Get help. Refer a patient. Find hope. 888-364-5977


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Find hope. 888-364-5977

July 05, 2016

Words with Wisniewski: Eating Disorders in Elite Adolescent Athletes

by Lucene Wisniewski, PhD


Article: Eating Disorder Pathology in Elite Adolescent Athletes. International Journal of Eating Disorders, vol. 49, issue 6, p. 553-562. Giel, Hermann-Werner, Mayer, Diehl, Schneider, Thiel, & Zipfel. (2016). Access the article here.


This study examined eating disorder pathology in a large group (n=1138) of elite adolescent athletes.  

The researchers assessed body weight, weight control behaviors, and body acceptance. They also screened overall for core eating disorder symptoms as well as for depression and anxiety.  

What the researchers discovered:

21.5% of athletes screened positively for eating disorder pathology. That is 1 in 5 athletes. This rate is much higher than in the general adolescent population. Eating disorder symptoms were more common among female than male athletes. Athletes with eating disorder pathology, regardless of gender, demonstrated increased levels of depression and anxiety.

Not all athletes had the same risk for eating disorder pathology. The researchers identified four subgroups of athletes who are at high risk to show eating disorder pathology:

1.  Athletes competing in weight-dependent sports (e.g., boxing, weight lifting, judo, taekwondo, freestyle wrestling)

2.  Athletes competing in sport disciplines that are not weight-dependent. but have these characteristics:

  • High on negative affect
  • Female
  • Male, and competing in the following types of sports: endurance (e.g., swimming, triathlon, speed-skating, running), technical (e.g., diving, alpine skiing, long jump), or power (e.g., shot-put, hurdles)

Athletes competing in weight-dependent disciplines reported widespread use of compensatory behaviors to influence body weight. It is interesting to note that the most common compensatory behavior reported by athletes was dehydration (e.g., sauna, exercise in sweat suites). The authors suggest that short term weight control methods used by athletes might be embedded in a sport-specific subculture and that  “… this does not mean that these practices are less alarming. Rapid weight loss has extensive negative consequences for performance in sports, physical health and cognitive functioning.”

The findings of this study may be important to the reader since they alert us to the fact that elite athletes are at increased risk for eating disorder behavior, especially in sports that are weight-dependent such as boxing and weight lifting. This study also makes us aware that athletes may be using dehydration methods to alter weight quickly and these are no less dangerous than other eating disorder behaviors. Such behaviors may be considered normal in some sport cultures, but could be considered a red flag.   

At The Emily Program we are careful to stay abreast of any new research data that will help us to better understand and serve individuals with eating disorders.

About the Author

Lucene Wisniewski, PhD

Lucene Wisniewski, PhD

Lucene Wisniewski, PhD, FAED is Chief Clinical Integrity Officer of The Emily Program and is an Adjunct Assistant Professor of Psychological Sciences at Case Western Reserve University. From 2006-2014, she served as Clinical Director and co-founder of the Cleveland Center for Eating Disorders, a comprehensive eating disorder treatment program. Her research and clinical interests include using empirically founded treatments to inform clinical programs. She provides workshops on the CBT and DBT treatment of eating disorders internationally and publishes in peer reviewed journals as well as invited book chapters. Dr. Wisniewski has been elected fellow and has served on the board of directors and as the co-chair of the Borderline Personality Disorder special interest group of the Academy for Eating Disorders (AED). In 2013 the AED awarded Dr. Wisniewski the Outstanding Clinician Award to acknowledge her contribution to the field of eating disorder treatment.

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