1. Eating Disorders Result in Different Eating Disorder Outcomes?
Athletes and Eating Disorders: Does a Specialized Treatment for Athletes with
Eating Disorders Result in Different Eating Disorder Outcomes?
Laura Fewell,1,2 Riley Nickols,1 Amanda Schlitzer Tierney,1 and Cheri A. Levinson2
1McCallum Place Eating Disorder Centers, 231 W. Lockwood Ave, Ste. 201, St. Louis, MO 63119
2Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292
Background
Measures
Results
Disordered eating affects up to 20% of female and 8% of male athletes.1,2
Nearly two-thirds of those with EDs have an anxiety disorder and approximately half have a depressive disorder.3,4
Twenty-five percent of student athletes report symptoms of depression and 40% report “overwhelming” anxiety.5
ED treatment programs are not generally tailored to athletes, despite literature supporting the integration of exercise and sport into treatment.6,7
Understanding how athletes and non-athletes with EDs compare is necessary to tailor specialized ED treatments.
Eating Disorder Examination Questionnaire
28-item self-report measure of ED behaviors and thoughts
Excellent test-retest reliability and internal consistency8,9
Beck Depression Inventory II
Assesses severity of depression on 21 self-report items
High internal consistency and concurrent validity10,11
Penn State Worry Questionnaire
16 item self-report measure of trait worry
High internal consistency and good convergent validity12,13
ED symptomatology, depression, and worry were significantly lower at discharge than at admission in all patients (ps <.001).
Athlete-patients had significantly lower depression, worry, and ED symptomatology than non-athlete patients at admission and discharge (ps<.001).
An ANOVA showed ED symptomatology was significantly lower at 1 month follow-up than at admission but significantly higher than at discharge in all patients (Wilks’ Lambda = 0.43, F (2, 184) = , p <.01).
ED symptomatology at 1 month follow-up did not differ between athlete and non-athlete patients (p =.20).
Objectives
Discussion
Research Questions:
Do all patients improve after intensive ED treatment?
Do athlete patients differ from non-athlete patients at admission, discharge, and/or 1 month follow-up?
Hypotheses:
All patients will have significantly lower ED symptomatology, depression, and worry at discharge compared to admission.
All patients will have significantly lower ED symptomatology at 1 month follow-up than at admission.
Athlete patients will have similar ED symptomatology than non-athlete patients at all time points.
Athlete patients will have significantly lower depression and worry than non-athlete patients at admission and discharge.
Patients showed significant improvement across all measures and had significantly lower ED symptomatology, depression, and worry at discharge than at admission, though ED scores began trending up again at 1 month follow-up.
Athlete patients were significantly less impaired than non-athletes except at follow-up, suggesting that athletes may struggle as much or more than non-athletes after treatment.
• Athletes may benefit from increased support both at
discharge and transition back to sport.
Results indicate that athlete-specific programming at an ED clinic is beneficial overall. The treatment philosophy of this program supports recommended treatment guidelines6,7, which suggest the following:
*** p < .001
Increasing energy intake via an “eating plan”
Addressing exercise and food-related stress
Individualizing exercise plans and debriefing post workout
Providing psycho-education
Monitoring medical status and fittingly reintroducing sport
Participants
358 female (94%) and male (6%) patients between the ages of 14 and 29 (M=19.98, SD=3.92); 62 (17%) were athletes.