Body image concerns, dieting behavior, and eating disorder risk of Kenyan adolescent female athletes

Aim: The purpose of this study was to investigate body image concerns, dieting behaviors, and eating disorder risk among adolescent female athletes (n=61) and non-athletes (n=49) in Kenya. Methods: Eating disorder risk was assessed using the Eating Disorder Inventory version 3 (EDI-3), the EDI-3 referral form assessed pathogenic weight control measures (PWCM), and a figure rating scale (FRS) assessed body image concerns. Results: Athletes and non-athletes had similar raw scores across all EDI-3 subscales. More athletes than non-athletes had a body mass index (BMI) and 17.5 kg/m2 (16.1 vs. 0%, OR = 0.8, 95% CI 0.7–0.9, p=0.004) of which only half of these athletes (n=5, 8.2%) perceived themselves to be underweight. A sub-sample of athletes (16.4%) and non-athletes (26.5%) perceived themselves to be overweight while only 1.8% athletes and 11.1% non-athletes were classified as overweight according to body mass index cut-offs. Most (80.9%) participants desired a leaner body image, with 56% desiring a body image equivalent to a BMI and 17.5 kg/m2. Top foods restricted when trying to lose weight included dietary fats, carbohydrate rich foods, and dairy foods. Both groups reported to use PWCM; however, more athletes than non-athletes used PWCM (52.5% vs. 32.6%, p=0.031). Conclusion: Kenyan adolescent athletes and non-athletes presented with body image dissatisfaction, extreme dieting behavior, and at risk of an eating disorder. These findings highlight the need for a healthy eating and body image intervention program among this cohort of Kenyan adolescents and their entourage.