Who is at Risk in Sports/Exercise Environments?

Who is at risk in Sports/Exercise Environments? 

Eating disorders are complex mental illnesses influenced by genetic, biological, psychological, and socio-cultural factors. While no single cause explains why some individuals develop an eating disorder, certain personal characteristics and life experiences may increase vulnerability. For more information, refer to the "Why Do People Get Eating Disorders?" factsheet. 

Social and cultural factors can influence eating disorders. While exercise and sports participation often promote physical and mental health, sometimes these environments foster an over-evaluation of appearance and pressure to conform to unrealistic body ideals. Meaning they can influence how individuals perceive and value their body shape and size.   

Early identification and intervention are important for the effective treatment of eating disorders and it is therefore important to understand how fitness and sport environments contribute to risk. The following outline factors in sport and exercise environments which may increase the risk of an individual developing an eating disorder: 

Professional Athletes 

Certain professional environments can be problematic, especially where weight, body shape, and size are prerequisites for success or are believed to affect performance. These include “lean” or aesthetic sports (e.g., rhythmic gymnastics, figure skating, dance, and cheerleading),  weight-class sports (e.g., boxing or rowing), individual and endurance sports (e.g., swimming, running, cycling). Other factors influence risk, such as the level of competition, team camaraderie, and the coach. (Corazza et al., 2019; Dittmer et al., 2018; Godoy-Izquierdo et al., 2023;  Martenstyn et al., 2021). A 2023 study found that approximately 25.3% of athletes surveyed were classified as at risk for eating disorders (Torres-McGehee et al., 2023). 

Many professional athletes adhere to strict exercise and diet regimes, making the line between healthy and unhealthy behaviors difficult to detect. Athletes can be particularly susceptible to eating disorders when: 

• Aesthetics are emphasized as part of the activity or sport (e.g., figure skating, dancing, gymnastics). 

• Body type and weight are believed to directly affect performance (e.g., bodybuilders, wrestlers, boxers, jockeys, rowers). 

• They engage in endurance sports. 

• The sport focuses on individual performance rather than team performance. 

Recreational Gym-Goers 

Individuals who regularly attend the gym and engage in excessive exercise behaviors are also at risk. This may include those who: 

• Train despite injury or illness. 

• Engage in significant solitary exercising. 

• Over-evaluate weight and shape. 

• Feel especially guilty when they don't exercise. 

People interested in weight loss 

Dieting is the single biggest predictor for the onset of an eating disorder with women who diet having up to 18 times greater risk of developing an eating disorder (Patton et al., 1999).  

It may be that people intend to engage in healthy eating but instead resort to fad diets and unhealthy behaviours such as restricting calories and/or entire food groups, purging, using diet pills or laxatives and smoking (to suppress appetite).  

Due to stigma and health concerns, individuals living with obesity may engage in negative behaviours and fad dieting. Individuals with overweight/obesity are at increased risk of developing an eating disorder (House et al., 2022).  

Adolescence 

The peak period for the onset of an eating disorder is adolescence (Volpe et al., 2016). This time is often a period of intense change, uncertainty and anxiety for many individuals. Changes to the young person’s environment along with developmental physical and mental changes can result in feelings of self-consciousness, low self-esteem and greater comparison with peers 

Gender 

Approximately 15% of Australian women will experience eating disorders at some point during their life (Butterfly Foundation, 2022). This risk increases during key transition periods including from school to adult life, pregnancy and menopause. Risk is also increased for those with diabetes and Polycystic Ovary Syndrome (POCS) (Lalonde-Bester et al., 2024). 

Disordered eating amongst men is on the rise with males making up 33% of individuals in Australia with an eating disorder (Deloitte Access Economics, 2024). Males represent around 20% of individuals with anorexia nervosa, 30% with bulimia nervosa, 43% with binge eating disorder, between 55% and 77% with other specified feeding or eating disorders (OSFED) in Australia (Hay et al., 2015). Eating disorders and disordered eating behaviours in boys and men may present differently than in girls and women, particularly with muscularity-oriented disordered eating (Nagata et al., 2020).   

An Australian study found that 23% of transgender young people have a current or previous diagnosis of an eating disorder (Strauss et.al., 2017).   

Conclusion 

Early identification and intervention are crucial for the effective treatment of eating disorders. Understanding how fitness and sport environments contribute to risk is essential. By recognizing the factors that increase vulnerability, appropriate measures can be taken to support individuals and promote healthier environments in sport and exercise settings. 

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