The intersection of sport type and gender in patterns of disordered eating

doi:10.21203/rs.3.rs-3983269/v1

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The intersection of sport type and gender in patterns of disordered eating

https://doi.org/10.21203/rs.3.rs-3983269/v1

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published 05 Aug, 2024

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Although previous research has linked disordered eating to sports involvement, more recent research suggests that athleticism may protective against disordered eating. Due to inconsistent results on how physical activity affects disordered eating and limited research comparing sport types across weight control behaviours, we aimed to validate sport categorization across disordered eating components in men and women. In this online study, 209 men and 539 women completed questionnaires to assess components of disordered eating and overall sports participation. We found different predictive relationships between participation in different types of sports and disordered eating attitudes, behaviours, and cognitions across genders. For women, purging and restricting eating were associated with participation in ball game sports. Further, a focus on muscle building was associated with ball games and weight class sport participation. For men, body dissatisfaction and excessive exercise were associated with weight class sport participation. Cognitive restraint and muscle building were related to aesthetic sport participation. Purging was associated with aesthetic and weight class sports, whereas restricting eating was related to weight class and ball game sports. These inconsistencies suggest the need for further research to fully elucidate the relationship between participation in different types of sports and components of disordered eating.

Biological sciences/Psychology/Human behaviour

Health sciences/Health care/Weight management

Disordered eating is defined as “a spectrum between normal eating and an eating disorder and may include symptoms and behaviours of eating disorders, but at a lesser frequency or lower level of severity” [1, para. 1]. Disordered eating attitudes and behaviours range between eating (restricting eating, binge eating, purging), exercise (excessive exercise and muscle building), and body concerns (body dissatisfaction, cognitive restraint, negative attitudes toward obesity). These components, as described by experts in disordered eating research [2, p. 86] in Table 1.

Table 1

*Description of Disordered Eating Components* [2, p. 86]
Disordered Eating Component	Description
Body dissatisfaction	“Dissatisfaction with one’s weight and/or shape.”
Restricting eating	“Concrete efforts to avoid or reduce food consumption.”
Excessive exercise	“Physical exercise that is intense and/or compulsive.”
Purging	“Self-induced vomiting, laxative use, diuretic use, and diet pill use.”
Binge eating	“Ingestion of large amounts of food and accompanying cognitive symptoms.”
Cognitive restraint	“Cognitive efforts to limit or avoid eating, whether or not such attempts are successful.”
Muscle building	“Desire for increased muscularity and muscle building supplement use.”
Negative attitudes toward obesity	“Negative attitudes toward individuals who are overweight or obese.”

In the past, disordered eating has been linked to athleticism or sports affiliation [3]. These links are especially relevant for high-level weight-sensitive sports such as dance [4]. Recently, however, research in a general population of young adults indicated that athleticism was not significantly associated with disordered eating [5] and may serve as a protective factor in college athletes [6]. Further, some researchers argue that lower levels of physical activity could indirectly lead to the development of detrimental weight regulation behaviours, such as dieting and self-induced vomiting [7].

Researchers have attempted to examine how different types of sport may influence the development of disordered eating. For example, some researchers have focused on the impact of engaging in lean sports, which emphasize body composition, on, the development of disordered eating in women [8, 9]. Lean-weight sports include cheer, swimming, volleyball, and cross country running, whereas non-lean-weight sports consist of basketball, softball, soccer, and golf [10]. These studies serve to inform on preventive interventions in women playing sports [10] because female athletes are 14–19% more at risk for engaging in disordered eating than their male counterparts [11]; however, this sports categorization does not encompass muscular-driven disordered eating attitudes and behaviours in men or women.

Although research has indicated that athleticism in men increases the risk of disordered eating behaviours, including binge eating, vomiting, and using laxatives, diuretics, and use of diet pills [12], few studies have used male samples to further examine the relationship between involvement in specific sports and components of disordered eating [13]. The studies that do exist have several limitations, including methodological issues such as single-source sampling and using questionnaires with no pre-established psychometric properties [14]. One proposed sport categorization is to compare lean versus non-lean sports; however, this does not adequately represent gender differences as women tend to have a greater drive for thinness whereas men have a higher drive for muscularity [15], which could impact choice of activities.

