Characteristics of the Female Athlete Triad in Collegiate Cross-Country Runners

The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. Objective and Participants: The author's purpose in this study was to examine female cross-country runners' (N = 300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual dysfunction. Methods: The author used measures including the Orientation to Exercise Questionnaire, Calcium Rapid Assessment Method, and questions related to height, weight, exercise time, perceptions of eating disorders, and menstrual status. Previous or current eating disorders were reported by 19.4% of the women, 23.0% had irregular menstrual cycles, and 29.1% had inadequate calcium intake. Results: Those athletes perceiving a previous/current eating disorder scored higher on the Orientation to Exercise questionnaire than did those who did not perceive such. Conclusion: The author recommends educational efforts for the prevention of components of the Female Athlete Triad.     

Eating and exercise disorders in young college men

The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape, and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.     

Eating and Exercise Disorders in Young College Men

Abstract

The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.     

Psychosocial correlates of disordered eating in female collegiate athletes: validation of the ATHLETE questionnaire

Female athletes may be at greater risk for disordered eating than their nonathletic peers, but the psychological antecedents of this dysfunctional behavior in athletes have yet to be elucidated. The objective of this study was to develop an athletics-oriented measure of psychological predictors of disordered eating and to test its initial reliability and validity. Female athletes from 3 National Collegiate Athletics Association (NCAA) Division I universities completed the ATHLETE, a written questionnaire designed to assess psychosocial factors associated with disordered eating in athletes. Five distinct and internally consistent factors (Drive for Thinness and Performance, Social Pressure on Eating, Performance Perfectionism, Social Pressure on Body Shape, and Team Trust) were positively associated with and predictive of disordered eating behaviors in female athletes. The ATHLETE is a reliable and valid measure of psychological predictors of disordered eating in athletics and will be useful in studying the etiology of disordered eating in female athletes.     

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

Objective: The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants: Participants were 204 college athletes (M age = 20.16 years, SD = 1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88 years (SD = 16.68 years) and on their college team for 2.10 years (SD = 1.03 years). Methods: Participants completed a demographic and weight background questionnaire, Questionnaire for Eating Disorder Diagnoses, and the Bulimia Test-Revised. Results: The authors classified participants as eating disordered (n = 4, 2.0%), symptomatic (n = 52, 25.5%), and asymptomatic (n = 148, 72.5%). Few participants engaged in binge eating; most used exercise, as opposed to vomiting, dieting, laxatives, or diuretics, to control their weight. Conclusions: Female athletes suffer from eating disorders, and most experience symptom levels that are subclinical but problematic.     

A Description of Disordered Eating Behaviors in Latino Males

Abstract

Objective: To explore disordered eating and eating disorders (EDs) in Latino males. Participants: Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Methods: Participants were selected from a list of sections of required courses for first-year students on each campus. Self-report instruments were used to explore ED symptoms (the Eating Attitudes Test [EAT-26] and the Bulimia Test–Revised [BULIT-26-R] and the Beck Depression Inventory depression (BDI). Results: Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for bulimia nervosa. Depression symptomatology was found in those who scored above the cut-off point on both instruments of EDs. Conclusion: College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students.     

Two distinct mediated pathways to disordered eating in response to weight stigmatization and their application to prevention programs

ABSTRACT

Objective: Disordered eating behaviors among undergraduate women are common and, thus, are an important public health concern. Weight stigmatization, stress, and social withdrawal are often associated with disordered eating behaviors; however, it is unclear whether stress and social withdrawal act as mediators between weight stigmatization and disordered eating. By testing specific pathways to disordered eating, theory-driven prevention programs can be implemented. Methods: Self-reported surveys were administered to 217 undergraduate women during the Fall 2014 semester. Results: There were 2 distinct mediational pathways in response to weight stigmatization. Stress partially mediated the path between weight stigmatization and emotional eating (38%), whereas social withdrawal partially mediated the path between weight stigmatization and dietary restraint (44%). Conclusions: Stress and social withdrawal mediate the relationship between weight stigmatization and disordered eating. The results of this study identified potentially critical risk factors that, if addressed, may improve outcomes of campus-based disordered eating programs for women.     

