Preventing eating disorders among young elite athletes: a randomized controlled trial

Med Sci Sports Exerc. 2014 Mar;46(3):435-47. doi: 10.1249/MSS.0b013e3182a702fc.


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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletes / psychology*
  • Confidence Intervals
  • Feeding and Eating Disorders / prevention & control*
  • Female
  • Health Promotion / methods*
  • Humans
  • Male
  • Norway
  • Odds Ratio
  • Risk Reduction Behavior
  • Self Concept
  • Surveys and Questionnaires