Petrie and their colleagues proposed a sport categorization that is inclusive to all genders: endurance (cross-country, track, swimming), aesthetic (cheerleading, diving), weight dependent (wrestling), ball game (basketball, baseball, soccer, volleyball, hockey, lacrosse), power (football, downhill skiing), and technical (fencing, golf) sports [13]. Although this categorization has potential, too few participants were included in the aesthetic and weight-dependent sport categories to make statistically meaningful comparisons; thus, more research is needed to examine this categorization in a sample that includes an adequate number of males and females [13].

Due to the inconsistent results regarding the role of physical activity involvement on disordered eating in men and women [10], as well as the lack of research comparing sport type across specific weight control behaviours [13], the main objectives of this study were to: a) corroborate existing sport categorization across disordered eating components in a sample of men and women, and b) further close the gap in the literature by examining disordered eating attitudes and behaviours in men and women separately.

Our first research objective examined the relationships between participation in (yes vs. no) and frequency of physical activity. We hypothesized that active respondents who engage more frequently in physical activity would have BMIs within the normal weight range and greater levels of some components of disordered eating. The second research objective explored whether the type of sport influenced the prevalence of disordered eating components. The sports that participants reported engaging in were categorized previous literature [e.g., 10, 13] and, when reported activities were not included in previous categorizations, though deductive reasoning. Our final sports categories included aesthetic, ball games, endurance, and weight class activities. We hypothesized that weight-sensitive sports, such as aesthetic and weight-class sports, would be associated with greater disordered eating symptoms. Although we did not have a hypothesis about gender differences, the effect of gender was also included in the analyses of this research objective.

Participants

In total, 749 participants (ages 16–62) completed the online questionnaires, with 539 females (M_age = 27.98, SD = 10.94) and 209 males (M_age = 28.26, SD = 9.36). Based on a yes/no question, the participants were categorized according to whether they were physically active or inactive to examine differences in BMI and across components of disordered eating. Further, the participants listed the sports they participated in, which were subsequently categorized into aesthetic, ball games, endurance, and weight class sports [10, 13].

Measures

Demographic Questionnaire

The demographic questionnaire (internally generated) included questions to collect information about age, gender (“What is your gender?”), weight, height, and sports affiliation (“Do you participate in any sports and/or physical activity?” and “What sports and/or physical activity do you participate in?”). We asked participants, on average, how many days a week they participated in sport as a measure of sport frequency.

Eating Pathology Symptoms Inventory

The Eating Pathology Symptoms Inventory (EPSI) [16] measures disordered eating attitudes and behaviours within the past month. The EPSI is divided into eight subscales: Body Dissatisfaction (e.g., “I did not like how clothes fit the shape of my body;” α = .87), Binge Eating (e.g., “I ate until I was uncomfortably full;” α = .88), Cognitive Restraint (e.g., “I counted the calories of foods I ate;” α = .72), Purging (e.g., “I used diet pills;” α = .89), Restricting (e.g., “I skipped two meals in a row;” α = .86), Excessive Exercise (e.g., “I exercised to the point of exhaustion;” α = .86), Negative Attitudes Toward Obesity (e.g., “I felt that overweight people are lazy;” α = .88), and Muscle Building (e.g., “I thought my muscles were too small;” α = .79). The 45 items are answered using a 5-point Likert scale ranging from 0 (never) to 4 (very often). The EPSI has good psychometric qualities in non-clinical samples of both men and women [17]. The EPSI was derived from the DSM-5 and has indicated high convergent and divergent validity across gender and weight status [16].

Procedure

This study was approved by the University of XX Research Ethics Board (REB File #056-2020). The procedure follows all guidelines outlined by the Canadian Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2) and the University of XX research ethics board. Participants were recruited from social media via Facebook ( www.facebook.com ) and from SONA, an online tool facilitating students enrolled in psychology courses at the University of XX to participate in research. Social media participants had the opportunity to enter a draw prize for one of six $25 Amazon gift cards. The University of XX participants received bonus points applicable to selected psychology courses. Prior to completing the questionnaire package, all participants read a description of the study and provided their informed consent. After providing consent, participants completed the questionnaires through Qualtrics ( www.qualtrics.com ). In this study, the demographic questions were presented first, followed by the randomized questionnaire package.

