem, and frequency of engagement in preventive health behaviors. Hierarchical linear regression models were used to assess relationships between constructs. Results: Body appreciation, but not body satisfaction or self-esteem, significantly and positively predicted engagement in diet-, physical activity-, and weight-related health behaviors. No associations were found for substance use outcomes. Conclusions: Results illuminate health risks among college students and provide additional evidence to support the development of holistic preventive interventions that simultaneously address aspects of mental and physical health among college students.     

Normative Beliefs as Risk Factors for Involvement in Unhealthy Weight Control Behavior

Objective: The authors' aim in this study was to determine, after adjustment for the effects of body mass index and sociodemographic measures, whether sex-specific weight control norms would have significant independent relationships with the weight control behavior of college women and men. Participants: The authors used an anonymous questionnaire to assess a sample of 470 college students, aged 18 to 26 years, attending either a 2- year community college or a 4-year public university. Methods: To calculate body mass index, the authors objectively measured the height and weight of each participant. They conducted separate discriminant function analyses for women and men. Results: The discriminant function analyses clearly indicated that weight control norms of same-sex, close friends were the best discriminators of involvement in weight control. Conclusions: The findings indicate that perceived peer norms may be important but overlooked risk factors for engaging in unhealthy weight control practices. The authors discuss the implications of these findings in the context of student health promotion.