High Proportions of Low Body Mass Index and Menstrual Dysfunction among Rhythmic Gymnasts: Association with Body Image Distortion and Eating Behaviors and Attitudes

In aesthetic sports, a visually appealing physique is often deemed advantageous; however, excessive dietary restrictions may lead to health risks. We hypothesized that rhythmic gymnasts exhibit higher proportions of low body mass index (low BMI, <18.5 kg/m²) and menstrual dysfunction (MD) compared with not only non-aesthetic sports athletes but also non-athlete women. We measured BMI, menstruation conditions, body image (BI) distortion, Eating Attitude Test (EAT-26) scores, and eating behaviors in three female groups: rhythmic gymnasts (n=40), volleyball players as non-aesthetic sports athletes (n=46), and age-matched non-athletes (n=108). Logistic regression analyses were conducted to identify risk factors for low BMI and MD. The rhythmic gymnasts had significantly higher rates of low BMI and MD (p<0.001), greater BI distortion (p<0.05) and EAT-26 scores (p<0.001), and more frequent breakfast skipping (p<0.05) than the other two groups. Logistic regression analyses revealed that being a rhythmic gymnast and BI distortion (overestimation) were independently associated with a low BMI, and higher EAT-26 scores were independently associated with MD. These findings suggest that low BMI and MD are prevalent among rhythmic gymnasts and BI distortion and unhealthy eating attitudes may be associated with these conditions. Further research is required to prevent being underweight and related health risks among female athletes in various aesthetic sports.