Prior to data analyses, the assumptions underlying the statistical analyses were examined. The linearity of the data distribution was confirmed using scatter plots, and the normality of data distribution was evaluated based on skewness and kurtosis, which indicated a normal distribution (skewness < |1.5|; kurtosis < |3.0|; The extreme outliers (> |3| SD) were winsorized. The assumption of homogeneity of variance was examined using Levene’s homogeneity test for independent samples t-tests. The assumption of multicollinearity was assessed for each linear regression. The levels of the variance inflation factor and the predictors’ tolerance were appropriate, below 10 and above .20, respectively [18].

Physical Activity versus Inactivity

Compared to inactive participants, individuals who indicated participating in sports had lower BMIs and greater levels of Cognitive Restraint, Excessive Exercise, and Muscle Building with small to medium effect sizes based on previously established guidelines [19] of small (d = .20), medium (d = .50), and large (d = .80) effect sizes (see Table 2). Greater frequency of physical activity (i.e., more days/week participating in sport) was associated with lower levels of Body Dissatisfaction (r = − .16, p < .001), Purging (r = − .19, p < .001), Restricting (r = − .20, p < .001), and Binge Eating (r = − .17, p < .001), as well as higher levels of Cognitive Restraint (r = .16, p < .001) and Excessive Exercise (r = .38, p < .001).

Table 2

*Means of Active and Inactive Participants on Disordered Eating*
	Active		Inactive
	M	SD	M	SD	t	df	p	Cohen’s d
BMI	25.20	5.97	27.11	8.53	-2.89	268.48	.004	.26
Body Dissatisfaction	13.82	6.72	14.65	6.78	-1.47	727	.142	.12
Cognitive Restraint	5.91	2.90	4.67	3.02	5.04	730	< .001	.42
Purging	3.30	4.96	3.21	5.20	0.22	730	.825	.02
Restricting	7.66	5.51	8.40	5.57	-1.60	730	.109	.13
Excessive Exercise	8.75	4.88	4.74	4.53	10.00	728	< .001	.81
Negative Attitudes Toward Obesity	5.83	4.81	6.02	4.85	-0.47	729	.639	.04
Binge Eating	12.39	6.87	12.88	6.80	-0.85	728	.398	.07
Muscle Building	4.50	4.12	3.80	4.18	2.05	729	.041	.17

Sport Type Comparisons

Table 3 presents the number of participants who reported engaging in different activities. Participants engaged in a variety of different activities, with most participants reporting activities in multiple categories; the most popular sport reported by participants was walking, followed by running, yoga, weightlifting, and cycling. Overall, participation in sports in more than one of the categories, regardless of their type, was associated with higher levels of Cognitive Restraint (r = .16, p < .001), Excessive Exercise (r = .34, p < .001), and Muscle Building (r = .08, p = .041). Participation in multiple types of sport was not associated with Body Dissatisfaction, Binge Eating, Purging, Restricting, or Negative Attitudes towards Obesity. Independent samples t-tests revealed that inactive participants had a significantly higher BMI (M = 27.11 kg/m²), which fell within the overweight range (BMI = 25 kg/m²–29.9 kg/m²), than respondents who played aesthetic, t(423) = 3.25, p = .001, d = .31, ball game, t(438) = 3.67, p < .001, d = .34, and endurance sports, t(645) = 2.91, p = .004, d = 0.23 (see Table 3).

