Function Over Form: A Longitudinal Study of Predictors and Mediation Pathways for Disordered Eating in Elite Athletes.

Background: The aetiological pathway from societal pressure to meet appearance ideals to disordered eating through appearance-based concerns (e.g., drive for thinness) is well established in the general population; however, its relevance for elite athletes is unclear. This study investigated longitudinal predictors and mediation pathways for disordered eating in athletes, including sports and societal pressures as risk factors, and appearance-based concerns and athlete-specific cognitions as mediators.

Methods: Elite athletes predominantly from Australia and the US completed online surveys at baseline between March-September 2023 (T1, N = 178, 72.4% female, M_age = 23.9, SD_age = 7.0), with follow-ups at 6-months (T2, N = 110) and 12-months (T3, N = 91). The survey assessed disordered eating, weight pressures in sport, societal pressures for appearance, athlete-specific mediators (drive for leanness for performance, athletic identity), and body image concerns. Regression analyses employing multiple imputation were used to examine longitudinal predictors and mediation pathways with disordered eating as the outcome, adjusting for autocorrelations and gender.

Results: Increased disordered eating over 12-months was significantly predicted by higher levels of T1-weight pressures in sport (β = 0.18, p = .046) and T1-drive for leanness for performance (β = 0.21, p = .025). T1-Societal pressures, T1-athletic identity, and T1-body image concerns did not significantly predict increases in disordered eating over time. None of the indirect pathways were significant.

Conclusions: It appears that weight pressures in sport and drive for leanness for performance contribute more to risk of disordered eating in elite athletes than traditional pathways of societal pressures and body image concerns. These findings, together with findings from previous research, were synthesised into a new model of disordered eating in elite athletes, providing targets for future intervention.