Pathogenic weight‐control methods and self‐reported eating disorders in female elite athletes and controls

To determine the use of pathogenic weight‐control methods and prevalence of self‐reported eating disorders (ED) among female elite athletes and non‐athletic controls, the Eating Disorder Inventory (EDI) and a self‐developed questionnaire were administered to the total population of Norwegian female elite athletes (n=603) and age‐ and home community‐matched controls (n=522). The response rate in both athletes and controls was 86%; 97% of the athletes and 90% of the controls had body mass index (BMI) values within or below the optimal level (20–25). Athletes had a significantly lower mean BMI 20.8 (95% confidence interval (CI), 20.7–20.9) than controls 21.5 (95% CI 21.3–21.7). A similar fraction of the athletes (31%) and controls (27%) were dieting. Most athletes dieted to enhance performance (73%); most controls dieted to improve appearance (83%). Significantly more athletes (11%) than controls (7%) used pathogenic weight‐control methods. Athletes competing in aesthetic and endurance sports were the leanest groups, and athletes competing in aesthetics, endurance‐ and weight‐dependent sports most frequently reported the use of the more severe pathogenic weight‐control methods. A similar fraction of athletes (22%) and controls (26%) were classified as being at risk of developing ED based on the subscale scores of the EDI. However, a higher fraction of athletes in aesthetics‐, endurance‐, and weight‐dependent sports than athletes in technical sports, ballgames, power sports and non‐athletic controls were classified as being at risk of developing ED. In contrast to previous reports, our results demonstrated that a number of athletes also competing in sports where the participants are considered less weight‐conscious were using pathogenic weight‐control methods (technical 10% and ballgames 8%). A similar percentage of athletes (12%) and controls (11%) actually reported having an ED.