Table 3

*All Sports Reported by Participants*
Sport	Total	Men		BMI
	N (%)	N(%)	N(%)	M	SD
Aesthetic	232 (31.0%)	20 (9.6%)	209 (38.8%)	24.87	5.55
Yoga	183	6	175	24.70	5.41
Gymnastics	22	5	17	21.76	3.40
Horseback riding/racing	19	7	12	26.01	6.64
Figure skating	15	4	10	25.38	5.26
Dancing	12	0	11	24.57	5.71
Pilates	4	0	4	22.86	2.27
Aerobics	3	0	3	29.54	5.31
Zumba	3	0	3	28.77	2.67
Cheerleading	2	0	2	25.68	0.25
Ball game	246 (32.9%)	106 (50.7%)	138 (25.6%)	24.63	5.60
Basketball	91	60	31	24.26	6.06
Volleyball	50	5	44	25.56	5.66
Tennis	48	24	24	24.14	6.14
Baseball	40	24	16	24.47	5.59
Hockey	36	10	26	24.72	4.73
Golf	28	16	12	24.96	5.81
Football	28	21	8	24.00	5.33
Rugby	24	11	12	25.35	4.88
Soccer	15	3	12	25.96	7.84
Field hockey	6	0	6	24.67	5.51
Badminton	2	0	2	27.28	8.07
Curling	2	1	1	27.34	5.57
Endurance	457 (61.1%)	114 (54.5%)	337 (62.5%)	25.38	6.15
Walking	352	72	275	25.47	5.96
Running	231	74	156	24.49	5.21
Cycling	131	51	78	24.37	4.91
Swimming	22	1	20	25.95	8.90
High-intensity interval	15	0	15	27.19	10.55
Skiing	12	1	10	25.69	5.18
Hiking	6	0	6	24.51	6.43
Snowshoeing	6	0	6	23.33	1.48
Snowboarding	5	0	5	24.03	1.27
Cross-country skiing	4	0	4	27.26	7.27
CrossFit	3	2	1	25.95	3.03
Kayaking	3	1	2	32.06	11.94
Low-impact cardio	2	0	2	24.46	0.61
Weight class	184 (24.6%)	52 (24.9%)	128 (23.7%)	25.81	6.00
Weightlifting	145	37	105	26.05	6.11
Boxing	41	14	26	25.21	5.46
Martial arts	11	5	5	26.01	6.23
Kickboxing	2	0	2	27.02	1.66
Note. The total scores in each category do not correspond to the sum of the individual sports because participants could select more than one sport within a category. Sports with n = 1 were not included as individual sports in the table but were included in the total for each category. In aesthetic sports: ballet, pole dancing. In ball games: netball, racquetball, ringette, softball, ultimate frisbee. In endurance: rollerblading, rowing, skateboarding, sailing.

Multiple response crosstabulations were calculated because the participants could indicate that they participated in more than one sport, resulting in respondents who are included in more than one sports category [20]. For this purpose, the EPSI subscales were dichotomized according to their first and third quartiles, indicating lower and higher subscale scores (see Table 4). Most aesthetic sports participants had higher Body Dissatisfaction scores, whereas most ball game, endurance, and weight class participants had lower Body Dissatisfaction. In all sports categories, the majority of participants had higher Cognitive Restraint scores. Sports category membership was not associated with higher levels of Purging, as most participants reported lower scores on this subscale. Unexpectedly, the majority of ball game players had higher Restricting and Negative Attitudes Toward Obesity scores; in contrast, the opposite was true for all other sports categories. Engaging in any type of sport was related to greater Excessive Exercise. Lower scores in Binge Eating were only found in participants engaged in endurance sports. Most ball game and weight class participants reported higher Muscle Building scores, and most aesthetic and endurance athletes had lower scores.

Table 4

*Crosstabulations of Dichotomized Disordered Eating Components (quartile cutoff scores) Across Sports Categories*
DE component	Sports categories
	Aesthetic		Ball game		Endurance		Weight class
	n	%	n	%	n	%	n	%
Body Dissatisfaction
Low scores (≤ 9)	57	47.11	72	58.54	127	52.70	52	52.00
High scores (≥ 19)	64	52.89	51	41.46	114	47.30	48	48.00
Cognitive Restraint
Low scores (≤ 3)	42	35.90	54	46.56	97	42.36	30	33.71
High scores (≥ 8)	75	64.10	62	53.45	132	57.64	59	66.29
Purging
Low scores (≤ 0)	112	67.47	95	51.91	223	66.37	98	72.06
High scores (≥ 5)	54	32.53	88	48.09	113	33.63	38	27.94
Restricting
Low scores (≤ 3)	74	57.81	49	40.83	135	54.88	62	60.19
High scores (≥ 12)	54	42.19	71	59.17	111	45.12	41	39.81
Excessive Exercise
Low scores (≤ 3)	33	27.27	37	27.01	75	32.19	14	13.33
High scores (≥ 11)	88	72.73	100	72.99	158	67.81	91	86.67
Negative Attitudes Toward Obesity
Low scores (≤ 2)	86	60.56	67	47.18	140	52.83	52	50.49
High scores (≥ 9)	56	39.44	75	52.82	125	47.17	51	49.51
Binge Eating
Low scores (≤ 7)	61	47.66	55	45.83	120	52.17	41	46.59
High scores (≥ 17)	67	52.34	65	54.17	110	47.83	47	53.41
Muscle Building
Low scores (≤ 1)	56	52.34	40	31.01	121	51.49	17	19.77
High scores (≥ 7)	51	47.66	89	68.99	114	48.51	69	80.23
Note. The values represent the number of participants within each sport category. The highest n for each sport category is bolded. DE = disordered eating.

