Reducing eating disorder risk among male athletes: A randomized controlled trial investigating the male athlete body project.
Perelman H, Schwartz N, Yeoward-Dodson J, Quinones IC, Murray MF, Dougherty EN, Townsel R, Arthur-Cameselle J, Haedt-Matt AA. Int J Eat Disord. 2022;55:193-206. doi 10.1002/eat.23665.
A program that addresses risk factors for eating disorders among male collegiate athletes can reduce drive for muscularity, decrease supplement use, and improve satisfaction with specific body areas.
Eating disorders cause long-term harmful physiological and psychological effects. Furthermore, relative energy deficiency in sport leads to multi-system dysfunction (e.g., low bone density, metabolic abnormalities) and limits the ability to continue sport participation. Female athletes with eating disorders are studied extensively, but research specific to preventing eating disorders among male athletes is lacking.
Perleman and colleagues conducted a randomized controlled trial with male collegiate athletes to determine if the Male Athlete Body Project (MABP) can reduce risk factors for eating disorders (e.g., body dissatisfaction, drive for muscularity body-ideal internalization, and muscle dysmorphia).
The researchers randomized 112 male athletes with a prior endorsement of body dissatisfaction from an NCAA Division II and an NCAA Division III university. A total of 79 participants met all intake requirements and completed the study. The participants were randomized into a MABP intervention group or an assessment-only group. The MABP content was modified from the Female Athlete Body Project to change sex-specific language (e.g., female/women to male/men) and “Female Athlete Triad” to “relative energy deficiency in sport”). All participants completed assessments at baseline to evaluate body dissatisfaction (including 5 subscales), muscle dysmorphia (including 6 subscales), drive for muscularity, and internalization of the muscular ideal. Members of the intervention group attended three sessions that focused on group discussion about eating disorders-related topics, goal setting, and role playing to practice addressing body shaming and “fat talk”. The participants then repeated all assessments after completing the intervention and four weeks later.
Overall, the intervention group had significant reductions in drive for muscularity, decreased supplement use, and improved satisfaction with specific body areas immediately post-intervention and at 4-week follow-up compared to the control group.
Male athletes are at unique risk of developing an eating disorder, especially an athlete with a high drive for muscularity or prioritizing body appearance over sport performance. Clinicians should observe male athletes for these behaviors and refer to specialized care when necessary. Future research should continue to evaluate the effectiveness of the MABP in reducing eating disorder risk and relative energy deficiency in sport in male athletes. A major limitation of this study is that 87% of participants were white. Therefore, these results cannot be generalized to other athletes.
Clinicians should consider implementing components of the MABP with male athletes, especially those in high-risk sports.
Questions for Discussion
Does your organization have an eating disorder intervention specific to male athletes? If so, has it been effective to prevent or treat eating disorders in this population?
Eating Disorders in Adolescents
The Man in the Mirror: Disordered Eating and Body Image among Males in Weight-Intensive Sports
The Male Athlete Triad – A Consensus Statement From the Female and Male Athlete Triad Coalition
Many NCAA Clinicians Fail to Screen Mental Health
A Tale of Two Runners: A Case Report of Athletes’ Experiences with Eating Disorders in College
Two voices: Recovery from Disordered Eating as told by an Elite Male Athlete and his Sports Nutritionist.
Written by: Rebecca Rodriguez
Reviewed by: Jeffrey Driban