Eating psychopathology in athletes: methods of identification and intervention

Background: The incidence of eating psychopathology in athletes is considerably higher than in the general population. Facilitating the early identification and successful management of eating problems in this group is therefore essential. Objectives: The thesis aimed to improve our empirical understanding of the identification and management of eating problems in athletes. Three areas were investigated. First, a measure of compulsive exercise was evaluated as a method of identification of eating psychopathology in athletes. Second, the thesis explored coach methods of identification and management of eating problems among their athletes. Finally, athlete experiences of disclosing and seeking treatment for eating disorders were explored. Main findings: The Compulsive Exercise Test was found to be a useful measure in screening for eating psychopathology in athletes. Track and field coaches relied heavily on the physical symptoms of disordered eating when identifying potential eating problems in athletes. Coaches described difficulties in identifying eating psychopathology in athletes, and in signposting athletes to appropriate support. Individual differences in the perceived value of disclosing an eating disorder were discovered among athletes currently seeking treatment. Lastly, athletes described struggling to engage with their eating disorder treatment programme, particularly where exercise was restricted or reduced. Implications: The findings suggest a need for greater support, education and resources for coaches and sports professionals in identifying and facilitating treatment access among their athletes. The Compulsive Exercise Test may be one way to assist sports professionals in identifying athletes with elevated levels of eating psychopathology. Athletes may be more willing to engage with treatment programmes when they are closely involved in goal setting and their exercise and sporting commitments are incorporated where possible

Responses of track and field coaches to athletes with eating problems

This study aimed to explore how track and field coaches respond to athletes with eating problems. Eleven experienced coaches participated in semi-structured interviews exploring their responses to, and challenges faced when, working with athletes with eating problems. The analysis revealed three themes relating to the strategies employed by coaches. The first theme indicated a supportive approach, where coaches were proactive in seeking support and in reducing training at the early stages of an eating problem. The second theme outlined an avoidant approach, characterised by coach reluctance to be involved in managing eating problems, and a lack of confidence in their knowledge of eating disorders. The third theme involved a confrontational approach, where coaches employed strict rules and engaged in coercion to persuade athletes to seek treatment. All of the coaches reported facing challenges in persuading athletes to seek treatment and were frustrated by a lack of available support. The study highlights the importance of providing resources and support services where coaches can seek advice. Coach education packages can utilise the findings to highlight the strengths and limitations of different coach strategies, and to reinforce the importance of their role in identification and intervention when eating problems in athletes are suspected