Gender Differences Across Sport Type

A series of linear regressions were conducted to determine if sport type membership (dummy coded) predicted disordered eating variables above and beyond the variance accounted for by other sport type membership and no membership. The series of linear regressions were calculated in the women-only (see Table 5) and men-only samples (see Table 6). Each regression consists of one block with aesthetic, ball game, endurance, and weight class sports as the predictors (0 = does not participate in that sport type; 1 = does participate in that sport type). The predicted criterion consisted of the EPSI subscales: Body Dissatisfaction, Cognitive Restraint, Purging, Restricting, Excessive Exercise, Negative Attitudes Toward Obesity, Binge Eating, and Muscle Building.

In women, sport type significantly accounted for significant variance in the following disordered eating components: Cognitive Restraint, F(4, 523) = 7.43, p < .001, R² = 0.05; Purging, F(4, 523) = 3.97, p = .004, R² = .03; Restricting, F(4, 523) = 3.58, p = .007, R² = .02; Excessive Exercise, F(4, 521) = 37.01, p < .001, R² = .22; and Muscle Building, F(4, 522) = 13.68, p < .001, R² = .10. In contrast, sport type did not statistically account for variance in Body Dissatisfaction, F(4, 521) = 1.37, p = .244, R² = .01, Negative Attitudes Toward Obesity, F(4, 523) = 0.69, p = .595, R² = .00, and Binge Eating, F(4, 522) = 0.53, p = .533, R² = .00. The most at-risk sport type was ball game, which emerged as a statistically significant predictor of Purging, Restricting, Excessive Exercise, and Muscle Building. Weight-class women athletes were more likely to engage in Cognitive Restraint, Excessive Exercise, and Muscle Building. Women participating in endurance sports tended to engage in Cognitive Restraint and Excessive Exercise. Participation in all sports categories significantly predicted Excessive Exercise. None of the sport types significantly predicted Body Dissatisfaction, Negative Attitudes Toward Obesity, and Binge Eating.

Table 5

Linear Regressions of Sport Type Membership Predicting Disordered Eating in Women
Sport type	Body Dissatisfaction
	B	SE B	t	p
Aesthetic	-1.00	0.50	-1.51	.131
Ball game	.80	0.68	1.19	.235
Endurance	− .32	0.69	-0.47	.639
Weight class	.90	0.70	1.28	.200
	Cognitive Restraint
	B	SE B	t	p
Aesthetic	0.48	0.08	1.64	.103
Ball game	0.18	0.03	0.60	.548
Endurance	0.64	0.10	2.06	.040
Weight class	0.91	0.13	2.90	.004
	Purging
	B	SE B	t	p
Aesthetic	-0.41	0.43	-0.93	.350
Ball game	1.72	0.45	3.86	< .001
Endurance	0.12	0.45	0.27	.790
Weight class	0.06	0.46	0.14	.891
	Restricting
	B	SE B	t	p
Aesthetic	-0.57	0.56	-1.02	.310
Ball game	1.83	0.58	3.18	.002
Endurance	-1.08	0.58	-1.85	.064
Weight class	0.08	0.60	0.14	.888
	Excessive Exercise
	B	SE B	t	P
Aesthetic	1.14	0.45	2.54	.011
Ball game	1.34	0.46	2.89	.004
Endurance	1.63	0.47	3.47	< .001
Weight class	3.70	0.48	7.72	< .001
	Negative Attitudes Toward Obesity
	B	SE B	t	P
Aesthetic	-0.60	0.47	-1.28	.202
Ball game	0.37	0.49	0.77	.442
Endurance	0.05	0.49	-0.09	.926
Weight class	0.41	0.50	0.81	.416
	Binge Eating
	B	SE B	t	P
Aesthetic	-0.17	0.70	-0.24	.809
Ball game	0.73	0.72	1.03	.305
Endurance	-0.41	0.73	-0.56	.574
Weight class	0.67	0.74	0.90	.366
	Muscle Building
	B	SE B	t	P
Aesthetic	0.15	0.35	0.42	.675
Ball game	1.15	0.36	3.25	.001
Endurance	-0.35	0.36	-0.96	.336
Weight class	2.22	0.37	6.05	< .001
Note. Statistically significant predictors are presented in boldface

