THE PREVALENCE OF DISORDERED EATING IN THE OLDER FEMALE ATHLETIC POPULATION

Abstract

Objectives The objectives of this study were to examine the prevalence of disordered eating (DE), pathogenic behaviours and menstrual irregularity in the older female athletic population, and to compare with an equivalent sedentary population. Design Cross sectional retrospective self reporting survey. Setting Research was conducted in Shropshire, UK, with participants recruited locally and across the UK through social media. Participants Athletes (n = 84) were female runners training at least three times a week with a minimum weekly mileage of 15 miles. Participants were recruited at local running clubs and training venues, in addition to online club websites, forums and Facebook. Controls (n = 77) were also recruited through social media sites and local neighbourhood venues. 5 Main Outcome Measures DE prevalence was assessed using the validated Eating Disorders Examination Questionnaire (EDE-Q), assessing eating attitudes and pathogenic behaviours. The International Physical Activity Questionnaire (IPAQ) was used to measure activity level, and further questions evaluated menstrual irregularity and weekly mileage. Menstrual status was defined as eumenorrhoeic with a menstrual cycle of 28 days (± 7 days), oligomenorrhoeic with intervals greater than 35 days and amenorrhoeic with cycles greater than 90 days. Results Athletes scored significantly greater in the subscale of eating concern (P = 0.015), however there was no significant difference in other subscales or global scores. Overall prevalence of those “at risk” of DE was 22.6% in the athletic group compared with 22.1% in the control (P = 0.934). Pathogenic behaviours were all more frequent in the athletic group, with compulsive exercise significantly more common in the athletic population (26.2% vs. 9.1%, P = 0.005). A total of 4 runners (4.8%) and 1 control (1.3%) met the criteria for an eating disorder (ED) or an eating disorder not otherwise specified (ED-NOS). There was no significant difference in menstrual irregularity, with greater contraceptive use in the athletic group (36.9% vs. 14.3%, P = 0.001) and more controls were post-menopausal (40.3% vs. 15.5%, P = 0.001). 6 Conclusions There is a considerable prevalence of DE in both the athletic and sedentary older female population. Furthermore compulsive exercise is significantly greater in the athletic population and in combination with DE has potential for detrimental consequence. This study demonstrates the need for awareness of DE and facets of the female athlete triad in older females, with targeted education and prevention, in both the sedentary and athletic populations.