Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes

• Published in: BMJ Open Sport & Exercise Medicine Vol. 9; no. 4; p. e001731
• Main Authors: Vardardottir, Birna, Olafsdottir, Anna Sigridur, Gudmundsdottir, Sigridur Lara
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 24.10.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Athletes; Body composition; Body image; Eating behavior; Eating disorders; Energy; Exercise; Females; Males; Nutrition; Original Research; Questionnaires; Self image; Sport and exercise psychology; Sporting injuries; Sports & exercise medicine; Sporting injuries; Body image; Sports & exercise medicine; Eating disorders; Sport and exercise psychology
• ISSN: 2055-7647; 2055-7647
• DOI: 10.1136/bmjsem-2023-001731

ObjectivesDisordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its relationship with REDs are unknown. This cross-sectional study aimed to evaluate associations of all three with REDs symptoms.MethodsElite and subelite Icelandic athletes (n=83, 67.5% females) answered the Low Energy Availability in Females/Males Questionnaires (LEAF-Q/LEAM-Q), Eating Disorder Examination–Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI) and Muscle Dysmorphic Disorder Inventory (MDDI). Body composition was assessed via dual-energy X-ray absorptiometry; resting metabolic rate via indirect calorimetry; and blood samples were drawn for analysis of nutrition and hormonal status. Females were compared based on LEAF-Q total score (≥8 (at risk) vs <8). Simple linear regression was applied to evaluate associations of (a) testosterone with other objective measures and LEAM-Q scores in males; and (b) LEAF-Q/LEAM-Q scores with EDE-QS, EAI and MDDI scores.ResultsIn total, 8.4% of participants scored above cut-off on EDE-QS, 19.3% on EAI and 13.3% on MDDI. Females with LEAF-Q total score ≥8 had higher median scores on EDE-QS, EAI and MDDI compared with those scoring <8. Testosterone was positively associated with iron and inversely with total iron-binding capacity but was not associated with scoring on any of the administered questionnaires.ConclusionDrive for muscularity and aesthetic physique may play a role in the complex presentation of REDs. Screening for muscle dysmorphia, in addition to disordered eating and compulsive exercise, could therefore facilitate early detection of REDs.