Eating Disorders and Disordered Eating in Competitive Cycling: A Scoping Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Methodological Rationale
2.2. Stage 1: Identifying the Research Question
2.3. Stage 2: Identifying Relevant Studies
- Key search terms for all databases:
- “Disordered eating” “cyclists” “competitive cycling”
- “Eating disorders” “cyclists” “competitive cycling”
- “Eating patterns” “cyclists” “competitive cycling”
- “Eating attitudes” “cyclists” “competitive cycling”
- “Nutrition habits” “cyclists” “competitive cycling”
- “Race weight” “cyclists” “competitive cycling”
- “leanness” “cyclists” “competitive cycling”
- “Eating disorders” “anorexia” “bulimia” “disordered eating” “cyclists” “competitive cycling”
- Inclusion criteria were:
- Articles written in English;
- Peer-reviewed articles;
- Articles that include specific reference to Eating Disorders and/or Disorder Eating in competitive cycling;
- Articles related to the areas above with the addition of eating patterns, attitudes and nutrition habits in competitive cycling;
- Articles with any reference to race weight and leanness;
- Articles related to any of the above in any competitive cycling setting.
- Exclusion criteria were:
- If dietary or nutrient intake were measured with no reference to disordered eating patterns or eating disorders;
- Articles not published;
- Articles without full-text access;
- Grey literature;
- Articles not written in English.
2.4. Stage 3: Study Selection
2.5. Stage 4: Charting the Data
2.6. Stage 5: Collating, Summarising and Reporting the Results
3. Findings and Discussion
3.1. Cycling as an ‘at-Risk’ Sport
3.2. Power to Weight Ratio
3.3. Energy Requirements and Low Energy Availability
3.4. The Social Environment of Competitive Cycling
3.5. Nutrition Support
3.6. Relationship between Eating Disorders/Disordered Eating and Exercise Addiction
3.7. Recommendations from Identified Literature
4. Conclusions and Recommendations
Year Location | Sample Number (Sex) | Age (Years) | Body Mass | Height | Discipline | Level | Reported Cycling Hours | Study Aims | Study Design | Measurement Instrument | Findings Relevant to Scoping Review | Reported Limitations in Paper |
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Ferrand and Brunet 2004 [41] France | 42 (M) | 21.8 ± 3.7 | Only BMI reported. 20.5 ± 1.4 kg/m2 | Not reported | Not reported | Amateur classified as Regional (n = 12), National (n = 13) and elite (n = 17) | Not reported | To examine the associations between dimensions of perfectionism and eating disorder symptoms among 42 young male amateur cyclists (M = 21.8 yr., SD = 3.7) over the three performance categories (Elite, National, Regional). | Cross-sectional self-reported survey | Eating Attitudes Test (EAT-26); Multidimensional Perfectionism Scale |
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Riebl et al., 2007 [58] USA | 124 (61 cyclists and 63 non cyclists as control) (M) | 31.6 ± 10.4 (cyclists) and 23 ± 6.3 (control) | 72.5 ± 7.6 (cyclists) and 80.5 ± 16.1 kg (control) | Not reported | Not reported | Not reported | Inclusion criteria included training a minimum of 5 h on a bicycle each week throughout the year; have participated in cycling for no less than 1 year. | To determine the prevalence of subclinical disordered eating behaviours among male cyclists, whether male cyclists self-report having an eating disorder, and whether male cyclists meet the daily recommendations for the major food groups according to the Dietary Guidelines for Americans. | Cross-sectional self-reported survey | The Eating Attitudes Test-26 (EAT-26) (7–9), Survey of Eating Disorders Among Cyclists (SEDAC) (10), and a nutrition questionnaire were completed by the study participants. |
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Gorrell et al., 2019 [55] USA | 612 mixed sport (24 cyclists) (M) | 18–26 (M = 20.99) | Not reported | Not reported | Not reported | Not reported. Sample from National College Athletics Association (NCAA) schools | Not reported | To characterise unhealthy exercise and eating behaviour according to competitive athlete status, as well as per sport type. | Cross-sectional self-reported survey | Eating disorder examination questionnaire EDE-Q |
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Muros et al., 2020 [12] Spain | 4037 cyclists and triathletes (cyclists = 2037) (F and M) | 37.72 ± 9.67 | Only BMI reported 23.74 ± 2.69 kg/m2 | Not reported | Not reported | Not reported. Federated cyclists in Spain | 10.94 ± 4.64 | To describe and predict eating disorders according to sex, body mass index, age and sport discipline within a sample of athletes. | Cross-sectional self-reported survey | The revised restraint scale (RRS); the five-item SCOFF; the Mediterranean diet (MD) adherence screener (MEDAS) |
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Filaire et al., 2007 [40] France | 15 cyclists (44 full sample) (M) | 21.2 ± 2.8 | 68.0 ± 6.5 kg | 180 ± 0.06 cm | Road cycling | National | Weekly distance covered ranged between 600 and 750 km. The athletes took part in races each weekend, with distance ranging from 100 to 150 km. | To test the hypothesis that male athletes who feel pressured to maintain a specific body weight present an elevated risk of subclinical eating disorders. | Cross-sectional self-reported survey | Eating Attitudes Test (EAT-26); Multidimensional Perfectionism Scale; Body Esteem Scale; Profile of Mood States |
