Who Else At the Game Is at Risk?

The problem of eating disorders among competitive athletes is well known, but you have only to look to the sidelines to find undetected disordered eating. The groups affected are the auxiliary unit groups, including color guards, dance line members, dancers and majorettes. In a study among auxiliary unit members at three southern universities, the prevalence of disordered eating was nearly 30% (J Athletic Training 2009; 44:418).

Certified athletic trainer Toni M. Torres-McGehee, PhD and colleagues recently reported that, just as competitive athletes, collegiate auxiliary unit members often have disordered eating patterns. And, because these students are not members of the National Collegiate Athletic Association (NCAA), which promotes screening for eating disorders, their disordered eating behaviors often are overlooked. Like most performers and elite athletes, the color guards, dancers, and majorettes often face pressures to be thin.

Dr. Torres-McGehee and colleagues screened 101 female students (35 in the color guard, 47 dance line participants, and 19 majorettes) with the Eating Attitudes Test (EAT-26) and the Figural Stimuli Survey, which tests body dissatisfaction. The Figural Survey consists of 9 body silhouettes representing body mass indexes from 18.3 to 45.4 kg/m2. The students were asked to pick the silhouettes that represented their appearance in normal clothing, then how they would prefer to look in normal clothing; and their appearance in performance costumes and how they would prefer to look in their performance costumes. The researchers also took anthropometric measurements from all study participants and used a questionnaire to ask about ethnicity, dance background, menstrual cycle function, and years dancing and weight requirements.

More than a fourth were affected

Based on the results from the EAT-26, the investigators estimated a 29.7% prevalence rate of disordered eating among the auxiliary unit members. The test results also revealed that 21% of the participants used purgatives, and 14% vomited to control their weight or shape. As for irregular menses, 15.8% of the young women reported having irregular periods and 12.5% were amenorrheic. The group at greatest risk for disordered eating was majorettes, followed by the color guard and the dance line. The color guard members reported the greatest frequency of binge eating (20%) and vomiting (14.3%), whereas majorettes reported the highest frequency of using laxatives or diet pills (26.3%).

The Figural Stimuli Silhouette scores indicated that respondents perceived themselves as heavier than the silhouettes corresponding with their actual body mass indexes (BMIs). Thus, the study participants felt they should look smaller when wearing their costumes or uniforms, which explained the association between ideal BMI in normal clothing and in performance attire and the EAT-26 total scores. Body image and body dissatisfaction may be affected by performance uniforms that include 1-piece form-fitting uniforms with or without open midriffs. Thus, regardless of what the student was wearing, her perceived body image was different from the ideal body image.

The authors believe their findings validate concerns that collegiate auxiliary unit members may have an unacceptable prevalence of disordered eating, and also highlight the need to address unhealthy weight-management behaviors among these students. Because mandatory medical examinations do not apply to auxiliary members, unlike athletes, the authors call for development of screening programs that would help identify such non-athletes at risk for disordered eating.