A recent study shows a staggering percentage of cyclists are aware of eating disorders in female cycling.
Scan the abstract of the May 2022 paper published in BMC Sports Science, Medicine, and Rehabilitation to the conclusion, and the words jump from the page. The first sentence reads, “Female cyclists are at risk of developing Eating Disorders (EDs), and they are aware of this risk.” Concerns about Eating Disorders in female cycling and disordered eating (DE) in elite and recreational athletes are not new phenomena. The media’s obsession with fitness, weight, and body shape trickled down to general society long ago.
The detrimental physical and mental toll of the unhealthy preoccupation has shined a light on an issue that has flooded the female peloton for decades. ED and DE risk in female athletes, especially those participating in endurance sports, is estimated to be as high as 42 percent. More is known of the risk and prevalence than ever before as brave athletes step up to tell their stories.
Know Better, Do Better
So then, have we learned anything from the words of Maya Angelou when she says, “Do the best you can until you know better. Then when you know better, do better.”? The authors asked a large and diverse group of female cyclists a series of questions to find out. The results will make you wonder how we all could do better.
The study’s design is straightforward. The researchers asked 122 female cyclists a multi-faceted questionnaire, beginning with demographics, current weight, and ideal personal weight before moving on to the EAT-26.
Eating Attitudes Test for ED Risk
The Eating Attitudes Test (EAT-26) consists of 26 items to screen for and identify, not diagnose, eating disorder risk. The widely used standardized measure is a highly reliable and valid tool for recognizing symptoms and concerns characteristic of EDs. The EAT-26 consist of three subsets, dieting, bulimia and food preoccupation, and oral control.
- I am terrified about being overweight.
- I feel extremely guilty after eating.
- I feel that food controls my life.
- I like my stomach to be empty.
- I feel that others pressure me to eat.
Of the 122 athletes that completed the EAT-26, 39 scored above 20 points, indicating potential risk. That’s 32 percent who would benefit from further clinical evaluation. Another 28 percent scored slightly below, suggesting the risk of disordered eating. The average score was well above the 5-10 percent estimated in the general female population.
Do you want to know your EAT-26 score? Find it out here.
Disordered Eating Behavior
From there, the researchers assessed four items regarding Disorder Eating behavior based on aspects widely researched in the literature. The topics covered binge eating, self-induced vomiting, laxative or diuretics abuse, and overtraining. The athletes responded based on the frequency of behavior within the prior six months.
Example questions include:
- Gone on eating binges where you feel unable to stop?
- Ever made yourself sick (vomited) to control your weight or shape?
- Ever used laxatives, diet pills, or diuretics (water pills) to control your weight or shape?
- Exercised more than 60 minutes a day to lose or control your weight?
After analyzing the data, the authors determined that more than half (50 percent) of the female cyclists exhibited Disordered Eating behaviors. The group most commonly reported eating binges and overtraining, with 25 percent engaging in the behavior one or more times a week.
In addition, five percent of female cyclists noted losing more than 8 kg in the past six months, and 13 percent said they had received Eating Disorder treatment.
Eating Disorders in Female Cycling Awareness
In the next phase of the study, the scientists attempted to get an impression of the perception of the topic of Eating Disorders in athletes by asking five questions related to awareness. The self-designed and scored list is the first of its type in the literature and where the study gets interesting.
Examples of the questions include:
- Do you think the sport of women’s cycling is a risk factor for developing EDs?
- Were you ever strongly encouraged to lose weight to improve your performance?
- Do you know anyone with an ED?
- If yes, are they female cyclists?
- Did you feel uncomfortable while completing this questionnaire?
The results give a revealing look into the mentality of female cyclists regarding ED awareness. More than 80 percent felt their sport put them at greater risk of developing DE behaviors or an ED.
Ninety percent knew someone with ED, typically a fellow female cyclist, and the vast majority lost weight to improve their performance after being told to do so. Both are relevant trigger factors for the development of DE and ED.
They Knew Better But Didn’t Do Better
That’s not the most alarming or telling result. Of the cyclists that scored above the 20-point threshold on the EAT-26 (indicating potential ED risk), almost 90 percent answered “yes” to three of the five awareness questions.
The cyclists studied knew better, but they weren’t doing better.
The female cyclists at the most significant risk are aware of the problem with their actions but, in some cases, do it anyway. But why?
Conclusion: Eating Disorders in Female Cycling
That is the question at the throbbing heart of the ED debate in cycling. The study, others like it, and media reports on the topic tend towards more awareness of ED risk. Elite athletes’ mental and physical well-being is valued more than ever before, yet cyclists are under pressure to lose weight for performance. Moreover, the athletes themselves are well aware of the potentially devastating effects and know others who’ve suffered.
Prevention, early detection, and treatment of DE and ED are essential steps toward protecting the health and well-being of elite athletes. It’s not good enough to put the burden back on the athletes to look out for themselves.
Despite how much we know better and want to do better, the drive to be the best at the cost of our health is a price many elite athletes are willing to pay. It may not make ‘cents’ if you’re not in that situation. Now that we know better, more needs to be done better to support elite athletes.
Are athletes and the people that are supposed to be taking care of them doing better?
Comment below! Your fellow cyclists want to know.
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Semi-retired as owner and director of his private Orthopedic Physical Therapy practice after over 20 years, Chris is blessed with the freedom to pursue his passion for virtual cycling and writing. On a continual quest to give back to his bike for all the rewarding experiences and relationships it has provided him, he created a non-profit. Chris is committed to helping others with his bike through its work and the pages of his site.
In the summer of 2022, he rode 3,900 miles from San Francisco to New York to support the charity he founded, TheDIRTDadFund. His “Gain Cave” resides on the North Fork of Long Island, where he lives with his beautiful wife and is proud of his two independent children.
You will read him promoting his passion on the pages of Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. Chris is co-host of The Virtual Velo Podcast, too!