Key Points - Collegiate student-athletes are at risk for eating disorders, with females at greater risk than males. - Although their eating disorder risk was not as prevalent as in female student-athletes, male student-athletes displayed a 17.3% risk, which was higher than previously reported in the literature. - The eating disorder risk was observed across sport type (endurance, aesthetic, power, ball, and technical sports) for all athletes, but the highest risk was seen in endurance (ie, cross-country, swimming, track) and ball or team (ie, baseball, basketball, soccer, softball, volleyball, beach volleyball) sports. - Athletics departments should consider integrating universal guidelines or policies and best practices to guide prevention (via education), recognition, evaluation, rehabilitation, treatment measures, and return-to-play guidelines for student-athletes with disordered eating and eating disorders. Abstract Context: Eating disorders (EDs) are a cluster of behavioral conditions characterized by uneasy thoughts and behaviors that grow into severe or persistent eating disturbances. The demands on student-athletes may create mental and physical stressors that increase the likelihood of EDs and disordered eating. Objective: To examine the ED risk through eating attitudes and behaviors in male and female student-athletes and across various sport types (endurance, aesthetic, power, ball or team, or technical sports). Design: Cross-sectional study. Setting: Collegiate athletics. Patients or Other Participants: National Collegiate Athletic Association Division I and II student-athletes (n = 2054; males = 631; females = 1423) from 40 institutions. Main Outcome Measure(s): Participants completed a web-based demographic survey and the Eating Attitudes Test-26 (EAT-26). Multiple X2 analyses examined participants classified as at risk for EDs. Independent-samples t tests and a 1-way analyses of variance compared sex and sport type across EAT-26 totals and subscale (Dieting, Bulimia, and Oral Control) scores. Results: Overall, 25.3% (n = 520/2054) of student-athletes were classified as at risk for EDs. Differences were found between sex and ED risk (X2 1,2054 = 32.9, P = .01; 17.3% [n = 109/631] males, 28.9% [n = 411/1423] females) and across ED risk and sport type (X2 4,2054 = 13.4, P = .01). When examining females only, we observed differences across ED risk and sport type (X2 4,1423 = 13.4, P = .01). No differences were evident across ED risk and sport type for males. Differences were seen between sex and binge eating (X2 1,2054 = 6.8, P = .009), sex and diet pill use (X2 1,2054 = 19.6, P = .01), and sport type and diet pill use (X2 4,2054= 12.2, P = .016), excessive exercise (X2 4,2054 = 32.1, P = .01), and losing more than 20 lb (9 kg) in the last 6 months (X2 4,2054 = 10.2, P = .037). Conclusions: Student-athletes in the collegiate setting are at risk for EDs. Medical professionals, such as athletic trainers, need to be educated on the potential risk factors that may lead to EDs. Protocols for prevention, screening and recognition, and referral should be developed for student-athletes at risk for EDs.
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