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Higher prevalence of eating disorders among adolescent elite athlete than controls


This Norwegian study, recently published in Medicine & Science in Sports & Exercise, also confirmed that a clinical interview still is the best available method to identify eating disorders among both elite athletes and controls.

This Norwegian investigation, which is part of a larger PhD-project, is the first to confirm that the prevalence of eating disorders (ED) is higher among adolescent elite athletes than controls and higher in female than in male adolescent elite athletes.


The total population of first-year students at 16 Norwegian Elite Sport High Schools (n=677) and 2 randomly selected high schools (controls, n=421) were invited to participate.


Clear message 

The researchers behind this investigation, PhD candidate Marianne Martinsen and Professor Jorunn Sundgot-Borgen (to the left), are clear on their messages:



- This study also confirms the difficulties that exist when it comes to identifying male and female athletes “at risk” for ED


- There is a need for a clinical interview to reliably identify athletes who already have developed an ED, Sundgot-Borgen and Martinsen agree on.


Self-report + clinical interview to confirm the diagnosis “eating disorders”

This was a 2-phase study, including a self-report questionnaire (part I) followed by clinical interviews (part II).


The subjects reporting symptoms associated with ED were classified as "at risk" for ED.

In part II, all "at-risk" athletes (n=153), a random sample of not "at risk" (153), and a random sample of 50% of the controls classified as "at risk" (91) and not "at risk" (88) were invited to the clinical interview to screen for ED

(i.e., meeting the Diagnostic and Statistical Manual of Mental Disorders criteria).


Prevalence of ED higher in athletes than controls

In part I, more controls than athletes were classified as "at risk" for ED based on self-reports (51% vs 25%).

In part II, the prevalence of ED among the total population of athletes and controls was estimated to be 7% versus 2%, with the ED prevalence being higher for young female athletes than for female controls (14% vs 5%) and higher for male athletes than for their control counterparts (3% vs 0%).



There is a need for further development and validation of screening instruments designed for athletes. A sport-specific instrument should be designed for different kinds of sports and athlete levels. Until this is established, a clinical interview should be used for accurately identify athletes at risk to develop eating dosorders.


Education about health and performance-related nutrition and body composition should be administered at an earlier age than high school.


The main purpose of this PhD-project is to succsessfully intervene at the school-level and reduce the incidence of eating disorders among this young group of peoples.


This project was run by the Oslo Sports Trauma Research Group and the Norwegian School of Sport Sciences.


Download the paper in Medicine & Science in Sports & Exercise.