Appropriate Terminology for the Alcohol,Eating, and Physical Activity Relationship

Abstract

“Drunkorexia” merges prior literature identifying positive relationships between (a) alcohol use/abuse and disordered eating/eating disorders, (b) alcohol use/abuse and physical activity, and (c) disordered eating/eating disorders and physical activity. The term, highlighting an individual's proactive and/or reactive weight management behaviors (ie, disordered eating, physical activity) in relation to alcohol consumption, originated in news editorials and has recently gained recognition via use in scholarly publications. The purpose of this commentary is to recommend discontinuing use of the term “drunkorexia” due to (a) inconsistent definitions of drunkorexia across investigations, (b) drunkorexia being a misnomer, and (c) the medical community's lack of recognition/acceptance of drunkorexia. Because the behaviors encompassed by drunkorexia are of concern to researchers and health professionals, future investigations are still warranted. However, until a medically recognized term/phrase is accepted, scholars should utilize more appropriate characterizations such as “weight-conscious drinkers,” “weight management behaviors of drinkers,” or “Eating Disorders Not Otherwise Specified” (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).     

History of sexual abuse and parental alcohol misuse: Risk,outcomes and protective factors in adolescents

This study examined the school performance, suicidal involvement, disordered eating behaviors, pregnancy risk and chemical use of teenagers with a history of sexual abuse or parental alcohol misuse and found that they had higher rates of these adverse outcomes than among a comparison group of teenagers without such background risk factors. Adolescents with dual-risk background reported higher levels of suicide risk, disordered eating, sexual behaviors and chemical abuse than teenagers with only one background risk factor. Among index group members, protective factors against these adverse outcomes included a high degree of religiosity and the ability to discuss problems with family or friends. Risk factors that increased the likelihood of adverse outcomes included depression, perceived substance use in school and worries about family financial security.The first author was supported in the preparation of this article by a grant from the Lois and Samuel Silberman Fund of New York.     

Implicit Family Process Rules in Eating-Disordered and Non-Eating-Disordered Families

Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This study compared implicit family process rules (specifically rules pertaining to kindness; expressiveness and connection; constraining thoughts, feelings, and self; inappropriate caretaking; and monitoring) in families with a young-adult female diagnosed with an eating disorder—either anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified—and families with a young-adult female without an eating disorder diagnosis. One hundred two families (51 eating disordered and 51 comparison) participated in the study. Mothers, fathers, young-adult female children, and siblings completed the Family Implicit Rules Profile ( Harper, Stoll, & Larson, 2007 ). Results indicated that eating-disordered families are governed by a greater proportion of constraining family rules than are non-eating-disordered families. Additionally, eating-disordered youth reported a lower proportion of facilitative family rules and a higher proportion of constraining family rules than did parents and siblings. Theoretical, research, and clinical implications are discussed.     

Body mass index, disordered eating behavior, and acquisition of health information: examining ethnicity and weight-related issues in a college population

OBJECTIVE AND PARTICIPANTS: To investigate ethnic differences related to weight, the authors assessed body mass index, dysfunctional eating, receipt of health information, and perceived obstacles to healthy lifestyles of 210 ethnically diverse college women. METHODS: The authors used the Eating Attitudes Test to assess dieting, food preoccupation, and bulimic behaviors. RESULTS: The authors found no ethnic differences in body mass index or disordered eating, but African Americans were more likely than were European Americans and Latina Americans to receive nutrition information from professionals and less likely than European Americans to perceive time as an obstacle. Overall, receipt of health information from a professional was related to fewer disordered eating behaviors; however, the specific eating behavior that was reduced varied by ethnicity. CONCLUSIONS: Health professionals should reconsider traditional assumptions of disordered eating behavior as a European American problem and consider cultural appropriateness in the development of effective health programs.     

Interview with Susie Orbach,Ph.D., C.S.W.