In men, sport type significantly accounted for variance in the following: Body Dissatisfaction, F(4, 196) = 1.75, p = .141, R² = .04; Cognitive Restraint, F(4, 197) = 3.00, p = .020, R² = .06; Purging, F(4, 197) = 7.03, p < .001, R² = .13; Restricting Eating, F(4, 197) = 9.31, p < .001, R² = .16; and Excessive Exercise, F(4, 197) = 3.09, p = .017, R² = .06. Conversely, sport type did not statistically account for variance in Negative Attitudes Toward Obesity, F(4, 196) = 0.57, p = .684, R² = .01, Binge Eating, F(4, 196) = 1.32, p = .263, R² = .03, and Muscle Building, F(4, 197) = 1.98, p = .099, R² = .04. Men who engaged in aesthetic sports were at a higher risk of engaging in Cognitive Restraint, Purging, and Muscle Building. Men who engaged in weight-class sports tended to have higher Excessive Exercise but lower Body Dissatisfaction and Purging. Men ball players tended to have greater levels of Restricting. Endurance sports were not a significant predictor of any disordered eating component. None of the sport types significantly predicted Negative Attitudes Toward Obesity and Binge Eating.

Table 6

Linear Regressions of Sport Type Membership Predicting Disordered Eating in Men
Sport type	Body Dissatisfaction
	B	SE B	t	p
Aesthetic	1.30	1.46	0.89	.374
Ball game	-0.29	0.94	-0.30	.761
Endurance	-0.29	1.00	-0.29	.771
Weight class	-2.38	1.02	-2.34	.021
	Cognitive Restraint
	B	SE B	t	P
Aesthetic	1.84	0.65	2.84	.005
Ball game	-0.34	0.41	0.81	.418
Endurance	0.59	0.44	1.33	.184
Weight class	-0.05	0.45	-0.11	.915
	Purging
	B	SE B	t	P
Aesthetic	4.20	1.40	3.00	.003
Ball game	0.91	0.90	1.01	.314
Endurance	-1.18	0.96	-1.23	.220
Weight class	-3.98	0.98	-4.08	< .001
	Restricting
	B	SE B	t	P
Aesthetic	1.53	1.14	1.34	.182
Ball game	1.45	0.73	1.99	.048
Endurance	-0.04	0.78	-0.05	.961
Weight class	-4.41	0.79	-5.56	< .001
	Excessive Exercise
	B	SE B	t	P
Aesthetic	1.19	1.16	1.03	.304
Ball game	0.83	0.74	1.12	.264
Endurance	0.36	0.79	0.45	.652
Weight class	2.01	0.80	2.49	.013
	Negative Attitudes Toward Obesity
	B	SE B	T	P
Aesthetic	0.35	1.15	0.30	.761
Ball game	-0.91	0.74	-1.23	.218
Endurance	0.57	0.79	0.73	.467
Weight class	-0.69	0.80	-0.87	.388
	Binge Eating
	B	SE B	T	P
Aesthetic	1.45	1.59	0.91	.362
Ball game	0.39	1.02	0.38	.703
Endurance	-2.13	1.09	-1.95	.052
Weight class	-0.56	1.11	-0.50	.615
	Muscle Building
	B	SE B	T	p
Aesthetic	2.50	1.11	2.25	.026
Ball game	0.03	0.71	0.04	.966
Endurance	-1.42	0.76	-1.88	.062
Weight class	0.69	0.77	0.89	.375
Note. Statistically significant predictors are presented in boldface

