Eating Disorders and Disordered Eating in Competitive Cycling: A Scoping Review

Abstract

This article reports on the findings from a scoping review on eating disorders and disordered eating in competitive cycling. The review was informed by a scoping review methodological framework as well as the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) reporting guidelines. PubMed, SPORTDiscus and Web of Science were used to identify relevant literature for review. Fourteen studies met the eligibility criteria and were included in the full review. A narrative synthesis was used to summarise the main findings and themes across the included literature. Findings from the review are presented under the following themes: cycling as an ‘at-risk’ discipline; power to weight ratio; energy requirements and risk of low energy availability; the social environment of cycling; nutrition support provision; relationship between eating disorders/disordered eating and exercise addiction; and recommendations made in identified literature. Overall, the literature suggests competitive cycling is a sport with a high prevalence of disordered eating and/or eating disorders and a sport with unique risk factors that contribute to this. Crucially, more research is needed in this area. The article concludes with the gaps in the literature highlighted, implications for future research, and applications to policy and practice suggested.

A Review of Mental Health Issues in High-Performance and Elite-Level Cycling

“…A large proportion of reviewed papers focus on ED symptomatology or susceptibility. This may reflect cycling's complex socioenvironmental risk factors, where ED and unhealthy weight-management behaviours can be prevalent [46]. Several papers indicated that weight-related stressors are a commonly acknowledged vocational pressure (e. g. [31,33]).…”

Body Mass Index trends in men’s Grand Tour cycling events from 1992-2022: Implications for athlete wellbeing and regulatory frameworks

“…Signi cantly, such practices could render athletes vulnerable to comorbid physical and mental health conditions; alongside associations with clinical and subclinical ED presentations [39], adverse weight-management behaviours have been linked to low energy availability and increased risks for RED-S [9,40], heart disease [8], obsessive compulsive disorder [41] substance use disorders [42], and exercise addiction [10]. Furthermore, there have been reports of support teams, medical staff, and other stakeholders closely monitoring racers' anthropometrics, body mass composition, and optimal weight, which has ampli ed weight-related pressures and injurious habits [9,18,43].…”

“…Owing to the performance-based associations of low weight and environmental and social in uences, clinical and subclinical EDs and harmful weightmanagement behaviours may be prevalent within cycling [10]. Evidence indicates that elite-level riders can often adopt an extreme approach to weight loss, including disordered eating [11,17], fasting [13], self-induced vomiting [9], the use of laxatives [13], and weight cycling in the lead up to competitions [38].…”

“…Based on anecdotal and primary observations, male elite-level road cyclists may be vulnerable to weight-management problems due to performance pressures and the interactions between body mass, optimal weight, and competitive success [9]; the emphasis on aerodynamics and power-to-weight and mass ratios might precipitate or aggravate deleterious habits as competitors can frequently seek to attain a speci c physique [10]. Riebl et al noted that competing male riders had elevated scores on the Eating Attitudes Test-26 compared to the general population and many racers contended that EDs were somewhat common within the sport [11].…”

“…This is notable in disciplines where anthropometric characteristics, including body mass, can directly affect competitive performance levels. In these events, weight-related issues may be a prominent concern for athletes [7], leading some to adopt harmful behaviours that can align with ED symptomatology [2] or increase risks for additional physical and psychiatric morbidities (e.g., [8]).Based on anecdotal and primary observations, male elite-level road cyclists may be vulnerable to weight-management problems due to performance pressures and the interactions between body mass, optimal weight, and competitive success [9]; the emphasis on aerodynamics and power-to-weight and mass ratios might precipitate or aggravate deleterious habits as competitors can frequently seek to attain a speci c physique [10]. Riebl et al noted that competing male riders had elevated scores on the Eating Attitudes Test-26 compared to the general population and many racers contended that EDs were somewhat common within the sport [11].…”