Behind the locker room door

We typically think of girls and young women in sports such as gymnastics, with its recognized focus on weight management, when we consider sports' role in eating disorders. But a study published in this month’s issue of the Journal of the American Dietetic Association indicates we might need to give added consideration to the effects sports are having on young males.

In this study, researchers at the University of Minnesota who have been following 4,746 Minneapolis-St. Paul teenagers as part of Project EAT (Eating Among Teens), surveyed teens who said they were in a sport or activity where it was important to stay a certain weight. Twenty percent of the males reported participating in sports emphasizing their weight. Perhaps surprisingly, that was more males subject to sports-related weight concerns, than females.

And in contrast to girls, where participation in weight-related sports activities rose with their family’s income level, among boys it was the reverse, with nearly half from low and low-middle income brackets.

The increased risks for eating disorders found among sports participants has been widely documented. The significance of these concerns was highlighted in an especially troubling finding among these growing teenagers. The researchers found that 17% of the young people, of both genders, involved in these sports activities were underweight — that’s considerably higher than the 3.3% of underweight kids among the general population.

As the researchers noted, adolescents can feel pressure to lose weight or maintain a certain weight due to the demands of the sport as well as society’s expectations of successful sports participants. They noted studies documenting that coaches, teammates, parents, and even a young participant’s drive to achieve, increase risks for unhealthful weight-control behaviors.

But the degree to which participating in these activities increased the risks for unhealthful weight-control behaviors among the young males was startling. Compared to those not engaged in sports, there was about a six-fold increase each in vomiting, laxative use and diuretic use in the past week among male participants. And they had a 3.7 times higher steroid usage and nearly 3 times more diet pill usage. Overall, more than 10% of the young male sports participants had engaged in some type of extreme weight control behavior during the past year. These significant associations remained despite their BMI, economic status, education level and other possible factors.

While the effect of sports participation in increasing the chances for such risky behaviors among the girls was less than the boys, the researchers noted it was mostly due to the higher prevalence of such weight-control behaviors among the general population of females regardless of if they were participating in sports. In fact, overall, about 17% of female sports participants as compared with 11.5% of nonparticipating girls had engaged in some extreme weight-control behavior during the past year.

The researchers did consider the seasonality of certain activities, which is why they looked at these behaviors over both the past week and year long periods, and the results were nearly the same. What was especially helpful about this study was that the researchers didn’t set out to pre-define what sports activities young people might feel pressure to control or lose weight, but let them define it based on their perception of weight pressure.

Although, as with any population study, they couldn’t untangle the associations to demonstrate causation — perhaps those more preoccupied with their weight are drawn into these sports activities, for example, rather than just the sports increasing the weight-controlling efforts — but this information can still serve as a helpful heads up to parents, teachers and healthcare providers to be especially on the alert for unhealthful efforts to control weight among these teens and help promote their body acceptance.