The scarce literature that includes contradictory findings demonstrates the importance of further understanding the role of physical activity involvement on disordered eating in adult men and women, comparing sport type across specific disordered eating behaviours and attitudes [10, 13]. Overall, in this study, physically active participants had higher levels of cognitive restraint, excessive exercise, and muscle building. Further, our results indicated that increase exercise frequency is associated with some, but not all, components of disordered eating; increased exercise frequency was associated higher cognitive restraint and excessive exercise but lower body dissatisfaction, purging, restricting, and binge eating. Thus, our results partially confirm research suggesting that disordered eating attitudes and behaviours are not associated with [5]. Given that increased exercise was negatively correlated with many behaviours associated with unhealthy eating such as purging, restricting, and binge eating, the current results partially supportive the role of exercise as a protective factor against disordered eating [see 6].

In the current study, individuals who engaged in sports or physical activity had an average BMI of 24.96 kg/m², within the healthy weight range. In contrast, participants who reported not engaging in sports or physical activity had a significantly greater average BMI of 27.11 kg/m², considered overweight. In sum, the present findings suggest that being active in a sport is generally associated with higher levels of excessive exercise, which was captured in this study by items pertaining to engaging in strenuous exercise nearly every day and to the point of exhaustion; however, it was also related to a healthier BMI. The positive outcomes associated with physical activity are essential to overall health; however, maintaining a positive balance can be challenging because it may lead to adverse outcomes such as disordered eating, especially excessive exercise. Following recommended guidelines, such as 150 minutes of moderate-intensity aerobic activity and two days of muscle-strengthening activity per week [27], can improve physical and psychological well-being while preventing excessive exercise.

Due to the multiple burdens associated with all eating pathologies, this study aimed to corroborate existing sports categorization in a sample of men and women across disordered eating components and further mend the gap in the literature on disordered eating attitudes and behaviours in men. Types of sports had different predictive relations with disordered eating attitudes, cognitions, and behaviours across genders (see Table 7). For women, purging and restricting eating were more strongly associated with being involved with a ball game sport compared with participation in other sports. Further, for women, muscle building was more associated with ball games and weight class sports. Each sport type significantly contributed to the variance in excessive exercise; thus, no sports affiliation is not indicative of excessive exercise. Although sport type, as a whole, predicted cognitive restraint, individual sport types did not uniquely contribute to the variance in this variable. For men, body dissatisfaction and excessive exercise were associated with participating in a weight class sport. Cognitive restraint and muscle building were more related to aesthetic sports than other sports. Purging was associated with aesthetic and weight class sports, whereas restricting eating was related to the latter and ball game sports.

Table 7

*Summary of Predictive Relations with Disordered Eating Components Across Genders*
Disordered eating component	Sports Activity
	Men	Women
Body dissatisfaction	Weight class
Restricting eating	Ball games, Weight class	Ball games
Excessive exercise	Weight class	Aesthetic, Ball games, Endurance, Weight class
Purging	Aesthetic, Weight class	Ball games
Binge eating
Cognitive restraint	Aesthetic	Endurance, Weight class
Muscle building	Aesthetic	Ball games
Negative attitudes toward obesity

Previous literature supports that women who play ball games and men who engage in weight-class sports are more likely to engage in disordered eating attitudes, behaviours, and cognitions [21]. Although participating in any sport was consistently associated with most components of disordered eating according to the overall predictive models, the present findings suggest that, when comparing the relative contribution of each type of sport, differences in sport type was not a reliable predictor across genders. With the possible exception of men who engage in aesthetic sports, women involved in sports were more at risk for developing disordered eating attitudes and behaviours compared to men engaged in sports. This finding is consistent with well-documented prevalence rates of disordered eating, which are higher in women compared to men [22].

When comparing each sport category without accounting for gender, higher body dissatisfaction was found in those who played aesthetic sports, whereas higher body dissatisfaction and muscle building were related to participation in endurance sports. Restricting and negative attitudes towards obesity were higher among ball game players compared to other sports. Cognitive restraint and excessive exercise were related to participation in all sport categories; binge eating was related to participation in all sports, except for endurance sports. Altogether, ball game sports had prevalence proportions in favour of disordered eating more frequently than other sports categories. Aesthetic and weight-class sports were associated with greater disordered eating on half of the subscales, whereas endurance sports were only once related to a higher disordered eating score.