An interview with Susie Orbach highlights the trajectory of her career and current thinking on body image issues and eating disorders. Dr. Orbach’s work in this area as a clinical social worker, psychoanalyst, best-selling author and social activist has spanned three decades. In this interview she reflects on her earlier books, Fat is a Feminist Issue and Hunger Strike: An Anorectic’s Struggle as a Metaphor for Our Age, and discusses her current work and perspectives within the context of contemporary culture.     

Management of Allergic Respiratory Disease by the Nurse Practitioner

The results of several studies have established the validity of the SCOFF questionnaire (a 5-question screening tool for eating disorders), but researchers need to explore further replicability using the US version in the graduate school population. In this study, the authors asked 335 graduate students attending the Northwestern student health clinic on the Chicago campus to complete a written survey anonymously. A total of 305 (91%) patients completed the survey. The sensitivity and specificity for the SCOFF was 53.3% and 93.2%, respectively. This produced a PPV (the proportion who tested positive on the screen and actually had an eating disorder) of 66.7% and an NPV (the proportion of those who tested negative on the screen and actually did not have an eating disorder) of 88.7%. More than 80% of respondents were dissatisfied with their shape and weight, with over one third having a moderate to severe body image disturbance. The SCOFF is an easy instrument to administer that health care providers can use to screen for eating disorders in the primary care setting.     

Eating disorders in graduate students: exploring the SCOFF questionnaire as a simple screening tool

The results of several studies have established the validity of the SCOFF questionnaire (a 5-question screening tool for eating disorders), but researchers need to explore further replicability using the US version in the graduate school population. In this study, the authors asked 335 graduate students attending the Northwestern student health clinic on the Chicago campus to complete a written survey anonymously. A total of 305 (91%) patients completed the survey. The sensitivity and specificity for the SCOFF was 53.3% and 93.2%, respectively. This produced a PPV (the proportion who tested positive on the screen and actually had an eating disorder) of 66.7% and an NPV (the proportion of those who tested negative on the screen and actually did not have an eating disorder) of 88.7%. More than 80% of respondents were dissatisfied with their shape and weight, with over one third having a moderate to severe body image disturbance. The SCOFF is an easy instrument to administer that health care providers can use to screen for eating disorders in the primary care setting.     

Multiple sexual victimizations among adolescent boys and girls: prevalence and associations with eating behaviors and psychological health

The purpose of this study was to assess the prevalence of sexual abuse, including multiple victimizations, among adolescents and to examine associations among history of sexual abuse, disordered eating behaviors and psychological health. The sample included 81,247 students (40,946 girls and 40,301 boys) in 9th and 12th grade in Minnesota public schools. Sexual abuse was reported by 14.7% of girls and 6.2% of boys. Sexual abuse was associated with unhealthy eating behaviors, suicidal thoughts and attempts, and lower emotional well-being and self-esteem. Students who reported a single or multiple forms of sexual abuse were more likely than their non-abused peers to binge-eat (Odds Ratio: girls = 1.93-2.32; boys = 2.26-5.61), fast (OR: girls = 1.68-2.34; boys = 1.33-2.32), use diet pills (OR: girls = 1.50-4.30; boys = 2.99-17.29) or laxatives (OR: girls = 1.87-5.11; boys = 3.89-29.22), vomit (OR: girls = 1.75-4.06; boys = 2.82-24.16), and have suicidal thoughts/attempts (OR: girls = 3.01-6.12; boys = 3.35-9.46). Boys and girls reporting multiple sexual victimizations and had the highest odds ratios for disordered eating behaviors. Future research should explore strategies for primary prevention of revictimization and secondary prevention of detrimental effects of abuse.     

Energy Drinks,Weight Loss,and Disordered Eating Behaviors

Abstract

Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association–National College Health Assessment II confidentially online during February 2012. Results: This study revealed that the majority reported lifetime consumption of energy drinks (68.4%) and a substantial minority (30.2%) reported past-30-day consumption. Chi-square and t test results suggest that consumption is associated with concerns about personal appearance, weight loss attempts, and disordered eating behaviors (eg, vomiting). Hierarchical logistic regressions revealed that after controlling for demographics, the relations between energy drink consumption and the act of trying to lose weight, the use of diet pills, and the use of vomiting/laxatives remained significant. Conclusions: The current findings suggest that energy drink consumption is associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors. Future research should examine the prevalence of energy drink consumption for the purpose of weight loss.     

