Preventing Eating Disorders among Young Elite Athletes: A Randomized Controlled Trial

MARTINSEN, MARIANNE1; BAHR, ROALD1; BØRRESEN, RUNI2; HOLME, INGAR1; PENSGAARD, ANNE MARTE3; SUNDGOT-BORGEN, JORUNN4

Medicine & Science in Sports & Exercise: March 2014 - Volume 46 - Issue 3 - p 435–447
doi: 10.1249/MSS.0b013e3182a702fc
Clinical Sciences

Purpose: To examine the effect of a 1-yr school-based intervention program to prevent the development of new cases of eating disorders (ED) and symptoms associated with ED among adolescent female and male elite athletes.

Methods: All 16 Norwegian Elite Sport High Schools were included (intervention group [n = 9] and control group [n = 7]). In total, 465 (93.8%) first-year student athletes were followed during high school (2008–2011, three school years). The athletes completed the Eating Disorder Inventory 2 and questions related to ED before (pretest), immediately after (posttest 1), and 9 months after the intervention (posttest 2). Clinical interviews (Eating Disorder Examination) were conducted after the pretest (all with symptoms [n = 115, 97%] and a random sample without symptoms [n = 116, 97%]), and at posttest 2, all athletes were interviewed (n = 463, 99.6%).

Results: Among females, there were no new cases of ED in the intervention schools, while 13% at the control schools had developed and fulfilled the DSM-IV criteria for ED not otherwise specified (n = 7) or bulimia nervosa (n = 1), P = 0.001. The risk of reporting symptoms was lower in the intervention than in the control schools at posttest 1 (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.23–0.89). This effect was attenuated by posttest 2 (OR = 0.57, 95% CI = 0.29–1.09). The intervention showed a relative risk reduction for current dieting (OR = 0.10, 95% CI = 0.02–0.54) and three or more weight loss attempts (OR = 0.47, 95% CI = 0.25–0.90). Among males, there was one new case of ED at posttest 2 (control school) and no difference in the risk of reporting symptoms between groups at posttest 1 or 2.

Conclusion: A 1-yr intervention program can prevent new cases of ED and symptoms associated with ED in adolescent female elite athletes.

1Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY; 2Faculty of Teacher Education, Buskerud University College, Drammen, NORWAY; 3Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, NORWAY; 4Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY

Address for correspondence: Marianne Martinsen, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, PB 4014 Ullevål Stadion, N-0806 Oslo, Norway; E-mail: marianne.martinsen@nih.no

Submitted for publication May 2013.

Accepted for publication July 2013.

© 2014 American College of Sports Medicine