These findings are only partially consistent with the two studies used to model our sports categorization to compare disordered eating rates across sport types. In the first study [10], compared to non-lean sports, such as ball games, lean sports, including aesthetic and endurance sports, were associated with greater levels of disordered eating. In the second study [13], sport type (i.e., endurance, ball game, and power) was not associated with disordered eating. The finding that people who were physically active tended to have greater disordered eating tendencies compared to inactive individuals is consistent with previous literature [23]; however, even in a sample including males and females, sports emphasizing leanness and those that were weight-dependent (e.g., wrestling) had a higher risk of disordered eating than ball game sports.

In contrast, Rosendahl and colleagues [24] found that non-athletes are at greater risk of disordered eating than athletes and that leanness sports (endurance, aesthetic, weight class, and antigravitation sports) were associated with greater disordered eating compared to non-leanness sports (power, technical, ball game sports) in boys but not girls; however, they were using an adolescent sample. Some researchers concluded that men in a weight-sensitive sport are especially susceptible to disordered eating compared to ball games relative to women [24, 25, 26]. The discrepancies among the findings in the existing literature could be the result of differences in samples and/or sport categorization (e.g. some studies classified endurance as weight-sensitive sports [e.g., 24], whereas others did not [e.g., 26]). The inconsistent results across studies imply the presence of unaccounted variables. For example, although some studies link ball game sports with increased disordered eating, including this one, others suggest a decrease. Therefore, additional factors such as the level of competitiveness warrant further investigation.

A few limitations to the present study were noted. First, the data was collected at the beginning of the COVID-19 pandemic (January–April 2020), which significantly impacted the general population’s eating habits and sport participation [28, 29]. Second, the non-probability, cross-sectional sampling does not allow inferences about causality. Third, since participants could choose multiple responses, finding an appropriate inferential analysis to examine differences among sport types was challenging. A series of linear regressions were conducted to determine if sport type membership (dummy coded) predicted disordered eating variables above and beyond the variance accounted for by other sport type membership and no membership.

Due to only partially consistent findings, future research is needed to corroborate further existing sports categorization in a sample of men and women across disordered eating components. Examining the motivation to engage in disordered eating could elucidate whether athletes engage in such attitudes and behaviours due to body appearance or functionality, as seen in a study with an adolescent sample [30].

This study illustrates the complex relationship between sports affiliation and disordered eating in men and women. The findings provide insight into the recommended guidelines for physical activity in the general population, that is, to focus on endurance-type sports at a regulated frequency. The results inform us of the demographics of participants in multiple sports. For individuals who want to improve their physical health but are uncertain as to where to start, the current findings indicate which sport may match your demographic characteristics, such as gender and BMI.

Availability of supporting data

Supporting data is available from the corresponding author.

Availability of supporting data

Supporting data is available from the corresponding author.

Competing interests

We have no competing interests

Funding

Funding was not received for this project.

Author Contribution

This data in this paper was collected as part of D.B.'s masters thesis. L.B. is her primary graduate supervisor. D.B. and L.B. contributed to the development of the project and the current data analytic plan. D.B. wrote the initial draft and conducted the data analysis. L.B. edited drafts of the manuscript. Both authors reviewed the final manuscript.

Acknowledgements

We would like to thank Dr. Lilly Both and Dr. Bryn Robinson for serving on Danie Beaulieu’s graduate supervisory committee. Dr. Janine Olthuis provided invaluable comments that informed the presentation of the current results.

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No competing interests reported.

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The intersection of sport type and gender in patterns of disordered eating

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Journal Publication

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Abstract

Introduction

Methods

Participants

Measures

Demographic Questionnaire

Eating Pathology Symptoms Inventory

Procedure

Results

Physical Activity versus Inactivity

Sport Type Comparisons

Gender Differences Across Sport Type

Discussion

Availability of supporting data

Declarations

Competing interests

Funding

Author Contribution

Acknowledgements

References

Additional Declarations

Status:

Journal Publication

Version 1