The occurrence of eating disorders are a serious problem worldwide. A major problem with this disease, abnormal eating behaviour that can threaten your health or even your life,(1)
is that the mortality prevalence rates are highest among those who are not under professional care: per 100 000 females, 370 die suffering from Anorexia Nervosa and 1500 women with Bulimia die.(2) The worldwide prevalence of eating disorders among athletes, 0-19% for men, and 6-45% for women, is higher than the prevalence within the general population.(3) According to the Trimbos Institute, the presence of an eating disorder at some point in time for Dutch civilians is 0.7%.(4) However no specific prevalence numbers are available for the Dutch athlete population.
The development and existence of eating disorder pathology is harmful for body functions and mental health; a lack of energy availability, menstrual dysfunction, persisting psychological distress and even death.(5)Due to the fact that, for many people with eating disorders, body image, dieting and over exercising is part of their everyday lives, the focus in this study is on sportswomen- and men. (3)
Different types of eating disorders are historically described in the DSM-5. The two main types of eating disorders are Anorexia Nervosa and Bulimia, respectively 'distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat' and 'frequent episodes of binge eating followed by inappropriate behaviours such as self-induced vomiting to avoid weight gain'.(6) In this study, no diagnose is made for the participants. In stead, measurements of eating disorder pathology has been performed throughout a self-completion questionnaire which contain questions of the Nederlandse Vragenlijst Eetgedrag (NVE) and the Dutch version of the Eating Disorder Inventory-2 (EDI-2), written by professor dr. Tatjana van Strien.(7) The NVE is a Dutch questionnaire about eating behaviour. It is also known as the Dutch Eating Behaviour Questionnaire (DEBQ). The goals of the NVE are to determine whether someone tends to eat when in stress; there are external stimuli, someone is dieting or has the tendency for dis-inhibition.(8)
The full EDI-2 is part of the methods to determine whether a participant shows signs of eating disorder pathology. The EDI-2 can detect sub clinical forms of an eating disorder in risk groups such as athletes.(9) The EDI-2 will be explained in more detail in the methods section.
What is known and what is unknown
Even though a lot of research has been done about eating disorder related behaviour, possible treatments and possible risk factors, there is still a lot of discrepancy within literature whether an active sports-life can protect people from developing an eating disorder, or that the practice of (different types of) sports increase the risk of having this serious condition.(10) A lot of risk factors have been studied,...