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Yates et al., 2003 [60] Not reported | 190 (36 cyclists) (F and M) | Not reported | Not reported | Not reported | Not reported | Not reported | Not reported | To differentiate groups of highly conditioned, competitive athletes on the basis of Exercise Orientation Questionnaire (EOQ) scores and self-reported psychiatric symptoms. | Cross-sectional self-reported survey | Exercise Orientation Questionnaire (EOQ) |
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Haakonssen et al., 2015 [25] Australia | 37 (F) | 18–36 | 58.4 ± 5.9 kg | 170 ± 7 cm | Road cycling | Professional and amateur | Not reported | To investigate the satisfaction of elite female cyclists with their body weight (BW) in the context of race performance, the magnitude of BW manipulation, and the association of these variables with menstrual function. | Cross-sectional self-reported survey | Female Cyclist Weight Management Questionnaire (Created by research team) |
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Hoon et al., 2019 [24] Australia | 97 (M) | 32.0 ± 1.7 | 73.1 ± 1.4 kg | 180.4 ± 1.0 cm | Road, Track and Mountain Bike | Participants were categorized as Local, National (i.e., top domestic competition) or International level | 13.9 ± 0.8 h | To investigate the perceptions and practices of achieving ‘race weight’ in a population of trained male cyclists. A secondary focus was to investigate the use of gym-based strength training, a possible attenuator of the side effects associated with weight reduction. | Cross-sectional self-reported survey | Survey created by research team |
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Sousa Fortes et al., 2017 [57] Brazil | 43 | Risk of ED: 21.33 ± 1.84 No risk of ED: 21.49 ± 1.75 | Not reported | Not reported | Road cycling | Not reported | Risk of ED: 10.23 ± 1.12 No risk of ED: 10.26 ± 1.07 per week | The aim of this study was to compare the maximum oxygen consumption (VO2max) between road cyclists with and without risk for eating disorders. | Cross-sectional self-reported survey | Eating Attitudes Test 26 (EAT-26) |
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Hale and Divin [61] 2011 USA | 98 (M) | 34 ± 4.1 | Not reported | Not reported | Not reported | Amateur to professional | Not reported | To examine eating behaviours in competitive male cyclists across racing categories. | Cross-sectional self-reported survey | Eating Attitudes Test 26 (EAT-26) |
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Viner et al., 2015 [35] USA | 10 (F and M) | Male: 42.0 ± 7.7 Female: 38.4 ± 10.3 | Male: 72.4 ± 6.8 kg Female: 62.8 ± 12.2 kg | Male: 177.9 ± 4.2 cm Female: 165.4 ± 6.4 cm | Road cycling and mountain biking | Competitive | Male: 1.4 ± 0.6 Female: 0.8 ± 0.4 per day | To analyse eating behaviours that may contribute to LEA. | Cross-sectional self-reported survey | The Three-Factor Eating Questionnaire (TFEQ)—participants who scored 10 or higher were considered restrained eaters (RE) who consciously limit EI as a means of weight control |
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de Bruin and Oudejans 2018 [39] Netherlands | 8 mixed sport (1 cyclist) (F) | Not reported | Not reported | Not reported | Not reported | International | Not reported | To explore the role of contextual body image in the development of EDs in female athletes participating in at-risk sports. | Qualitative | Interview |
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Cook and Dobbin 2022 [36] UK | 36 (M) | 23.1 ± 3.9 (18–30) | 70.4 ± 7.1 kg | 180.5 ± 6.1 cm | Road cycling | Elite (n = 8), category 1 (n = 9), category 2 (n = 19) | 16.4 ± 3.2 (10–22) per week | To assess the association between sports nutrition knowledge, nutrition intake, energy availability and training characteristics with the risk of an eating disorder amongst highly trained, competitive male cyclists. | Cross-sectional self-reported survey | The Brief Eating Disorder in Athletes Questionnaire (BEDA-Q) |
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Cook and Luke 2017 [56] USA | 179 (F and M) | 32.5 ± 12.9 | Not reported | Not reported | Not reported | High school to professional | Not reported | To establish prevalence rates for primary and secondary EXD in a sample of cyclists. Our secondary purpose was to examine potential differences in EXD and level of competition, competition history and exercise amount. | Cross-sectional self-reported survey | Drive for Thinness subscale of the Eating Disorder Inventory-2 |
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Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Roberts, C.J.; Hurst, H.T.; Hardwicke, J. Eating Disorders and Disordered Eating in Competitive Cycling: A Scoping Review. Behav. Sci. 2022, 12, 490. https://doi.org/10.3390/bs12120490
Roberts CJ, Hurst HT, Hardwicke J. Eating Disorders and Disordered Eating in Competitive Cycling: A Scoping Review. Behavioral Sciences. 2022; 12(12):490. https://doi.org/10.3390/bs12120490
Chicago/Turabian StyleRoberts, Charlie Jon, Howard Thomas Hurst, and Jack Hardwicke. 2022. "Eating Disorders and Disordered Eating in Competitive Cycling: A Scoping Review" Behavioral Sciences 12, no. 12: 490. https://doi.org/10.3390/bs12120490