A framework for identifying risk factors for eating disorders and disordered eating in athletes from selected combat sports

Diagnostic manuals, such as DSM-V and ICD11, enable psychiatrists and clinical psychologists to diagnose various types of eating disorders. However, there is no systematic tool available to assess athlete vulnerability for eating disorders before an athlete displays clinically significant symptoms. Only three studies on eating disorder risk factors in combat sports athletes have been published in the last 30 years (Thiel, Gottfried and Hesse, 1993; Dale and Landers, 1999; and Taheri, Irandoust, and Razipoor, 2017), despite this thesis finding that at least 15 combat sports athletes have reported a potential association (Table 50). This is notwithstanding that hundreds of medical longitudinal and cross-sectional studies have reported risk factors which appear to be relevant to such disorders (see Chapter 4). This thesis follows the approach set out by Gough et al (Gough, Thomas, and Oliver, 2019) in creating new insights by synthesising what has already been learnt about eating disorder risk factors in the medical literature with what has been found by the weight change literature in combat sports.Using a novel methodology, the thesis systematically identifies and extracts the generic eating disorder risk factors from the medical literature base (comprising 478 articles). These risk factors are then thematically categorised to produce an original framework, the Eating Disorder Risk-factor Identification framework (‘the framework’), see Chapter 4), that can be used by researchers as a thinking tool to screen the weight change literature (comprising 136 studies) from five combat sports (boxing, judo, wrestling, taekwondo and MMA). The purpose of the screening is to identify potential associations between distinguishing features of these combat sport environments which may reduce or increase the risk of later developing an eating disorder (see Chapters 5 and 6).The purpose of the thesis is to create a thinking framework that can help researchers’ identify associations between risk factors and the features of a particular environment, such as combat sports. The thesis analyses a large literature base, beyond what would ordinarily be achievable by a single study. The study’s multi-disciplinary and multi-method design uses data from published peer-reviewed articles to offer explanations for why combat sports athletes may be more likely to develop an eating disorder, through an analysis of eating disorder risk factors and the features of the combat sports environment. Future research will need to use and develop the framework to demonstrate its application to other environments.<br>