"In Favor of Myself for Athletes": A Controlled Trial to Improve Disordered Eating, Body-Image and Self-Care in Adolescent Female Aesthetic Athletes

Objective: An eating disorder can have devastating effects on an athlete’s health and performance, especially in athletes participating in sports in which low body weight or leanness confers a competitive advantage. The current study aimed to develop and examine the impact of a prevention program focused on positive protective factors, to reduce the risk of development of eating disorders and health-compromising behaviors among aesthetic athletes. Methods: Participants were 49 female figure skaters and dancers aged 10-16 years (13.1 ± 1.6) and 46 age-andbranch-matched controls. The intervention program included ten weekly 45 min structured sessions, focusing on promoting self-care habits and positive body esteem. The program was team-based and included multiple interactive methods. Outcomes were measured at baseline, post-intervention, and 3 months follow-up using the Eating Disorders Inventory-2, the Eating Disorders Examination Questionnaire-8, the Thin-Ideal Internalization and SocioCultural Attitudes towards Appearance Questionnaire-4, the Body Esteem Scale, and the Body Appreciation Scale. Results: Aesthetic athletes in the prevention program "In Favor of Myself for Athletes" demonstrated significant improvements in several outcome measures, many with a large effect size, compared with control athletes. Results revealed significant decreases in drive for thinness (P<0.001; ƞ2=0.170) and eating disorder symptoms (P<0.001; ƞ2=0.243), increased body esteem (P<0.001; ƞ2=0.213), decreased influences on body image by media (P<0.001; ƞ2=0.168), and more. The program had greater impact on athletes aged 10-12 years compared to 13-16-year-olds in terms of thin-ideal internalization (F(2.79, 160.00)= 3.267; p=0.027) and body esteem (F(2.52, 160.00)= 3.095; p=0.038). Conclusion: This study provides an initial indication that "In Favor of Myself for Athletes" may produce an effective impact on promoting a positive body image and self-care in female adolescent athletes.