Grand Slam on Cancer

A winner of 59 Grand Slam championships including a record 9 Wimbledon singles titles, Martina Navratilova is the most successful woman tennis player of the modern era. Martina was inducted into the International Tennis Hall of Fame, named “Tour Player of the Year” seven times by the Women's Tennis Association, declared “Female Athlete of the Year” by the Associated Press, and ranked one of the “Top Forty Athletes of All-Time” by Sports Illustrated. Equally accomplished off the court, Martina is an author, philanthropist, TV commentator, and activist who has dedicated her life to educating people about prejudice and stereotypes. After coming out as a lesbian in 1981, Martina became a tireless advocate of equal rights for lesbian, gay, bisexual, and transgender (LGBT) people, and she has contributed generously to the LGBT community. Martina is the author of seven books, including most recently Shape Your Self: My 6-Step Diet and Fitness Plan to Achieve the Best Shape of your Life, an inspiring guide to healthy living and personal fitness. Martina was diagnosed with breast cancer in 2010.     

Eating dysfunctions in college women: the roles of depression and attachment to fathers

The authors examined the roles of depression and attachment to fathers in college women's eating dysfunctions. Three-hundred six undergraduate women completed (1) a diagnostic measure of eating dysfunctions that categorized them as asymptomatic, symptomatic but not eating disordered, or eating disordered; (2) 3 dimensional measures of attachment to fathers; and (3) a dimensional measure of depression. Depression was directly related to severity of participants' eating dysfunction; the eating-disordered group had scores consistent with clinical depression. After controlling for depression, 3 facets of attachment to fathers significantly differentiated the 3 groups.     

Body Mass Index,Disordered Eating Behavior,and Acquisition of Health Information: Examining Ethnicity and Weight-Related Issues in a College Population

Objective and Participants: To investigate ethnic differences related to weight, the authors assessed body mass index, dysfunctional eating, receipt of health information, and perceived obstacles to healthy lifestyles of 210 ethnically diverse college women. Methods: The authors used the Eating Attitudes Test to assess dieting, food preoccupation, and bulimic behaviors. Results: The authors found no ethnic differences in body mass index or disordered eating, but African Americans were more likely than were European Americans and Latina Americans to receive nutrition information from professionals and less likely than European Americans to perceive time as an obstacle. Overall, receipt of health information from a professional was related to fewer disordered eating behaviors; however, the specific eating behavior that was reduced varied by ethnicity. Conclusions: Health professionals should reconsider traditional assumptions of disordered eating behavior as a European American problem and consider cultural appropriateness in the development of effective health programs.     

Eating Disorder Treatment as a Process of Mind–Body Integration: Special Challenges for Women

The concept of body image remains too focused on internal representation and not enough on internal experiencing. Body image is but one expression of the more foundational body self. When an eating disorder is conceptualized as an attempt to manage an impaired sense of body self (and associated disregulation), the ultimate goal of treatment becomes embodiment. The eating disordered body must be worked with as an actual as well as symbolic body and understood within its own developmental trajectory. The gender-specificity of eating disorders is explored by focusing on three particular bodily challenges for females in our society: (1) Women are more likely than men to unconsciously use their bodies as repositories for their dissociated need and desire, (2) girls’ bodies are mirrored in a more distorted and overstimulating manner than boys’ and (3) because girls are the same biological sex as their usual primary caretakers, they are more likely to be used as narcissistic extensions. A clinical example is presented, illustrating the influence of these female bodily challenges on the development of body self and eating disorders and how these issues play out in treatment. An intensive clinical focus on the patient’s and therapist’s body states allows for the desomatization and integration of dissociated affect, resulting in a more integrated body–mind self and a decreased need for an eating disorder.